Mechanics of pericardial effusion: A simulation study

Francesco Scardulla, Antonino Rinaudo, Salvatore Pasta, Cesare Scardulla

Research output: Contribution to journalArticle

Abstract

Pericardial effusion is a pathological accumulation of fluid within pericardial cavity, which may compress heart chambers with hemodynamic impairment. We sought to determine the mechanics underlying the physiology of the hemodynamic impairment due to pericardial effusion using patient-specific computational modeling. Computational models of left ventricle and right ventricle were based on magnetic resonance images obtained from patients with pericardial effusion and controls. Myocardial material parameters were adjusted, so that volumes of ventricular chambers and pericardial effusion agreed with magnetic resonance imaging data. End-diastolic and end-systolic pressure-volume relationships as well as stroke volume were determined to evaluate impaired cardiac function of biventricular model. Distributions of myocardial fiber stresses and their regional variation along left ventricular wall were compared between patient groups. Both end-diastolic and end-systolic pressure-volume relationships shifted to the left for patients with pericardial effusion, with right ventricle diastolic filling particularly restricted. Left ventricle function as estimated by Starling curve was reduced by pericardial effusion. End-systolic fiber stress of left ventricle was significantly reduced as compared to that found for healthy patients. Myocardial stress was found increased at interventricular septum when compared to that exerted at lateral wall of left ventricle. Right ventricular myocardial stress was reduced as a consequence of the pressure equalization between right ventricle and pericardial effusion. Diastolic right ventricle collapse in patients with pericardial effusion is related to higher myocardial fiber stress on interventricular septum and to an extensible pericardium reducing motion of ventricular chambers, with right ventricle particularly restrained. These findings likely portend progression of pericardial effusion to cardiac tamponade.

Original languageEnglish
Pages (from-to)205-214
Number of pages10
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Volume229
Issue number3
DOIs
Publication statusPublished - Mar 4 2015

Fingerprint

Pericardial Effusion
Mechanics
Heart Ventricles
Hemodynamics
Magnetic resonance
Stress Fibers
Fibers
Pericardium
Physiology
Blood Pressure
Starlings
Cardiac Tamponade
Imaging techniques
Fluids
Stroke Volume
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Pressure

Keywords

  • cardiac tamponade
  • computer modeling
  • Pericardial effusion

ASJC Scopus subject areas

  • Mechanical Engineering
  • Medicine(all)

Cite this

Mechanics of pericardial effusion : A simulation study. / Scardulla, Francesco; Rinaudo, Antonino; Pasta, Salvatore; Scardulla, Cesare.

In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 229, No. 3, 04.03.2015, p. 205-214.

Research output: Contribution to journalArticle

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