Slinker B K, Ditchey R V, Bell S P, LeWinter M M
Circulation. 1987 Aug;76(2):357-62. doi: 10.1161/01.cir.76.2.357.
Recently proposed concepts of pericardial surface pressure, as opposed to liquid pressure, have advanced our understanding of the relationship between pericardial and heart chamber pressures. However, the subsequent suggestion that right heart intracavitary pressure equals, or nearly equals, pericardial surface pressure is not strictly consistent with the physiology of pericardial constraint. If right heart pressure equals pericardial surface pressure, then transmural right heart pressure equals zero. Because of the difficulty in measuring pericardial pressure directly in the beating heart we designed an experiment in the recently arrested canine heart in situ to measure pericardial pressure indirectly and to test the hypothesis that right heart transmural pressure is zero under reasonably physiologic, static equilibrium conditions. According to a static equilibrium analysis of the pressures acting across the walls of the heart, at a given volume the change in right heart pressure caused by removing the pericardium is equal to the pericardial pressure when the pericardium is intact. We found that this drop in pressure caused by pericardiectomy did not equal right heart pressure and therefore that right heart transmural pressure does not equal zero.
与液体压力不同，最近提出的心包表面压力概念推进了我们对心包压力与心腔压力之间关系的理解。然而，随后提出的右心腔内压力等于或几乎等于心包表面压力的观点与心包约束的生理学并不完全一致。如果右心压力等于心包表面压力，那么右心跨壁压力就等于零。由于在跳动的心脏中直接测量心包压力存在困难，我们设计了一个实验，在近期停跳的犬原位心脏中间接测量心包压力，并检验在合理的生理静态平衡条件下右心跨壁压力为零这一假设。根据对作用于心壁的压力进行的静态平衡分析，在给定体积下，去除心包引起的右心压力变化等于心包完整时的心包压力。我们发现，心包切除引起的压力下降并不等于右心压力，因此右心跨壁压力并不等于零。
