Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion

 

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dc.contributor.author Ntsekhe, Mpiko en_ZA
dc.contributor.author Matthews, Kerryn en_ZA
dc.contributor.author Syed, Faisal F en_ZA
dc.contributor.author Deffur, Armin en_ZA
dc.contributor.author Badri, Motasim en_ZA
dc.contributor.author Commerford, Patrick J en_ZA
dc.contributor.author Gersh, Bernard J en_ZA
dc.contributor.author Wilkinson, Katalin A en_ZA
dc.contributor.author Wilkinson, Robert J en_ZA
dc.contributor.author Mayosi, Bongani M en_ZA
dc.date.accessioned 2015-11-23T12:37:00Z
dc.date.available 2015-11-23T12:37:00Z
dc.date.issued 2013 en_ZA
dc.identifier.citation Ntsekhe, M., Matthews, K., Syed, F. F., Deffur, A., Badri, M., Commerford, P. J., ... & Mayosi, B. M. (2013). Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion. PloS one, 8(10), e77532. doi:10.1371/journal.pone.0077532 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15350
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0077532
dc.description.abstract 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. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Cytokines en_ZA
dc.subject.other Hemodynamics en_ZA
dc.subject.other Fibrosis en_ZA
dc.subject.other Inflammatory diseases en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other Catheterization en_ZA
dc.subject.other Mycobacterium tuberculosis en_ZA
dc.subject.other Pericardium en_ZA
dc.title Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2013 Ntsekhe et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.