A novel technique for measurement of pericardial pressure

deVries, Gwyneth; Hamilton, Douglas R.; Keurs, H. E. D. J. Ter; Tyberg, John V.

doi:10.1152/ajpheart.2001.280.6.h2815

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…Due to the geometry of the pericardial cavity, most of the pericardial fluid is found at the atrioventricular and the intraventricular sulcus [31] . Pressure in the pericardial cavity increases during diastole (laminae approach) and decreases during systole [33] , [46] , [140] . Notably, the hydrostatic pressure depends on the position within the pericardial cavity, being higher close to the ventricular walls and lower at the sulcus.…”

Section: From Development To Homeostasis Disease and Regeneration: Mmentioning

confidence: 99%

Interplay between cardiac function and heart development

Andrés-Delgado

Mercader

2016

Biochimica et Biophysica Acta (BBA) - Molecular Cell Research

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Mechanotransduction refers to the conversion of mechanical forces into biochemical or electrical signals that initiate structural and functional remodeling in cells and tissues. The heart is a kinetic organ whose form changes considerably during development and disease. This requires cardiomyocytes to be mechanically durable and able to mount coordinated responses to a variety of environmental signals on different time scales, including cardiac pressure loading and electrical and hemodynamic forces. During physiological growth, myocytes, endocardial and epicardial cells have to adaptively remodel to these mechanical forces. Here we review some of the recent advances in the understanding of how mechanical forces influence cardiac development, with a focus on fluid flow forces. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

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Section: From Development To Homeostasis Disease and Regeneration: Mmentioning

confidence: 99%

Interplay between cardiac function and heart development

Andrés-Delgado

Mercader

2016

Biochimica et Biophysica Acta (BBA) - Molecular Cell Research

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“…This phenomenon is due to the viscoelastic properties of the parietal pericardium (Holt, 1970 ). During the diastole (laminae approach) the P p increases and during the systole it decreases (Smiseth et al, 1985 ; DeVries et al, 2001 ; Hamilton et al, 2004 ). The P p becomes more negative during inspiration and less during expiration (in humans ~ 3 mmHg endexpiration and −5 mmHg endinspiration) (Kenner and Wood, 1966 ; Spodick, 1997 ).…”

Section: Hydrodynamicsmentioning

confidence: 99%

Physiology of pericardial fluid production and drainage

et al. 2015

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The pericardium is one of the serosal cavities of the mammals. It consists of two anatomical structures closely connected, an external sac of fibrous connective tissue, that is called fibrous pericardium and an internal that is called serous pericardium coating the internal surface of the fibrous pericardium (parietal layer) and the heart (visceral layer) forming the pericardial space. Between these two layers a small amount of fluid exists that is called pericardial fluid. The pericardial fluid is a product of ultrafiltration and is considered to be drained by lymphatic capillary bed mainly. Under normal conditions it provides lubrication during heart beating while the mesothelial cells that line the membrane may also have a role in the absorption of the pericardial fluid along with the pericardial lymphatics. Here, we provide a review of the the current literature regarding the physiology of the pericardial space and the regulation of pericardial fluid turnover and highlight the areas that need to be further investigated.

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“…AJP-Heart Circ Physiol • VOL 298 • JANUARY 2010 • www.ajpheart.org cardial pressure, which requires perforation of the pericardial sac, can alter the pressure of interest (6). This is the first report of a pericardial pressure measurement in an intact pericardial sac.…”

Section: H290 Percutaneous Pericardial Accessmentioning

confidence: 88%

A transatrial pericardial access: lead placement as proof of concept

Kassab

Svendsen

Combs

et al. 2010

American Journal of Physiology-Heart and Circulatory Physiology

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A safe, easy, and quick access into the pericardial space may provide a window for diagnostics and therapeutics to the heart. The objective of this study was to provide proof of concept for an engagement and access catheter that allows access to the pericardial space percutaneously. A multilumen catheter was developed to allow navigation and suction fixation to the right atrial appendage/wall in a normal swine model. Advancement through the multilumen catheter using a second catheter with a distal needle tip allows access to the pericardial space without pericardial puncture and advancement of a standard guide wire into the space. Navigation into the pericardial space was undertaken by fluoroscopy alone and was accomplished in 10 swine (5 acute and 5 chronic). As a specific application of this pericardial access method, a pacing lead was implanted on the epicardial surface. Five chronic swine experiments were conducted with successful pacing engagement verified by lead impedance and pacing threshold and sensing. Lead impedance exceeded 1,000 ⍀ preengagement and dropped by an average of 200 ⍀ upon implant (769 Ϯ 498 ⍀). Pacing thresholds at 0.4 ms ranged from ϳ0.5 to 2.1 V acutely (1.03 Ϯ 0.92 V). No cardiac effusion or tamponade was observed in any of the acute or chronic studies. The ability to engage, maintain, and retract the right atrial appendage/wall and to engage an epicardial lead was successfully demonstrated. These findings support the feasibility of safe access into the pericardial space in a normal swine model and warrant further investigations for clinical translation. epicardial surface; lead placement; pericardial pressure; effusion A NONSURGICAL, PERCUTANEOUS device that permits rapid and safe access into the pericardial space is highly desirable and would have significant potential for expanding cardiac diagnostics and therapies. These applications may extend from identification of diagnostic markers in the pericardial fluid, administration of therapeutic factors with angiogenic, myogenic, and antiarrhythmic potential, and epicardial pacing lead delivery and tissue ablation (1, 2, 4, 5, 15-17, 20, 25).Clinically, the only nonsurgical means for accessing the pericardial space is the subxiphoid needle approach (ultrasound-guided apical and parasternal needle catheter) (18, 21). The method includes a sheathed needle with a suction tip designed for grasping the pericardium and accessing the pericardial space using a transthoracic approach, while avoiding myocardial puncture. This device is advanced from a subxiphoid position into the mediastinum under fluoroscopic guidance and positioned onto the anterior outer surface of the pericardial sac. In diseased or dilated hearts, the pericardial space is significantly smaller than normal, and the risk of puncture of the right ventricle (RV) or other cardiac structures is more prominent. This stems from the fact that, in disease conditions, the pericardium is a very stiff membrane, and hence the suction of the pericardium provides little deformation of the ...

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A novel technique for measurement of pericardial pressure

Cited by 9 publications

References 30 publications

Interplay between cardiac function and heart development

Interplay between cardiac function and heart development

Physiology of pericardial fluid production and drainage

A transatrial pericardial access: lead placement as proof of concept

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