Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Constriction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed1990

Effect of an upper-arm constricting device on arm blood pressure measurements.

Thousands of blood pressure measurements are done daily without the patients' disrobing. This study was therefore undertaken to determine the validity of such measurements, especially those taken when the patient's armsleeve has been rolled up onto the proximal aspect of the arm. An inflatable constricting device was applied to the proximal aspect of the arm and a standard sphygmomanometer was applied distal to the inflatable cuff. The constricting cuff was inflated to 0, 20, 40, 60, 80, and 100 mm Hg in random sequence, and the blood pressure was recorded at each level. Statistically significant elevations in the mean systolic blood pressure were detected at proximal constricting pressures of 80 mm Hg (P less than .01) and 100 mm Hg (P less than .001), and in the mean diastolic blood pressure at 20 mm Hg (P less than .005). However, the magnitude of the elevations was small: 3.9, 4.4, and 2.5 mm Hg, respectively. We conclude that though a proximal constricting device may induce statistically significant alterations in blood pressure measurements these alterations are small and not likely to affect treatment decisions.

Aged↗
PubMed1990

[An operative case of chronic constrictive pericarditis with silicosis and lumbar caries].

We reported a case of chronic constrictive pericarditis complicated with silicosis and lumbar caries, who was improved by the operation. The patient was a 65 year old man whose past occupation was a mason. He was admitted to our hospital with chronic heart failure on March, 1986. Atypical silicosis was diagnosed from the occupational history and the histopathological silicotic changes in mediastinal lymph nodes and fibrosis of alveolar wall. The diagnosis of chronic constrictive pericarditis was made from chest roentgenogram and intracardiac catheterization. The symptoms of chronic constrictive pericarditis was improved by the pericardial resection. The exact pathogenesis of the chronic constrictive pericarditis could not be identified from the histology of pericardial tissue, but tuberculosis was suspected because of the past history of tuberculous pleurisy and the recurrence of lumbar caries.

Aged↗
PubMed1989

[Peracute constrictive, idiopathic pericarditis--a case report of an acute life-threatening disease picture].

Generally, idiopathic pericarditis is considered a benign, self-limiting disease. Frequently, the exsudative phase of the disease is followed by a mild form of transitory constriction of the pericardium. The case reported here shows an unusual course of the disease. Shortly after the symptoms of exsudative pericarditis subsided a life-threatening form of pericardial constriction developed within weeks. In case of chronic pericardial constriction perioperative mortality for partial pericardiectomy is not insignificant. This is a result of myocardial damage that is difficult to assess prior to surgery. For that reason a partial pericardiectomy should be attempted as early as possible, even in cases with acute pericardial constriction.

Acute Disease↗
PubMed1989

Constrictive pericarditis presenting as pleural effusion of unknown origin.

Despite the known association of pleural effusion with constrictive pericarditis, the presentation of constrictive pericarditis as pleural effusion of unknown origin has, to our knowledge, never been described. After evaluating such a case, we retrospectively analyzed all cases of established constrictive pericarditis seen in this institution in the last six years. The clinical and laboratory features of this cohort of 30 patients are similar to those of other reported series. Pleural effusion was present in 18 (60%) of 30 cases. In six (12%) of the 18 cases, pleural effusion was a major component of the clinical presentation, and in three (10%) of these six cases, the persistence of pleural effusion of unknown origin was the indication for referral to this institution. Analysis of pleural fluid in four cases revealed three exudates and one transudate. We believe this is the first report of unexplained pleural effusion as the presenting manifestation of constrictive pericarditis, and this diagnosis should be added to the list of causes of unexplained pleural effusion.

Adolescent↗
PubMed1977

Pericardial constriction as a late complication of coronary bypass surgery.

A 55-year-old man had progressive dyspnea, recurrent atrial arrhythmias, and severe right heart failure following coronary bypass surgery. His condition improved only slightly with the usual decongestive therapy. When transferred for further studies 5 months after the operation, he had typical clinical and hemodynamic findings of constrictive pericarditis. Review of chest films following the bypass operation revealed a large pericardial effusion or hematoma, the incomplete resolution of which probably caused the pericardial constriction confirmed at thoracotomy. The man was treated by pericardiectomy. A recent report on the incidence of overt tamponade soon after bypass surgery suggests that a significant volume of pericardial fluid accumulates in the early postoperative course in many instances and that late constriction may not be a rare complication. In treating patients who have circulatory congestion after such operations, it is important that the physician consider constrictive pericarditis and not assume that the clinical findings are the consquence of myocardial failure.

Coronary Artery Bypass↗
PubMed1988

Assessment of the left ventricular diastolic function in constrictive pericarditis by digitised M-mode echocardiography.

Digitised M-mode echocardiography was used to study the diastolic left ventricular function in ten patients with constrictive pericarditis. Each patient was matched for heart rate and stroke volume with a control patient who had normal left ventricular end-diastolic pressure and coronary arteries. All 20 patients underwent right and left cardiac catheterisation. In patients with constrictive pericarditis compared with controls, the median (range) left ventricular peak diameter lengthening rate, normalised for end-diastolic dimension, was 4.5 (2.5-8.0) s-1 and 2.9 (1.6-4.1) (p less than 0.01), and the rapid filling period fraction of diastole was 0.28 (0.18-0.37) and 0.37 (0.21-0.58) (p less than 0.05), while the mitral valve E-F slope was 20.1 (10.5-39.2) cm/s and 11.8 (7.6-14.5) (p less than 0.05), respectively. Thus, the early rate of left ventricular diameter lengthening is increased in constrictive pericarditis independent of heart rate and stroke volume, while the actual duration of the rapid filling period is decreased. These results, obtained noninvasively, extend the findings of previous invasive studies. The method may help in the difficult clinical diagnosis of constrictive pericarditis, although there is some overlap with the normal control range.

Adult↗
PubMed1986

Constrictive perivenous mesh prosthesis for preservation of vein integrity. Experimental results and application for coronary bypass grafting.

Saphenous veins undergo dramatic morphologic changes when used as coronary bypass grafts, and careful preparation of the graft alone is inadequate in preventing these changes. In this study, the use of a constrictive mesh for vein graft was evaluated. Fourteen sheep were subjected to a 5 cm resection of the carotid artery. Six sheep (Group A) received a jugular vein interposition graft, and the other eight sheep (Group B) received a jugular vein graft on which the constrictive mesh had been applied. The diameter of grafts in Group A was 14 +/- 1 mm compared with 7 +/- 0.5 mm for Group B (p = 0.05). The animals were put to death 4 months later. Scanning electron microscopy showed a disruption of the endothelial lining in Group A and a normal endothelium in Group B. Microscopy showed a statistical difference between Groups A and B regarding regularity and thickness of the intimal hyperplasia. Group B showed a moderate and regular intimal thickening and increased vasa vasorum. This indicates that distention and subsequent damage of the vein graft may be minimized by use of a constrictive mesh. Saphenous grafts surrounded by this constrictive mesh were inserted in four patients. Vein diameters were, respectively, 5, 4.3, 3.5, and 3.5 mm before meshing. After insertion in the mesh, vein diameters were 4.3, 3.5, 2.8, and 2.5 mm, respectively. Angiography performed 2 months later showed patent grafts of regular caliber.

Animals↗
PubMed1985

Early and late results of pericardiectomy for constrictive pericarditis.

Records of 231 patients (171 males, 60 females; aged 10 months to 83 years [median 45 years]) who underwent operation for constrictive pericarditis at the Mayo Clinic from 1936 through 1982 were reviewed. All had had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. Preoperatively, 69% were in New York Heart Association Class III or IV and 81% had peripheral edema or ascites. Pericardiectomy was performed through a left anterolateral thoracotomy (34%), a median sternotomy (27%), a U incision (Harrington) (21%), or a bilateral anterior thoracotomy (18%). Postoperatively, 28% of patients had evidence of low cardiac output; 70% of the 32 deaths within 30 days of operation were due to low cardiac output. Operative risk was significantly (p less than 0.001) related to preoperative disability (1% for Class I or II; 10% for class III; 46% for Class IV). Median postoperative follow-up was 9 years (longest was 43 years). Probability of survival for patients dismissed alive from the hospital was 84% at 5 years, 71% at 15 years, and 52% at 30 years. Long-term survival (excluding operative mortality) was not significantly influenced by the disability class preoperatively, the operative approach, or the development of low cardiac output in the immediate postoperative period. At the end of the follow-up interval, there were 141 patients in whom functional capacity could be assessed; 140 were in Class I or II. We conclude that a poor hemodynamic result after complete pericardiectomy relates to the preoperative degree of constriction and resultant cardiomyopathy. We recommend early pericardiectomy when pericardial constriction is diagnosed, and we continue to use a left anterolateral thoracotomy as the preferred approach for most patients.

Adolescent↗
PubMed1979

The specification of metameric order in the insect Callosobruchus maculatus Fabr. (Coleoptera). I. Incomplete segment patterns can result from constriction-induced cytological damage to the egg.

Eggs of the pea-beetle Callosobruchus were divided into two at different stages of development. Both fragments were allowed to develop into partial larvae. The segment patterns of normal and partial larvae are described using cuticular markers of cell differentiation. To study the contribution of cytological damage to the segment gap phenomenon three different types of constriction were performed: complete and incomplete permanent constriction and complete temporary constriction. Changes in the structure of the egg can produce absence of segments resulting from two different effects. First, partial absence of segments results from a decreased egg circumference in the constriction region and involves the disturbance of a morphogenetic process (dorsal closure). Secondly, cytological damage can result in a gap between two arrays of segments. The loss of segments in the gap occurred in two different ways. In a spatial segment gap the two arrays of segments were physically discontinuous, whereas in a non-spatial gap the segments bordering the gap were juxtaposed in a physically continuous cuticle. The extent to which the gap phenomenon can be attributed to cytological damage is discussed. We also discuss, on the basis of certain dorsal defects, a possible stepwise specification of the dorsal transverse cuticular pattern.

Animals↗
PubMed1983

[Evaluation of constrictive pericarditis by computed tomography].

Since extensive studies of constrictive pericarditis by CT have not been reported, we performed a plain and contrast enhanced CT on 4 patients of constrictive pericarditis diagnosed by cardiac catheterization or echocardiography and confirmed at the time of surgical operation. The CT findings were as follows: The normal pericardium was smooth, could be visualized in the right and anterior regions of the heart, and was approximately or less 2 mm in thickness. On the other hand, the pericardium in constrictive pericarditis was irregularly thickened, was visualized even in the left and posterior regions of the heart, and was more than 2 mm in thickness. The mean CT value of the pericardium in constrictive pericarditis was significantly increased as compared with that of the normal pericardium. The contrast enhanced CT image revealed a marked dilatation of superior and inferior caval veins (SVC and IVC) even in the cases with normal size of each cardiac chamber. The ECG gated CT performed on one case demonstrated the impaired ventricular expansion. After pericardiectomy, the ventricular chambers showed a tendency to dilate, and the dimension of the SVC and IVC were reduced. Thus, CT is thought to be a useful noninvasive technique in evaluating the thickness of the pericardium, its pathology and the degree of dilatation in each cardiac chamber or the vena cavae.

Adult↗
PubMed1982

Constrictive epicarditis as a cause of delayed or absent response to pericardiectomy: a clinicopathological study.

It is widely held that constrictive pericarditis is curable by pericardiectomy, and failure to respond reflects an underlying myocardial disease. Fibrous epicarditis could account for residual cardiac constriction, and delayed hemodynamic response in some patients is an alternative explanation. To examine this, we studied the 12 consecutive patients with otherwise normal hearts treated with extensive pericardiectomy for constrictive pericarditis over the past 7 years. Three hemodynamic responses to pericardiectomy were observed: (1) rapid response, where central venous pressure (CVP) fell below 10 cm H2O by 24 hours in two patients; (2) delayed response, where CVP fell below 10 cm H2O by 48 hours in six patients; and (3) no response of CVP in four patients. The CVPs remained critically elevated (greater than 25 cm H2O) in three patients with delayed response until a sclerotic epicardial peel was resected. Another patient whose CVP of 30 cm H2O showed no change after parietal pericardiectomy was thought to have amyloid cardiomyopathy but instead at autopsy had constrictive epicardial sclerosis not recognized at parietal pericardiectomy. Histologic features of parietal pericardium had no correlation with hemodynamic response, whereas epicardial histology did correlate with hemodynamic response in four patients. The data showed a spectrum of postpericardiectomy delayed hemodynamic responses, which in some patients may be due to a slowly resolving or fixed component of fibrous epicarditis that may be clinically misconstrued as a cardiomyopathy. Interruption of visceral pericardial tissue may be as important as resection of the parietal pericardium in patients with epicardial sclerosis.

Adolescent↗
PubMed1994

[Pericardial constriction caused by epicardial patches of automatic implantable defibrillators. Apropos of 3 cases].

The authors report three cases of pericardial constriction secondary to implantation of an automatic defibrillator. In one case, the pericardial constriction occurred 1 year after implantation and was associated with ascending infection of the patch electrodes from the stimulator; the patient died when the patch electrodes were removed, the infection having eroded the left ventricular wall. In the other two cases, signs of constriction appeared 2 years after implantation. In one of these patients, surgery showed a fibrous pericardial reaction deforming the patch electrodes with a favourable outcome when the electrodes were removed. The other patient refused surgery. In the three cases, the diagnosis was confirmed by right heart catheterisation and ventriculography which showed signs of adiastole and severe deformation of the ventricular contours. Pericardial constriction due to patch electrodes is a potentially serious complication of implantable automatic defibrillators, the prevalence of which may be underestimated. The use of endocavitary or extra-pericardial electrodes should avoid this complication.

Defibrillators, Implantable↗
PubMed1995

[Prediction of ineffective outcome of surgical treatment for constrictive pericarditis].

The preoperative factors predicting the outcome of surgical treatment for constrictive pericarditis were investigated in 22 patients with constrictive pericarditis who underwent pericardiectomy. The NYHA functional class was improved in nine patients after surgery (improved group), but not in the other 13 patients (unimproved group). Preoperative right and left heart catheterization data and echocardiograms were compared between these two groups. Right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) were significantly higher in the unimproved group. The left atrial diameter (LAD) measured by echocardiography was significantly greater in the unimproved group. These results indicate that pericardiectomy will cause a worsened immediate outcome in patients with severe pericardial constriction. LAD was the most useful parameter in predicting the ineffectiveness of the pericardiectomy. If the borderline value of LAD is taken as 40 mm, the sensitivity and specificity predicting ineffective surgery were 92% and 89%, respectively. RAP and PCWP could not separate the two groups satisfactorily. Pericardiectomy should be performed before the pericardial constriction progresses, and before LAD reaches 40 mm.

Adult↗
PubMed1975

[The jugular pulse in constrictive pericarditis. Correlations between hemodynamics and external recordings].

The contours and chronologic changes of the jugular pulse curve have been studied in relation with 15 cases of constrictive pericarditis and compared with 17 cases of normal jugulogram. The diastolic venous collapse was found in 8 of 15 cases only. On the contrary, the pulse contour was normal in three cases, while the haemodynamic results were intensely abnormal. Inversely, some tracings with a diastolic venous collapse did not correspond to pericardial construction. More specific signs for cardiac restriction were looked for on the side of chronologic changes. The method of synchronous tracings makes it possible to measure the Q-Y, S2-Y and S2-V intervals. A significant correlation was established between the values of the Q-Y and S2-Y intervals and the mean right atrial pressure. By comparison with normal jugular vein tracings, each interval was given three zones of value (normal, intermediate, pathological). One may thus determine that pericardial constriction is severe when a minimum of two intervals was pathological, the third one having an intermediate value. Pericardial constriction was moderate when two parameters were pathological and the third normal, or when one parameter only was pathological, the other two having intermediate values. In all other cases, there was no pericardial constriction, whatever the contour of the jugular venous curve.

Adolescent↗
PubMed1994

Altered neuropeptide Y effects on noradrenaline levels in the paraventricular nucleus of rats following aortic constriction.

OBJECTIVE: To clarify whether central catecholamine systems are modulated by neuropeptide Y (NPY) soon after imposing an increased pressure overload on the heart. Recent evidence supports the view that the sympathetic nervous system actively participates in the development of cardiac hypertrophy. Since noradrenaline-containing neurons involved with cardiovascular regulation within the brain are known to coexist with NPY, it is possible that a functional interaction between NPY and noradrenaline exists centrally. DESIGN: The paraventricular nucleus (PVN) of aortic-banded Sprague-Dawley rats were sampled for noradrenaline levels using in vivo microdialysis and compared with samples taken from sham-operated controls. Autoradiographical localization of NPY receptors in the PVN was also carried out between animal groups. ANIMALS: Forty-eight Sprague-Dawley rats (weighing between 175 and 200 g). INTERVENTIONS: The 48 rats were randomly divided into two groups. One group underwent abdominal suprarenal aortic constriction. The control group underwent the same procedure without being banded. At 14 days postsurgery, the animals had microdialysis probes stereotaxically implanted into the PVN under anesthesia. A solution of NPY (10(-8) M) was perfused through the probe for 20 mins, and catecholamine levels were measured in the resulting perfusate. MAIN RESULTS: Extracellular noradrenaline concentrations in the PVN were found to be increased following aortic constriction compared with sham controls (P < 0.05). Infusion of NPY resulted in a reduction of noradrenaline concentration in sham animals (P < 0.05), whereas no change in noradrenaline concentration was evident in the aortic-constricted group. Autoradiography of NPY receptors in the PVN showed a significant decrease in the receptor density in aortic-constricted rats versus sham controls (P < 0.05). CONCLUSIONS: The results strongly support the view that NPY plays an important neuromodulatory role in the PVN regarding control of sympathetic output. It is suggested that cardiac hypertrophy may be precipitated secondary to changes in brain NPY levels and increased sympathetic activity.

Animals↗
PubMed1994

Hemodynamic changes after ligation of a major branch of the portal vein in rats: comparison with rats with portal vein constriction.

In chronic portal-hypertensive rat models, such as portal vein constriction or cirrhosis, the portal blood flow that effectively perfuses the hepatocytes is substantially reduced because of anatomical or functional shunts. It is possible therefore that a feedback mechanism from the liver to the splanchnic bed is responsible for the splanchnic hyperemia observed in chronic portal hypertension. To investigate the possible role of such a feedback mechanism, we examined the chronological changes in both portal and systemic hemodynamics in rats after ligation of a major branch of the portal vein that supplies about 80% of the liver circulation. Rats submitted to sham surgery and portal vein-constricted rats were also studied. Blood flow and portal-systemic shunting were measured by radioactive microsphere techniques. For 7 days after portal-branch ligation, transient portal hypertension resulted from an elevated portal resistance. However, no significant changes in portal venous inflow or splanchnic arteriolar resistance were found in the portal branch-ligated rats, whereas in the portal vein-constricted rats significant hyperdynamic changes in these parameters were noted. On the other hand, transient hyperdynamic changes occurred in the systemic circulation during the period from the fourth to the sixth day after portal-branch ligation, similar to those observed in the portal vein-constricted rats. The lack of hyperdynamic changes in the portal territory of the portal branch-ligated rats suggests that the splanchnic hyperemia found in chronic portal-hypertensive states is unlikely to be caused by a feedback mechanism from the ischemic hepatic parenchyma.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1977

Evidence that decreased cardiac output is not the stimulus to sodium retention during acute constriction of the vena cava.

It has been proposed that the antinatriuresis during constriction of the TVC is due to a decrease in CO. We have compared the effect on sodium excretion of comparable reductions in CO by three separate methods: TVC constriction, PA occlusion, and LV infarction. Dogs were studied during 10% of body weight saline loading and again after TVC constriction, PA occlusion, or LV infarction. CO fell 26 to 31% in all groups; sodium excretion was not significantly altered after PA occlusion (474 to 533 micronEq/min.) or LV infarction (587 to 609 micronEq/min.) but fell significantly after TVC constriction (504 to 271 micronEq/min.). Renal and systemic hemodynamoderate reduction of CO per se does not cause sodium retention. PA and TVC dogs had comparable increments in vena caval pressure but opposite changes in RVEDP; 4 to 0.9 mm. Hg (TVC) and 0.5 to 9.1 mm. Hg (PA).

Animals↗
PubMed1996

[Constrictive pericarditis after cardiac surgery].

Constrictive pericarditis is a rare complication of cardiac surgery. Among 7851 patients who underwent cardiac surgery at Nantes University Hospital, postoperative constrictive pericarditis was diagnosed in 5 patients: 0.63%. All patients were men aged 49 to 77 years (mean 62.5) Four patients underwent coronary artery bypass graft surgery and one patient required mitral and aortic valve replacement. The mean time to onset of symptoms after the first operation was 21 months. The main clinical symptom was right ventricular failure. In all patients, the diagnosis was established by right catheterization which showed diastolic dip-plateau. A radical pericardectomy was performed in all but one of the patients, who was treated medically. Clinical signs resolved in all five patients. The diagnosis of constriction after cardiac-surgery is not easy, as the symptoms are non-specific. A symptomatic patient believed to have myocardial failure after cardiac-surgery could therefore actually instead have occult constriction.

Aged↗