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Anatomical and Functional Computed Tomography for Diagnosing Hemodynamically Significant Coronary Artery Disease: A Meta-Analysis Physiological Stratification of Patients With Angina Due to Coronary Microvascular Dysfunction Lesion-Specific and Vessel-Related Determinants of Fractional Flow Reserve Beyond Coronary Artery Stenosis Cardiotoxicity and Cardiac Monitoring Among Chemotherapy-Treated Breast Cancer Patients Coronary Physiology in the Cardiac Catheterization Laboratory Randomized Comparison of FFR-Guided and Angiography-Guided Provisional Stenting of True Coronary Bifurcation Lesions: The DKCRUSH-VI Trial (Double Kissing Crush Versus Provisional Stenting Technique for Treatment of Coronary Bifurcation Lesions VI) Update on chronic thromboembolic pulmonary hypertension Genetic analyses in a cohort of 191 pulmonary arterial hypertension patients Haemodynamic definitions and updated clinical classification of pulmonary hypertension Circulating Plasma microRNAs In Systemic Sclerosis-Associated Pulmonary Arterial Hypertension

Review ArticleVolume 7, Issue 7, July 2019

JOURNAL:JACC Heart Fail. Article Link

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

BA Borlaug, YNV Reddy. Keywords: heart failure; hemodynamics; pericardium

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.