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The Journal of Invasive Cardiology Aug 2021Pericardial constriction can be present without pericardial calcium and often without pericardial thickening. This epicardial coronary artery motion abnormality due to...
Pericardial constriction can be present without pericardial calcium and often without pericardial thickening. This epicardial coronary artery motion abnormality due to entrapment in a thickened, fibrotic pericardium, is characteristic of constrictive pericarditis, and differentiates this entity from other close differential diagnoses, such as restrictive and dilated cardiomyopathy.
Topics: Coronary Vessels; Diagnosis, Differential; Humans; Pericarditis, Constrictive; Pericardium
PubMed: 34338662
DOI: No ID Found -
JACC. Cardiovascular Interventions Jun 2023
Topics: Humans; Treatment Outcome; Pericardial Effusion; Cardiac Tamponade; Pericardium
PubMed: 37204396
DOI: 10.1016/j.jcin.2023.03.053 -
Journal of Cardiovascular Pharmacology... Sep 2021Diabetes mellitus (DM) is a chronic and complex metabolic disorder and also an important cause of cardiovascular (CV) disease (CVD). Patients with type 2 DM (T2DM) and... (Review)
Review
Diabetes mellitus (DM) is a chronic and complex metabolic disorder and also an important cause of cardiovascular (CV) disease (CVD). Patients with type 2 DM (T2DM) and obesity show a greater propensity for visceral fat deposition (and excessive fat deposits elsewhere) and the link between adiposity and CVD risk is greater for visceral than for subcutaneous (SC) adipose tissue (AT). There is growing evidence that epicardial AT (EAT) and pericardial AT (PAT) play a role in the development of DM-related atherosclerosis, atrial fibrillation (AF), myocardial dysfunction, and heart failure (HF). In this review, we will highlight the importance of PAT and EAT in patients with DM. We also consider therapeutic interventions that could have a beneficial effect in terms of reducing the amount of AT and thus CV risk. EAT is biologically active and a likely determinant of CV morbidity and mortality in patients with DM, given its anatomical characteristics and proinflammatory secretory pattern. Consequently, modification of EAT/PAT may become a therapeutic target to reduce the CV burden. In patients with DM, a low calorie diet, exercise, antidiabetics and statins may change the quantity of EAT, PAT or both, alter the secretory pattern of EAT, improve the metabolic profile, and reduce inflammation. However, well-designed studies are needed to clearly define CV benefits and a therapeutic approach to EAT/PAT in patients with DM.
Topics: Adipose Tissue; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Exercise; Humans; Hypoglycemic Agents; Obesity; Pericardium; Risk Factors
PubMed: 33844605
DOI: 10.1177/10742484211006997 -
Experimental Physiology Aug 2020What is the central question of this study? Are the mechanisms that cause ventricular interdependence different when due to primary right to left ventricular pressure...
NEW FINDINGS
What is the central question of this study? Are the mechanisms that cause ventricular interdependence different when due to primary right to left ventricular pressure loading? What is the main finding and its importance? An instantaneous selective increase in aortic pressure causes an immediate increase in right ventricular end-systolic pressure independent of the pericardium, whereas a selective increase in pulmonary artery pressure decreases left ventricular diastolic compliance owing to a subsequent increasing right ventricular end-diastolic volume as a function of an intact pericardium limiting biventricular volume. Changes in contraction synchrony of either ventricle do not appear to be causing these effects.
ABSTRACT
I characterized the dynamic factors determining ventricular interdependence with and without the pericardium. I measured right (RV) and left ventricular (LV) pressures and volumes simultaneously using conductance catheters in seven pentobarbitone-anaesthetized open-chested 5- to 7-week-old piglets. I studied these effects during apnoea, inferior vena caval occlusion and rapid partial aortic and pulmonary arterial occlusions. Conductance catheter-defined long-axis regional volumes were assessed to define regional contractile synchrony. Closed-pericardium measures were made from an initial (baseline) volume, then after two 20 ml kg fluid loads followed by an open-pericardium step. Baseline RV and LV volumes were similar. Aortic occlusion increased LV pressures and volumes and RV end-systolic pressure such that RV end-systolic elastance increased without changes in RV contraction synchrony, not affected by the pericardium. Pulmonary artery occlusion increased RV end-systolic pressure but not end-systolic volume. On the subsequent beat, RV end-diastolic pressure increased, whereas LV end-diastolic volume and diastolic compliance decreased. These effects were attenuated by opening the pericardium. Contraction synchrony across longitudinal segments was unaltered by either aortic or pulmonary artery occlusion. I conclude that the determinants of systolic and diastolic ventricular interdependence are different. Increasing RV pressures causes diastolic RV-to-LV interdependence, decreasing LV diastolic compliance and dependent on an intact pericardium. An increase in LV end-systolic pressure increases RV end-systolic elastance independent of the pericardium and has a minimal effect on RV diastolic function or contraction synchrony.
Topics: Animals; Arterial Pressure; Diastole; Heart Ventricles; Pericardium; Swine; Systole; Ventricular Function
PubMed: 32436594
DOI: 10.1113/EP088550 -
Cardiac Electrophysiology Clinics Sep 2020Important physiologic and anatomic differences exist between the epicardium and endocardium, particularly of the ventricles, and these differences affect ablation... (Review)
Review
Important physiologic and anatomic differences exist between the epicardium and endocardium, particularly of the ventricles, and these differences affect ablation biophysics. Absence of passive convective effects conferred by circulating blood as well as the presence of epicardial fat and vessels and absence of intracavitary ridges and structures affect ablation lesion size when performing epicardial catheter-based ablation, whether using radiofrequency or cryothermal energy. Understanding differential effects in each environment is important in informing strategies to increase ablation lesion depth. When using actively cooled radiofrequency ablation, local impedance can be altered to selectively augment energy delivery.
Topics: Biophysical Phenomena; Catheter Ablation; Endocardium; Epicardial Mapping; Heart Ventricles; Humans; Patient Safety; Pericardium; Tachycardia, Ventricular
PubMed: 32771193
DOI: 10.1016/j.ccep.2020.05.006 -
Physiological Research Feb 2020Autologous and allogenic human pericardia used as biomaterials for cardiovascular surgery are traditionally crosslinked with glutaraldehyde. In this work, we have... (Comparative Study)
Comparative Study
Autologous and allogenic human pericardia used as biomaterials for cardiovascular surgery are traditionally crosslinked with glutaraldehyde. In this work, we have evaluated the resistivity to collagenase digestion and the cytotoxicity of human pericardium crosslinked with various concentrations of glutaraldehyde in comparison with pericardium crosslinked by genipin, nordihydroguaiaretic acid, tannic acid, and in comparison with unmodified pericardium. Crosslinking retained the wavy-like morphology of native pericardium visualized by second harmonic generation microscopy. The collagenase digestion products were analyzed using SDS-PAGE, capillary electrophoresis, and a hydroxyproline assay. Glutaraldehyde and genipin crosslinking protected the native pericardium efficiently against digestion with collagenase III. Only low protection was provided by the other crosslinking agents. The cytotoxicity of crosslinked pericardium was evaluated using xCELLigence by monitoring the viability of porcine valve interstitial cells cultured in eluates from crosslinked pericardium. The highest cell index, reflecting both the number and the shape of the monitored cells was observed in eluates from genipin. Crosslinking pericardium grafts with genipin therefore seems to be a promising alternative procedure to the traditional crosslinking with glutaraldehyde, because it provides similarly high protection against degradation with collagenase, without cytotoxic effects.
Topics: Biocompatible Materials; Cross-Linking Reagents; Glutaral; Humans; Iridoids; Masoprocol; Pericardium; Tannins; Transplants
PubMed: 31852209
DOI: 10.33549/physiolres.934335 -
IEEE Transactions on Bio-medical... Oct 2022Electrocardiographic Imaging (ECGI) aims to estimate the intracardiac potentials noninvasively, hence allowing the clinicians to better visualize and understand many...
Electrocardiographic Imaging (ECGI) aims to estimate the intracardiac potentials noninvasively, hence allowing the clinicians to better visualize and understand many arrhythmia mechanisms. Most of the estimators of epicardial potentials use a signal model based on an estimated spatial transfer matrix together with Tikhonov regularization techniques, which works well specially in simulations, but it can give limited accuracy in some real data. Based on the quasielectrostatic potential superposition principle, we propose a simple signal model that supports the implementation of principled out-of-sample algorithms for several of the most widely used regularization criteria in ECGI problems, hence improving the generalization capabilities of several of the current estimation methods. Experiments on simple cases (cylindrical and Gaussian shapes scrutinizing fast and slow changes, respectively) and on real data (examples of torso tank measurements available from Utah University, and an animal torso and epicardium measurements available from Maastricht University, both in the EDGAR public repository) show that the superposition-based out-of-sample tuning of regularization parameters promotes stabilized estimation errors of the unknown source potentials, while slightly increasing the re-estimation error on the measured data, as natural in non-overfitted solutions. The superposition signal model can be used for designing adequate out-of-sample tuning of Tikhonov regularization techniques, and it can be taken into account when using other regularization techniques in current commercial systems and research toolboxes on ECGI.
Topics: Algorithms; Animals; Body Surface Potential Mapping; Electrocardiography; Humans; Normal Distribution; Pericardium
PubMed: 35294340
DOI: 10.1109/TBME.2022.3159733 -
Seminars in Ultrasound, CT, and MR Feb 2022Congenital absence of the pericardium is a very uncommon condition that may be focal, unilateral or bilateral but most frequently involves the left sided pericardium....
Congenital absence of the pericardium is a very uncommon condition that may be focal, unilateral or bilateral but most frequently involves the left sided pericardium. Clinical signs and symptoms are often absent or nonspecific, overlapping with many other more common conditions. Imaging findings are distinctive if the features are sought and recognized.
Topics: Heart Defects, Congenital; Humans; Pericardium
PubMed: 35164909
DOI: 10.1053/j.sult.2021.05.005 -
Clinical Science (London, England :... Apr 2020Major shifts in human lifestyle and dietary habits toward sedentary behavior and refined food intake triggered steep increase in the incidence of metabolic disorders... (Review)
Review
Major shifts in human lifestyle and dietary habits toward sedentary behavior and refined food intake triggered steep increase in the incidence of metabolic disorders including obesity and Type 2 diabetes. Patients with metabolic disease are at a high risk of cardiovascular complications ranging from microvascular dysfunction to cardiometabolic syndromes including heart failure. Despite significant advances in the standards of care for obese and diabetic patients, current therapeutic approaches are not always successful in averting the accompanying cardiovascular deterioration. There is a strong relationship between adipose inflammation seen in metabolic disorders and detrimental changes in cardiovascular structure and function. The particular importance of epicardial and perivascular adipose pools emerged as main modulators of the physiology or pathology of heart and blood vessels. Here, we review the peculiarities of these two fat depots in terms of their origin, function, and pathological changes during metabolic deterioration. We highlight the rationale for pharmacological targeting of the perivascular and epicardial adipose tissue or associated signaling pathways as potential disease modifying approaches in cardiometabolic syndromes.
Topics: Adipogenesis; Adipokines; Adipose Tissue; Adiposity; Animals; Anti-Inflammatory Agents; Blood Vessels; Cardiovascular Diseases; Energy Metabolism; Humans; Inflammation; Inflammation Mediators; Molecular Targeted Therapy; Pericardium; Signal Transduction
PubMed: 32271386
DOI: 10.1042/CS20190227 -
The Canadian Journal of Cardiology Aug 2023
Topics: Humans; Pericardium; Heart Defects, Congenital
PubMed: 36931623
DOI: 10.1016/j.cjca.2023.03.012