Release of atrial natriuretic factor after pericardiectomy for chronic constrictive pericarditis

The mechanism by which atrial natriuretic factor (ANF) is released has been variably attributed to a number of stimuli including atrial distension,1,2 stretch,3 compliance4 and atria1 hypertension.5,6 In constrictive pericarditis, atrial pressures are markedly elevated in conjunction with fluid retention and diminished myocardial distensibility. Release of pericardial constriction would therefore allow increased distensibility at the same time atrial pressures are lowered. We describe a patient with severe calcific constrictive pericarditis in whom for the first time ANF levels and physiologic parameters were measured before and after pericardiectomy.