The normal pericardium does not affect left ventricular function.

Abstract

Whether the normal pericardium exerts a constraining effect on left ventricular (LV) diastolic compliance and/or systolic function is controversial. Left ventricular filling and performance were studied in 15 patients by two-dimensional transesophageal echocardiography (2D-TEE) measuring end-diastolic area (EDa), end-systolic area (ESa), ejection fraction area (EFa), and hemodynamics immediately pre- and post-pericardiotomy. To diminish the influences of other variables such as surgical stimulation, chest wall constraint, and autoregulation, measurements were performed in deeply anesthetized patients with the chest fully opened immediately before and after pericardiotomy (PC). No significant echocardiographic or hemodynamic changes were observed after PC. Although alterations in compliance cannot be excluded, no significant changes in LV diastolic filling (EDa, pulmonary capillary wedge pressure [PCWP]) or systolic performance (EFa, cardiac output [CO]) were found. Therefore, it is concluded that the normal pericardium does not exert a measurable constraining effect on LV performance.