Pericardial fluid: an underrated molecular library of heart conditions and a potential vehicle for cardiac therapy

  • Fábio TrindadeEmail author
  • Rui Vitorino
  • Adelino Leite-Moreira
  • Inês Falcão-Pires


The remote but heart-encircling location of pericardial fluid confers this biofluid unique properties. Once past the limitation of the invasive collection, for instance, on occasion of heart surgery or pericardiocentesis, the scrutiny of pericardial fluid content can be of great interest in cardiovascular research. This liquid concentrates many heart-derived factors, thus enclosing several surrogate markers for the diagnosis or prognosis of a large spectrum of diseases either pericardial (e.g. malignant or tuberculous pericarditis) or non-pericardial/heart diseases (e.g. coronary artery disease or valvular heart diseases). Herein, for the first time, the molecular knowledge of pericardial fluid is reviewed, through an in-depth literature search and mining, and then translated into a network map of the diseases influencing pericardial fluid composition. The suitability of pericardial fluid for biomarker research could be demonstrated by evident molecular profiles between different conditions as well as by stronger correlations to cardiac structural and functional parameters, fainter or lacking in plasma/serum. Also highlighted here are the results of mechanistic research conducted with pericardial fluid in several hot topics of research, such as chronotropy, inotropy, coronary perfusion and cardiac electrophysiology. Moreover, the progress in intrapericardial therapeutics, motivated by pericardial fluid’s low clearance rates, higher efficiency and lesser risk of systemic effects over conventional delivery methods, is surveyed and discussed.


Heart disease Pericardial fluid Systems medicine Biomarker Intrapericardial therapeutics 



The authors thank Portuguese Foundation for Science and Technology (FCT), European Union, Quadro de Referência Estratégico Nacional (QREN), Fundo Europeu de Desenvolvimento Regional (FEDER) and Programa Operacional Fatores de Competitividade (COMPETE) for funding iBiMED (UID/BIM/04501/2013 and POCI-01-0145-FEDER-007628) and UnIC (UID/IC/00051/2013), research units as well as RV’s (IF/00286/2015) and FT’s Fellowship Grant (SFRH/BD/111633/2015). The authors also thank the projects DOCnet (NORTE-01-0145-FEDER-000003), supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and the project NETDIAMOND (POCI-01-0145-FEDER-016385), supported by European Structural and Investment Funds, Lisbon’s Regional Operational Programme 2020 and national funds from the PFCT, for funding this work.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

395_2019_716_MOESM1_ESM.docx (170 kb)
Online Resource 1 Extended methods and supplementary figures (DOCX 170 kb)
395_2019_716_MOESM2_ESM.xlsx (334 kb)
Online Resource 2 Complete Molecular Survey of Pericardial Fluid (dataset given as an Excel file) (XLSX 334 kb)
395_2019_716_MOESM3_ESM.tif (459 kb)
Online Resource 3 Isolated node pairs derived from the Cytoscape analysis depicted in Figures 2 and 3 (TIFF 458 kb)
395_2019_716_MOESM4_ESM.docx (76 kb)
Supplementary material 4 (DOCX 76 kb)


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical Sciences, University of AveiroiBiMED-Institute of BiomedicineAveiroPortugal
  2. 2.Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do PortoUnIC-Unidade de Investigação CardiovascularPortoPortugal

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