The Role of the Pericardium in Heart Failure: Implications for Pathophysiology and Treatment

JACC Heart Fail. 2019 Jul;7(7):574-585. doi: 10.1016/j.jchf.2019.03.021.

Abstract

The elastic pericardium exerts a compressive contact force on the surface of the myocardium that becomes more substantial when heart volume increases, as in patients with various forms of heart failure (HF). Pericardial restraint plays an important role in determining hemodynamics and ventricular function in both health and disease. This review discusses the physiology of pericardial restraint in HF and explores the question of whether it can be targeted indirectly through medical interventions or directly through a number of existing and future therapies.

Keywords: heart failure; hemodynamics; pericardium.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Atrial Pressure
  • Cardiac Resynchronization Therapy
  • Diuretics / therapeutic use
  • Heart Failure / physiopathology*
  • Heart Failure / therapy
  • Hemodynamics*
  • Humans
  • Pericardiectomy
  • Pericardium / physiopathology*
  • Pericardium / surgery
  • Stroke Volume
  • Vasodilator Agents / therapeutic use
  • Ventricular Pressure
  • Ventricular Remodeling

Substances

  • Diuretics
  • Vasodilator Agents