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 ALTHOUGH it is well recognized that the diseased pericardium may cause a significant impairment to ventricular filling, the effect of the normal pericardium on the diastolic properties of the ventricles remains controversial. Based on measurements obtained with fluid-filled catheters, there has been a general consensus that pericardial pressure is equal to intrathoracic pressure,. 2 and is thus of little hemodynamic significance. However, Holt et al. ,3 using a flat liquid-containing balloon, demonstrated that the magnitude of pericardial pressure was substantial and similar to right atrial pressure.To Patients and methods Nine patients (mean age 54 years) scheduled for elective cardiac surgery gave informed consent to participate in this investigation; the protocol was previously reviewed and approved by the institutional ethics committee on human research.

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The effects of ultrasound on the mechanical properties of isometrically contracting rat papillary muscle have been studied as a function of the intensity of the ultrasonic irradiation. Each muscle was subjected to irradiation at 1.1., 2.2, and 3.3 W/cm2 at a frequency of 2.3 MHz. Ultrasonic irradiation caused heating in the vicinity of the muscle; thus it was necessary to separate the pure thermal and ultrasonic effects. After irradiation the bath temperature was increased so that the muscle reached the same temperature which occurred during ultrasonic irradiation. The mechanical parameters measured during the equivalent thermal procedure were compared with the parameters during irradiation. There was a significant (p less than 0.05) decrease in resting force which was significantly different from the equivalent thermal intervention and could be related to the ultrasonic intensity. Thus, the effect of ultrasound on rat papillary consists of two components, a thermal component which affects all parameters studied and a nonthermal component which affects only the diastolic force.

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A thick-wall spherical model for the rat left ventricle was used to deduce passive wall stiffness from diastolic pressure-volume data. This was done for rats in three age classes: young (1 mo), adult (17 mo) and old (17 mo). The model was based on finite deformation elasticity theory consistent with the magnitude of observed deformation. A least-squares procedure was used to determine elastic constants in postulated nonlinear stress-stretch relations for the myocardium. It was found that at a given level of stress, wall stiffness for ventricles in the young age class was consistently greater than wall stiffness in the other two classes. In addition, the difference in wall stiffness between rats in the adult and old age classes was found to be approximately 10%.

The relative changes in myocardial blood flows within different parts of the heart were measured in anaesthetized thoracotomized dogs during and following effusive pericardial tamponade. Blood flows measured in a group of animals bled to the same arterial hypotensive levels served as experimental controls. The results demonstrate that regional myocardial blood flows to all areas were severely reduced during tamponade. Regional differences in the relative responses were evident; right and left atrial flows decreased more than left ventricular or septal flows which in turn decreased more than right ventricular endocardial flows decreased more than epicardial and the flow within the left side of the septal wall decreased more than the right. Although decreases in aortic pressure and ventricular volumes can account for some of these changes in flow seen in tamponade, alterations in extravascular compression appear to further reduce the myocardial perfusion and may be responsible for the differences in regional responses. In further experiments when the pericardial cavity was drained following 2 h of tamponade, a hyperemic response was seen throughout the heart indicating that the myocardial flow during tamponade may have been insufficient to meet the cardiac demands. In conclusion tamponade appears to result in a disproportionate decrease in myocardial blood flow to various parts of the heart which cannot be explained on the basis of a decrease in blood pressure or a reduction in ventricular volume.

The left anterior descending coronary artery was cannulated in anesthetized, open-chest dogs for use as a coronary test bed to assess the coronary vascular actions of oxygenated, unmodified and pyridoxylated, partially cross-linked (polymerized), stroma-free hemoglobin solutions (SFHS). The actions of these SFHSs were assessed in this test bed, by comparison with perfusion with whole blood. Unmodified SFHS caused significant vasoconstriction, whereas pyridoxylated, partially polymerized SFHS did not do so. The existing coronary flow during perfusion with either SFHS preparation, under basal conditions, did not increase duririg intracoronary infusion of adenosine. Coronary flow-autoregulation was also altered during perfusion with either SFHS, because the "normal" reactive hyperemia response, observed in the control experiments, was not seen. These findings suggest that both unmodified and pyridoxylated cross-linked (70% polymers) hemoglobin preparations possess some vascular activity when tested in the canine coronary circulation.