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Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial Heart Failure With Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial Initial Invasive or Conservative Strategy for Stable Coronary Disease Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies Impact of intravascular ultrasound on the long-term clinical outcomes in the treatment of coronary ostial lesions 6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel) The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial Guideline‐Directed Medical Therapy for Patients With Heart Failure With Midrange Ejection Fraction: A Patient‐Pooled Analysis From the KorHF and KorAHF Registries

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.