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Am J Physiol Heart Circ Physiol 284: H350-H357, 2003. First published September 12, 2002; doi:10.1152/ajpheart.00444.2002
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Vol. 284, Issue 1, H350-H357, January 2003

Impact of pericardial restraint on right atrial mechanics during acute right ventricular pressure load

Hersh S. Maniar1, Sunil M. Prasad1, Sydney L. Gaynor1, Celeste M. Chu1, Paul Steendijk2, and Marc R. Moon1

1 Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri; and 2 Department of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands

Optimization of right atrial (RA) mechanics is important for maintaining right ventricular (RV) filling and global cardiac output. However, the impact of pericardial restraint on RA function and the compensatory role of the right atrium to changes in RV afterload remain poorly characterized. In eight open-chest sheep, RA elastance (contractility) and chamber stiffness were measured (RA pressure-volume relations) at baseline and during partial pulmonary artery (PA) occlusion. Data were collected before and after pericardiotomy. With the pericardium intact and partial PA occlusion, RA elastance increased by 28% (P < 0.04), whereas RA stiffness tended to rise (P = 0.08). However, after pericardiotomy, there was a significant fall in both RA elastance (54%, P < 0.04) and stiffness (39%, P < 0.04), and subsequent PA occlusion failed to induce a change in elastance (P > 0.19) or stiffness (P > 0.84). After pericardiotomy, RA elastance and stiffness fell dramatically, and the compensatory response of the right atrium to elevated RV afterload was lost. The ability of the right atrium to respond to changes in RV hemodynamics is highly dependent on pericardial integrity.

atrial function; conductance catheter; pulmonary artery occlusion


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