Browsing by Subject "Hemodynamics"

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    Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion
    (Public Library of Science, 2013) Ntsekhe, Mpiko; Matthews, Kerryn; Syed, Faisal F; Deffur, Armin; Badri, Motasim; Commerford, Patrick J; Gersh, Bernard J; Wilkinson, Katalin A; Wilkinson, Robert J; Mayosi, Bongani M
    BACKGROUND: Effusive constrictive pericarditis (ECP) is visceral constriction in conjunction with compressive pericardial effusion. The prevalence of proven tuberculous ECP is unknown. Whilst ECP is distinguished from effusive disease on hemodynamic grounds, it is unknown whether effusive-constrictive physiology has a distinct cytokine profile. We conducted a prospective study of prevalence and cytokine profile of effusive-constrictive disease in patients with tuberculous pericardial effusion. METHODS: From July 2006 through July 2009, the prevalence of ECP and serum and pericardial levels of inflammatory cytokines were determined in adults with tuberculous pericardial effusion. The diagnosis of ECP was made by combined pericardiocentesis and cardiac catheterization. RESULTS: Of 91 patients evaluated, 68 had tuberculous pericarditis. The 36/68 patients (52.9%; 95% confidence interval [CI]: 41.2-65.4) with ECP were younger (29 versus 37 years, P=0.02), had a higher pre-pericardiocentesis right atrial pressure (17.0 versus 10.0 mmHg, P<0.0001), serum concentration of interleukin-10 (IL-10) (38.5 versus 0.2 pg/ml, P<0.001) and transforming growth factor-beta (121.5 versus 29.1 pg/ml, P=0.02), pericardial concentration of IL-10 (84.7 versus 20.4 pg/ml, P=0.006) and interferon-gamma (2,568.0 versus 906.6 pg/ml, P=0.03) than effusive non-constrictive cases. In multivariable regression analysis, right atrial pressure > 15 mmHg (odds ratio [OR] = 48, 95%CI: 8.7-265; P<0.0001) and IL-10 > 200 pg/ml (OR=10, 95%CI: 1.1, 93; P=0.04) were independently associated with ECP. CONCLUSION: Effusive-constrictive disease occurs in half of cases of tuberculous pericardial effusion, and is characterized by greater elevation in the pre-pericardiocentesis right atrial pressure and pericardial and serum IL-10 levels compared to patients with effusive non-constrictive tuberculous pericarditis.
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    Synchronised capacitor discharge in the management of cardiac arrhythmias with particular reference to the haemodynamic significance of atrial systole
    (1965) Resnekov, Leon Zundel
    In December 1962 a boy of 15 years was referred to the National Heart Hospital because of a ventricular tachycardia, which had proved resistant to treatment with procaine amide, quinidine, atropine, prostigmine, prednisone and digoxin. A second stage, total correction for tetralogy of Pallot had been successfully performed two years before by Sir Russell Brock and the tachycardia followed a sudden blow on the cheat at his school. Further drug treatment to the point of toxicity proved equally unavailing and ten days after the onset of the arrhythmia severe congestive heart failure was present.