Pericardial fluid as a new material for clinical heart research

This article will review the results of recent clinical studies relating to the pericardial fluid in patients with various heart diseases. In ischemic patients, several angiogenic growth factors are accumulated in a high conc entration in pericardial fluid. These may contribute to the angiogenesis an d arteriogenesis, which are self-protecting mechanisms of myocardial ischem ia. In congestive heart failure, natriuretic peptides are released into the pericardial fluid in a higher concentration compared with plasma levels. T his suggests that these peptides may act as autocrine and/or paracrine fact ors. Pericardial fluid from ischemic patients induces cell proliferation an d apoptosis depending on the cell type. Intrapericardial drug administratio n may provide a reasonable therapeutic strategy for heart diseases. In conc lusion, the analysis of pericardial fluid appears to be a logical approach for elucidation of the pathophysiology of the heart. (C) 2001 Elsevier Scie nce Ireland Ltd. All rights reserved.