Diastolic ventricular interaction and ventricular diastolic filling

Jayne A. Morris-Thurgood, Michael P. Frenneaux

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)

Abstract

Because the ventricles share a common septum, the filling of one may influence the compliance of the other, a phenomenon known as direct diastolic ventricular interaction (DVI). This interaction is markedly enhanced when the force exerted by the surrounding pericardium is raised (pericardial constraint). In health, in the resting state, we operate near the top of the flat component of a J-shaped pericardial stress-strain relation. Therefore, pericardial constraint (and hence DVI) is only minor. When right ventricular volume/pressure acutely increases, such as during exercise, massive pulmonary embolism, or right ventricular infarction, pericardial constraint increases and significant DVI develops. In this setting, the measured left ventricular intracavitary diastolic pressure markedly overestimates the true left ventricular filling pressure, because the external forces must be subtracted. Although the pericardium can grow during chronic cardiac enlargement, we present evidence that in certain chronic disease processes, including heart failure, DVI may also be important.
Original languageEnglish
Pages (from-to)307-323
Number of pages17
JournalHeart Failure Reviews
Volume5
Issue number4
DOIs
Publication statusPublished - Dec 2000

Keywords

  • Animals
  • Blood Pressure
  • Diastole
  • Dogs
  • Heart Diseases
  • Humans
  • Hypertension, Pulmonary
  • Pericardium
  • Ventricular Function, Left
  • Ventricular Function, Right

Cite this