Influence of the Pericardium on Diastolic Compliance
The influence of the pericardium on diastolic compliance is a function of the distensibility of the pericardium itself, the distensibility of the cardiac chambers, and the total volume contained within the cardiac chambers . To illustrate the latter factor, it is reasonable to expect that at a given left ventricular volume, the influence of the pericardium on left ventricular compliance will be directly proportional to the volume contained within the other cardiac chambers, since it is the total cardiac volume that determines pericardial distention. An additional effect of the pericardium on diastolic compliance has to do with the fact that the intact pericardium has a substantial modulating influence on diastolic interaction between the ventricles, i.e., the amount of interaction is markedly reduced when the pericardium is removed [2, 3]. For some time, we have been particularly interested in examining both the distensibility of the pericardium and its influence on the diastolic pressure-volume relation of the cardiac chambers. We have not specifically studied diastolic ventricular interaction. However, our basic approach to assessing the influence of the pericardium on compliance is quite straightforward. We simply examine the intracavitary pressure-volume (or dimension) relation of a cardiac chamber before and after pericardiectomy. In this fashion, we determine the net effect of the pericardium on compliance; included in this net effect is the pericardial modulation of ventricular interaction. This chapter will serve to review certain aspects of this work which have already been completed and, in addition, more recent work which is currently in progress.
KeywordsCardiac Chamber Stretch Ratio Downward Shift Intact Heart Steep Portion
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