Circulation, Vol 73, 428-432, Copyright © 1986 by American Heart Association
JV Tyberg, GC Taichman, ER Smith, NW Douglas, OA Smiseth and WJ Keon
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.
ARTICLES
The relationship between pericardial pressure and right atrial pressure: an intraoperative study
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