RT Journal Article
SR Electronic
T1 Independence of changes in left ventricular diastolic properties of pericardial pressure.
JF British Heart Journal
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 125
OP 129
DO 10.1136/hrt.48.2.125
VO 48
IS 2
A1 P J Oldershaw
A1 E Shapiro
A1 M Mattheos
A1 M G St John Sutton
A1 D Gibson
YR 1982
UL http://heart.bmj.com/content/48/2/125.abstract
AB There has been much interest in the published reports as to the extent to which measured left ventricular diastolic properties are affected by the pericardium. In this study observations were made on 24 patients, seven days after cardiopulmonary bypass. Left ventricular dimensions were measured from echocardiographic recordings and left ventricular diastolic pressure assessed from measurements of isovolumic relaxation time. Pericardial pressure was measured directly using a small solid state transducer inserted into the pericardial space at the time of operation. Left ventricular diastolic properties were altered by either isometric handgrip or glyceryl trinitrate administration. Isometric handgrip produced an increase in cavity dimension at end-systole and diastole, with reduction in isovolumic relaxation time, suggesting an increase in left ventricular end-diastolic pressure; glyceryl trinitrate produced the reverse effect, with decreased cavity dimensions and prolongation of isovolumic relaxation time. These changes occurred in the absence of significant changes in pericardial pressure. We therefore conclude that even in the rather unusual conditions of the early postoperative period, when the sensitivity of pericardial pressure to small volume changes might be expected to be increased, substantial changes in left ventricular diastolic properties can occur without detectable alteration in pericardial pressure.