title: Effect of pericardial pressure on human coronary circulation.
abstract: A 52-year-old patient underwent percutaneous balloon pericardiotomy because of rapid fluid accumulation. During the procedure, we calculated the amount of blood flow to the nondiseased left anterior descending coronary artery while pericardial pressure was gradually increased by the infusion of warmed normal saline solution. Coronary vasodilator reserve was assessed by intracoronary adenosine. With increasing pericardial pressure, there was a continuous decline in coronary blood flow, due to an increase in coronary vascular resistance, and an unaffected hyperemic response throughout. The maximal hyperemic flow was far less under increased pericardial pressure than at normal pressure, which implies an augmented susceptibility to myocardial ischemia.
authors.affiliation: Cardiology Department, Heraklion University Hospital, Heraklion, Crete, Greece.
authors.forename: E I
authors.initials: EI
authors.lastname: Skalidis
authors.forename: G E
authors.initials: GE
authors.lastname: Kochiadakis
authors.forename: S I
authors.initials: SI
authors.lastname: Chrysostomakis
authors.forename: N E
authors.initials: NE
authors.lastname: Igoumenidis
authors.forename: E G
authors.initials: EG
authors.lastname: Manios
authors.forename: P E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D002305:Cardiac Tamponade / Q000503:physiopathology* / Q000601:surgery; D003326:Coronary Circulation / Q000502:physiology*; D015150:Echocardiography, Doppler; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010492:Pericardiectomy; D020519:Pericardiocentesis; D012086:Reoperation; D014655:Vascular Resistance / Q000502:physiology*