Pericardiotomy as a novel treatment for heart failure with preserved ejection fraction

Shunichi Doi; Barry A Borlaug

doi:10.1007/s10741-024-10451-5

Pericardiotomy as a novel treatment for heart failure with preserved ejection fraction

Heart Fail Rev. 2025 Jan;30(1):137-142. doi: 10.1007/s10741-024-10451-5. Epub 2024 Oct 8.

Authors

Shunichi Doi¹, Barry A Borlaug^{2

3}

Affiliations

¹ Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
² Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA. [email protected].
³ Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA. [email protected].

PMID: 39377998
DOI: 10.1007/s10741-024-10451-5

Abstract

The pericardium plays an important role in modulating cardiac performance and hemodynamics in patients with heart failure with preserved ejection fraction (HFpEF). Pericardial constraint increases filling pressures in patients with HFpEF, particularly those with the obesity phenotype, atrial myopathy, right ventricular dysfunction, and tricuspid regurgitation. Preclinical and early stage clinical studies indicate that pericardiotomy may become a novel treatment for HFpEF. This review summarizes and discusses the pathophysiology of pericardial restraint and the possibility of pericardiotomy in HFpEF.

Keywords: Catheter intervention; Heart failure with preserved ejection fraction; Pericardiotomy; Pericardium.

Publication types

Review

MeSH terms

Heart Failure* / physiopathology
Heart Failure* / surgery
Humans
Pericardiectomy* / methods
Pericardium / physiopathology
Pericardium / surgery
Stroke Volume* / physiology
Treatment Outcome