Impact of pericardial adhesions on diastolic function as assessed by vortex formation time, a parameter of transmitral flow efficiency

Cardiovascular Ultrasound

Research

Jeffrey J Heys¹  Michele Milano²  John Westerdale²  Minako Katayama³  Eileen M McMahon³  Farouk Mookadam³  Panupong Jiamsripong³  Mohsen S Alharthi³  Marek Belohlavek³  Anna M Calleja³ 

[1] Chemical and Biological Engineering, Montana State University, Bozeman, MT, USA;Department of Mechanical Engineering, Arizona State University, Tempe, AZ, USA;Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA;

关键词: Vortex Ring;    Left Ventricular Filling;    Diastolic Filling;    Constrictive Pericarditis;    Transmitral Flow;   

DOI  :  10.1186/1476-7120-8-42

 received in 2010-07-02, accepted in 2010-09-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundPericardial adhesions are a pathophysiological marker of constrictive pericarditis (CP), which impairs cardiac filling by limiting the total cardiac volume compliance and diastolic filling function. We studied diastolic transmitral flow efficiency as a new parameter of filling function in a pericardial adhesion animal model. We hypothesized that vortex formation time (VFT), an index of optimal efficient diastolic transmitral flow, is altered by patchy pericardial-epicardial adhesions.MethodsIn 8 open-chest pigs, the heart was exposed while preserving the pericardium. We experimentally simulated early pericardial constriction and patchy adhesions by instilling instant glue into the pericardial space and using pericardial-epicardial stitches. We studied left ventricular (LV) function and characterized intraventricular blood flow with conventional and Doppler echocardiography at baseline and following the experimental intervention.ResultsSignificant decreases in end-diastolic volume, ejection fraction, stroke volume, and late diastolic filling velocity reflected the effects of the pericardial adhesions. The mean VFT value decreased from 3.61 ± 0.47 to 2.26 ± 0.45 (P = 0.0002). Hemodynamic variables indicated the inhibiting effect of pericardial adhesion on both contraction (decrease in systolic blood pressure and +dP/dt decreased) and relaxation (decrease in the magnitude of -dP/dt and prolongation of Tau) function.ConclusionPatchy pericardial adhesions not only negatively impact LV mechanical functioning but the decrease of VFT from normal to suboptimal value suggests impairment of transmitral flow efficiency.

【 授权许可】

Unknown   
© Jiamsripong et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.