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Articles in PresS, published online ahead of print September 12, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00444.2002
Submitted on May 28, 2002
Accepted on September 9, 2002
1 Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO, USA
2 Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands Antilles
* To whom correspondence should be addressed. E-mail: maniarh{at}msnotes.wustl.edu.
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 right atrium's compensatory role to changes in RV afterload remain poorly characterized. Methods. In 8 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. Results. With the pericardium intact and partial PA occlusion, RA elastance increased by 28%(p<0.04) while RA stiffness tended to rise (p=0.08). However, following 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). Conclusions. Following pericardiotomy, RA elastance and stiffness fell dramatically, and the right atrium's compensatory response 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.
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