{"id":54779,"date":"2022-09-02T17:21:16","date_gmt":"2022-09-02T11:51:16","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=54779"},"modified":"2022-09-02T18:18:59","modified_gmt":"2022-09-02T12:48:59","slug":"concept-of-coupled-and-uncoupled-pericardial-constraint","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/concept-of-coupled-and-uncoupled-pericardial-constraint\/","title":{"rendered":"Concept of coupled and uncoupled pericardial constraint"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/HWDmqJVfMos\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Concept of coupled and uncoupled pericardial constraint<\/span><\/h2>\n<p>Coupled pericardial constraint is exerted by uniform liquid pressure as in cardiac tamponade. Uncoupled pericardial constraint is regional surface pressure as occurs in constrictive pericarditis. Mathematical modeling has shown that coupled pericardial constraint produces greater ventricular interdependence increasing the chance of pulsus paradoxus in cardiac tamponade. Uncoupled pericardial constraint produces a greater right ventricular elastance increasing the likelihood of Kussmaul&#8217;s sign [1].<\/p>\n<p>In coupled constraint of pericardial tamponade, uniform liquid pressure is exerted over the entire surface of the heart. This couples changes in volume of one chamber to changes in the volume of all others [2]. In contrast, uncoupled pericardial constraint in constrictive pericarditis is exerted by regional surface pressure which independently restricts changes in the volume of each chamber.<\/p>\n<figure id=\"attachment_54790\" aria-describedby=\"caption-attachment-54790\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-54790 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/09\/Coupled-and-uncoupled-pericardial-constraint.jpg\" alt=\"Coupled and uncoupled pericardial constraint\" width=\"1200\" height=\"718\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/09\/Coupled-and-uncoupled-pericardial-constraint.jpg 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/09\/Coupled-and-uncoupled-pericardial-constraint-300x180.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/09\/Coupled-and-uncoupled-pericardial-constraint-1024x613.jpg 1024w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/09\/Coupled-and-uncoupled-pericardial-constraint-768x460.jpg 768w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-54790\" class=\"wp-caption-text\">Coupled and uncoupled pericardial constraint (Diagrammatic representation)<\/figcaption><\/figure>\n<p>In coupled pericardial constraint of cardiac tamponade, venous flow becomes predominantly systolic and the x descent in right atrial pressure becomes more prominent. In uncoupled pericardial constraint of constrictive pericarditis, venous flow is mainly diastolic and the y descent becomes accentuated.<\/p>\n<p>Greater gains in ventricular interdependence produced by coupled pericardial constraint in cardiac tamponade increases the likelihood of pulsus paradoxus. Greater effective right ventricular elastance produced by uncoupled pericardial constraint in constrictive pericarditis increases the likelihood of Kussmaul&#8217;s sign.<\/p>\n<p><a href=\"https:\/\/johnsonfrancis.org\/professional\/ventricular-interdependence\/\">Ventricular interdependence<\/a> is that property of the normal heart in which distension of one ventricle alters the distensibility and filling of the other [3]. Ventricular interdependence is exaggerated in cardiac tamponade when the coupled pericardial constraint limits the total contents in the pericardial sac. Exaggerated reciprocal changes in mitral and tricuspid E wave velocity in cardiac tamponade is a Doppler echocardiographic correlate of reciprocal changes in right and left ventricular filling.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Takata M, Harasawa Y, Beloucif S, Robotham JL. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9390949\/\">Coupled vs. uncoupled pericardial constraint: effects on cardiac chamber interactions<\/a>. J Appl Physiol (1985). 1997 Dec;83(6):1799-813. doi: 10.1152\/jappl.1997.83.6.1799. PMID: 9390949.<\/li>\n<li>Tyberg JV. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9390948\/\">Invited editorial on &#8220;Coupled vs. uncoupled pericardial constraint: effects on cardiac chamber interactions&#8221;<\/a>. J Appl Physiol (1985). 1997 Dec;83(6):1797-8. doi: 10.1152\/jappl.1997.83.6.1797. PMID: 9390948.<\/li>\n<li>Shaver JA, Reddy PS, Curtiss EI, Ziady GM, Reddy SC. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11433831\/\">Noninvasive\/invasive correlates of exaggerated ventricular interdependence in cardiac tamponade<\/a>. J Cardiol. 2001;37 Suppl 1:71-6. PMID: 11433831.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Concept of coupled and uncoupled pericardial constraint Coupled pericardial constraint is exerted by uniform liquid pressure as in cardiac tamponade. Uncoupled pericardial constraint is regional surface pressure as occurs in constrictive pericarditis. Mathematical modeling has shown that coupled pericardial constraint produces greater ventricular interdependence increasing the chance of pulsus paradoxus in cardiac tamponade. Uncoupled pericardial [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":54788,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-54779","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Concept of coupled and uncoupled pericardial constraint - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/concept-of-coupled-and-uncoupled-pericardial-constraint\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Concept of coupled and uncoupled pericardial constraint - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Concept of coupled and uncoupled pericardial constraint Coupled pericardial constraint is exerted by uniform liquid pressure as in cardiac tamponade. Uncoupled pericardial constraint is regional surface pressure as occurs in constrictive pericarditis. Mathematical modeling has shown that coupled pericardial constraint produces greater ventricular interdependence increasing the chance of pulsus paradoxus in cardiac tamponade. Uncoupled pericardial [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/concept-of-coupled-and-uncoupled-pericardial-constraint\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2022-09-02T11:51:16+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-09-02T12:48:59+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/09\/Concept-of-coupled-and-uncoupled-pericardial-constraint.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1208\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/concept-of-coupled-and-uncoupled-pericardial-constraint\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/concept-of-coupled-and-uncoupled-pericardial-constraint\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Concept of coupled and uncoupled pericardial constraint\",\"datePublished\":\"2022-09-02T11:51:16+00:00\",\"dateModified\":\"2022-09-02T12:48:59+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/concept-of-coupled-and-uncoupled-pericardial-constraint\\\/\"},\"wordCount\":373,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/concept-of-coupled-and-uncoupled-pericardial-constraint\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2022\\\/09\\\/Concept-of-coupled-and-uncoupled-pericardial-constraint.jpg\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/concept-of-coupled-and-uncoupled-pericardial-constraint\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/concept-of-coupled-and-uncoupled-pericardial-constraint\\\/\",\"name\":\"Concept of coupled and uncoupled pericardial constraint - 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