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The human heart is enclosed in the pericardial cavity. The pericardiumconsists of a layered thin sac and is separated from the myocardium by a thinfilm of fluid. It provides a fixture in space and frictionless sliding of themyocardium. The influence of the pericardium is essential for predictivemechanical simulations of the heart. However, there is no consensus onphysiologically correct and computationally tractable pericardial boundaryconditions. Here we propose to model the pericardial influence as a parallelspring and dashpot acting in normal direction to the epicardium. Using afour-chamber geometry, we compare a model with pericardial boundary conditionsto a model with fixated apex. The influence of pericardial stiffness isdemonstrated in a parametric study. Comparing simulation results tomeasurements from cine magnetic resonance imaging reveals that addingpericardial boundary conditions yields a better approximation with respect toatrioventricular plane displacement, atrial filling, and overall spatialapproximation error. We demonstrate that this simple model ofpericardial-myocardial interaction can correctly predict the pumping mechanismsof the heart as previously assessed in clinical studies. Utilizing apericardial model can not only provide much more realistic cardiac mechanicssimulations but also allows new insights into pericardial-myocardialinteraction which cannot be assessed in clinical measurements yet.

The importance of the pericardium for cardiac biomechanics: From physiology to computational modeling