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

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dc.contributor.authorNtsekhe, Mpikoen_ZA
dc.contributor.authorMatthews, Kerrynen_ZA
dc.contributor.authorSyed, Faisal Fen_ZA
dc.contributor.authorDeffur, Arminen_ZA
dc.contributor.authorBadri, Motasimen_ZA
dc.contributor.authorCommerford, Patrick Jen_ZA
dc.contributor.authorGersh, Bernard Jen_ZA
dc.contributor.authorWilkinson, Katalin Aen_ZA
dc.contributor.authorWilkinson, Robert Jen_ZA
dc.contributor.authorMayosi, Bongani Men_ZA
dc.date.accessioned2015-11-23T12:37:00Z
dc.date.available2015-11-23T12:37:00Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationNtsekhe, 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. <i>PLoS One</i>, http://hdl.handle.net/11427/15350en_ZA
dc.identifier.chicagocitationNtsekhe, Mpiko, Kerryn Matthews, Faisal F Syed, Armin Deffur, Motasim Badri, Patrick J Commerford, Bernard J Gersh, Katalin A Wilkinson, Robert J Wilkinson, and Bongani M Mayosi "Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15350en_ZA
dc.identifier.citationNtsekhe, 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.0077532en_ZA
dc.identifier.ris TY - Journal Article AU - Ntsekhe, Mpiko AU - Matthews, Kerryn AU - Syed, Faisal F AU - Deffur, Armin AU - Badri, Motasim AU - Commerford, Patrick J AU - Gersh, Bernard J AU - Wilkinson, Katalin A AU - Wilkinson, Robert J AU - Mayosi, Bongani M AB - 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. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0077532 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion TI - Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion UR - http://hdl.handle.net/11427/15350 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15350
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0077532
dc.identifier.vancouvercitationNtsekhe M, Matthews K, Syed FF, Deffur A, Badri M, Commerford PJ, et al. Prevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusion. PLoS One. 2013; http://hdl.handle.net/11427/15350.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2013 Ntsekhe et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherCytokinesen_ZA
dc.subject.otherHemodynamicsen_ZA
dc.subject.otherFibrosisen_ZA
dc.subject.otherInflammatory diseasesen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherCatheterizationen_ZA
dc.subject.otherMycobacterium tuberculosisen_ZA
dc.subject.otherPericardiumen_ZA
dc.titlePrevalence, hemodynamics, and cytokine profile of effusive-constrictive pericarditis in patients with tuberculous pericardial effusionen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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