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J Appl Physiol (October 24, 2003). doi:10.1152/japplphysiol.00722.2003
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Submitted on July 11, 2003
Accepted on October 20, 2003

Opening the Pericardium During Pulmonary Artery Constriction Improves Cardiac Function

Israel Belenkie*, Rozsa Sas1, Jamie Mitchell1, Eldon R Smith1, and John V Tyberg1

1 Medicine, University of Calgary, Calgary, Alberta, Canada

* To whom correspondence should be addressed. E-mail: belenkie{at}ucalgary.ca.

During acute pulmonary hypertension, both the pericardium and the right ventricle (RV) constrain left ventricular (LV) filling; therefore, pericardiotomy should improve LV function. LV, RV and pericardial pressures and RV and LV dimensions and LV stroke volume (SV) were measured in 6 anesthetized dogs. The pericardium was closed, the chest left open and the lungs held away from the heart. Data were collected at baseline, during pulmonary artery constriction (PAC) and after pericardiotomy with PAC maintained. Results. PAC decreased SV by half. RV diameter increased and septum-to-LV free wall diameter and LV area (our index of LV end-diastolic volume) decreased. Compared to during PAC, pericardiotomy increased LV area and SV increased 35%. LV and RV compliance (pressure-dimension relations) and LV contractility (stroke work-LV area relations) were unchanged. Conclusions. Although series interaction accounts for much of the decreased cardiac output during acute pulmonary hypertension, pericardial constraint and leftward septal shift are also important. Pericardiotomy can improve LV function in the absence of other sources of external constraint to LV filling.




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