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Cardiovascular Research 1992 26(2):148-152; doi:10.1093/cvr/26.2.148
© 1992 by European Society of Cardiology
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Copyright © 1992, European Society of Cardiology

Differential effects of positive end expiratory pressure and cardiac tamponade on left-right ventricular mechanical function in the dog

Takaaki Nakamoto, Kun S Li, William E Johnston and William P Santamore

Philadelphia Heart Institute, Presbyterian Medical Center, 39th and Market Streets, Philadelphia, PA 19104, USA: T Nakamoto, K S Li, W P Santamore
Department of Anesthesia, Bowman Gray School of Medicine, Winston-Salem, NC, USA: W E Johnston.

Correspondence to Dr Santamore.

Objective: The aim was to examine the hypothesis that an increased coupling occurs between the ventricles during tamponade via a ventricular-pericardial-ventricular interaction, but that ventricular coupling would be unaltered or reduced with positive end expiratory pressure (PEEP). Methods: An in situ arrested, canine heart preparation was used. Changes in left and right ventricular pressure (dP1, dPr) and volume (dV1, dVr) caused by increasing the volume of the other ventricle were measured at normal and at matched levels of raised pericardial pressures (PP) caused by 20 cm H2O PEEP and by tamponade. Results: With PEEP, the coupling between the ventricles was unaltered when compared to control. With tamponade, dP1/dPr, dV1/dPr, dPr/dP1, and dVr/dP1 increased significantly (p<0.05) by 0.21(SEM 0.03, unitless), 0.45(0.04) ml·mm Hg–1, 0.18(0.03), and 0.28(0.04) ml·mm Hg–1 respectively. Conclusions: Augmented ventricular interdependence occurs during tamponade but not with PEEP, which may help to explain the different haemodynamic patterns observed under these conditions.

KEYWORDS pericardium; haemodynamics; ventricular interdependence

This study was supported in part by NIH Grants Nos HL36068 and HL40395.


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