The relationship between pericardial pressure and right atrial pressure: an intraoperative study

The objective of this study was to determine the constraining effect of the normal human pericardium. Accordingly, immediately after thoracotomy in nine patients undergoing elective cardiac surgery, we measured mean pericardial surface pressure over the lateral free wall of the left ventricle with a...

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Published inCirculation (New York, N.Y.) Vol. 73; no. 3; pp. 428 - 432
Main Authors TYBERG, J. V, TAICHMAN, G. C, SMITH, E. R, DOUGLAS, N. W. S, SMISETH, O. A, KEON, W. J
Format Journal Article
LanguageEnglish
Published Hagerstown, MD Lippincott Williams & Wilkins 01.03.1986
Subjects
Aged
Atrial Function
Biological and medical sciences
Blood Pressure
Female
Humans
Hydrostatic Pressure
Male
Medical sciences
Middle Aged
Pericardial Effusion - physiopathology
Pericardium - physiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Heart
Human
Catheterization
Surgery
Cardiovascular disease
Intraoperative
Hemodynamics
Right atrium
Pressure
Pericardium
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Summary:The objective of this study was to determine the constraining effect of the normal human pericardium. Accordingly, immediately after thoracotomy in nine patients undergoing elective cardiac surgery, we measured mean pericardial surface pressure over the lateral free wall of the left ventricle with a flat balloon as well as mean right atrial pressure while incrementally infusing up to 2.1 liters of Ringer's solution to increase right atrial pressure. In each case, the slope of the relationship between right atrial (range -4 to 20 mm Hg, overall) and pericardial pressures was near unity (1.16 +/- 0.20 mean +/- SD) and the intercept was approximately zero (0.71 +/- 2.48 mm Hg). Correlation coefficients ranged from .86 to .97. These observations suggest that right atrial pressure can be used as an estimate of pericardial surface pressure. If this is the case, true left ventricular preload (i.e., effective distending pressure or transmural diastolic pressure) might be estimated from the difference between left ventricular filling pressure and right atrial pressure, both conveniently measurable clinically by means of a triple-lumen, flow-directed catheter.
Bibliography:ObjectType-Article-1
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ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.73.3.428