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PubMedDate not supplied

[Diagnosis of constrictive pericarditis and restrictive cardiomyopathy by pulsed Doppler echocardiography].

Characteristics of flow through atrioventricular valves were analyzed by pulsed Doppler echocardiography (PDE) in 7 patients with either constrictive pericarditis or restrictive cardiomyopathy and 10 controls to determine the value of this technique in their differentiation. All patients were admitted with systemic venous congestion and underwent right and left heart catheterization. PDE variables considered included peak flow velocity (PV), acceleration time, peak velocity of the atrial component (PVA), PVA/PV quotient, duration of early diastolic fillings, deceleration of early diastolic filling, duration of diastolic flow and mean temporal velocity. Ventricular filling differed between patients and controls in that the former group was characterized by higher PV's, lower PVA's, higher deceleration and lower PVA/PV quotient. When we compared both patient groups we found a significant tendency toward higher PV's, faster deceleration and lower PVA/PV quotient in constrictive pericarditis.

Adult↗
PubMed1986

Effect of chemical sympathectomy on renal hydroelectrolytic handling in dogs with chronic caval constriction.

The effect of renal selective chemical sympathectomy by intrarenal infusion of 6-hydroxydopamine (6-OHDA, 5 mg/kg body weight) on the renal excretion of water and electrolytes was studied in 7 dogs in whom a syndrome of sodium and water retention and ascites formation was induced by partial constriction of thoracic inferior vena cava. Propranolol (1 mg) and phentolamine (3 mg) were also injected to obviate acute systemic hemodynamic changes. Sympathectomy was performed once in 4 dogs and three times in 3 dogs. Sympathectomy induced an abrupt and transient increase in urinary flow (from 170 +/- 30 to 890 +/- 60 ml/24 h) and sodium excretion (from 4.5 +/- 1.5 to 178 +/- 21 mEq/24 h). This was accompanied by an important fall in plasma renin activity (from 2.2 +/- 0.2 to 0.5 +/- 0.1 ng angiotensin I/ml/h) and aldosterone, and disappearance of ascites. It is concluded that chemical sympathectomy, by increasing renal sodium and water excretion, mobilizes the ascites induced by chronic caval constriction, a fact that highlights the role of the renal sympathetic system in the pathogenesis of sodium and water retention by the kidney.

Aldosterone↗
PubMedDate not supplied

Constrictive pericarditis following coronary bypass reoperation. Fibrotic pericardium and a foreign body reaction.

A 65-year-old male patient underwent two bypass operations because of coronary artery disease. After the second operation he developed congestive heart failure with breathlessness, ankle swelling, hepatomegaly and poor exercise tolerance. Echocardiographic and haemodynamic findings were characteristic of constrictive pericarditis. Pericardiectomy was performed three months after the second operation. The retrosternal space was replaced with fibrotic, patchy hyalinic tissue, and the pericardium was thick and rigid. Histologically, the thickened pericardium showed dense fibrosis and foreign-body granulomas with large multinuclear giant cells and irregular crystals. This report indicates that foreign body reaction following coronary artery bypass operation may result in constrictive pericarditis with severe heart failure.

Aged↗
PubMed1986

Regional and global myocardial function in the dog when nitrous oxide is added to halothane in the presence of critical coronary artery constriction.

The effect of substituting 66% nitrous oxide for nitrogen on global and regional myocardial function before and after critical constriction of the left anterior descending coronary artery (LAD) was studied in six open-chested dogs anesthetized with 1% halothane (inspired). Regional myocardial function was measured in the region of the LAD and in the region of the left circumflex artery using sonomicrometry, and LAD blood flow was measured. Administration of nitrous oxide produced moderate depression of global performance. Regional shortening in both myocardial segments was reduced, and dysfunction also appeared in the LAD segment. This dysfunction was observed in the presence of both normal coronary blood flow, and after critical constriction. The appearance of dysfunction when coronary blood flow was unimpaired suggests that ischemia may not be the only cause of regional myocardial dysfunction.

Animals↗
PubMedDate not supplied

[Phonomechanocardiography of constrictive pericarditis].

There were studied 19 constrictive pericarditis cases demonstrated by anatomist study. It was evident, at all of them, systemic veiny hypertension's syndrome. "Extinguished" cardiac noises and "quiet" heart only appeared at the 42% of the cases. 73% of patients were found with important incapacity. Lyan's pericardic protodiastolic crack was registered at the 75% of the cases and only at 2 cases (10.9%) it was found reinforcement of pulmonary noise II. It is agree with the haemodynamic discovery of pulmonary pression's light elevation. Characteristically, precordiogrammes showed great "A" wave, and it was agree with telediastolic pression's elevation of the two ventricles obtained by catheterism. Phlebogramme was characteristic of systemic veiny hypertension by impediment of ventricular filled at all the studied cases. Measurement of cardiac cycle's phases showed diminution at PE, Blumberger's intrasystolic quotient, left expulsion fraction (Carrard's method) and ventricular pression's elevation middle velocity (VPEMV). By the contrary Weissler's index was found elevated. Eventhough found ciphers could be considered like bordering normal values, there is a difference statistically significance in relation with the values that were found in sane subjects. These discoveries were interpreted in the base that the patient's heart with constrictive pericarditis acts at the curve's ascendent part of the ventricular function because it has incapacity to utilize Starling's mechanism. Process' chronicity produces myocardic atrophy by "discuss" and, by this, ventricular function's improvement can be no immediate to pericardiectomy. Apexcardiogramme shows the impedement to ventricular filled with its diastolic morphology which is very similar to intracavitary pression's curve ("square root's image"). It is postuled the hypothesis that these sicks do not develop important pulmonary hypertension, because right ventricle's poor diastolic distension impides generation of major expense and systolic pression and, by other side, the impedement to ventricular filled has repercussion over right auricle and systemic veiny territory much more distensible, with the known clinical consequences.

Adolescent↗
PubMed1978

Fetal death secondary to constriction and torsion of the umbilical cord.

Constriction and torsion of the umbilical cord is a cause of fetal death that is seldom noted. A stillborn fetus with these changes is described. The literature is reviewed. A localized absence of Wharton's jelly in the involved area of the cord is believed to be the etiologic factor in the constriction and subsequent torsion.

Adult↗
PubMed1977

Role of the baroreceptor reflex in the early phases after removing the renal artery constriction in conscious renal hypertensive rats.

Hemodynamic studies in unanesthetized rats with chronic one-kidney-Goldblatt hypertension showed a 25% increase in cardiac output and a 42% increase in peripheral resistance. Removal of renal artery constriction under either anesthesia and minor surgical trauma produced an immediate 20% drop in arterial pressure. At the end of the 6 observation period the pressure dropped 30% but still remained at a moderate hypertensive level. The hemodynamic measurement at that time suggested that the pressure drop was the result of a decrease in cardiac output. However, the data obtained 1 hour after removal of the constriction suggested that a vasodilating mechanism may also contribute to pressure normalization in the early phase of reversal of renal hypertension. In the sham-operated hypertensive rats the pressure remained unchanged, while the cardiac output dropped due to compensation by a proportional increase in peripheral resistance. In contrast, in the unclipped animals the same drop in cardiac output produced an equivalent fall in pressure because no change in peripheral resistance occurred. This was not due to an insufficiency of the baroreceptor reflex since bilateral splanchnicectomy performed at that time produced a striking hypotensive response, indicating an overactivity of the sympathetic system possibly due to the baroreceptor still reset to operate at a hypertensive level.

Animals↗
PubMed1983

[Secondary neoplastic subacute constrictive pericarditis disclosing a bronchial cancer].

In a fifty-three-year-old man, constrictive metastatic carcinoma of the pericardium revealed a bronchial carcinoma. The subacute course was rapidly progressive. Only partial pericardiectomy could be performed. Death occurred 16 days after the peripheral signs of compression of the heart became patent. In such cases early diagnosis, before signs of constrictive pericarditis become obvious, is very important.

Adenocarcinoma↗
PubMed1983

[Purulent pericarditis with a subacute constrictive course. Apropos of a case. Review of the literature].

A case of purulent pericarditis due to Hemophilus influenzae is reported. In spite of management by antibiotics and pericardial drainage, the disease ran a subacute course towards pericardial constriction. Fifty-two previously reported cases are reviewed. The most important clinical and paraclinical features are analyzed. Emphasis is put on the factors which promote subacute pericardial constriction.

Anti-Bacterial Agents↗
PubMed1984

[Differential diagnosis between constrictive pericarditis and cardiac amyloidosis by computerized M-mode echocardiography].

A diastole is a non specific haemodynamic syndrome which may result from constrictive pericarditis or from a restrictive cardiomyopathy. The aim of this study was to differentiate these two types of condition by analysis of computerised M mode recordings of the left ventricle. Three groups of patients were studied: 5 cases of confirmed cardiac amyloidosis (Am); 5 cases of constrictive pericarditis confirmed surgically (CP) and 10 normal subjects (NL). The study was based on analysis of parameters of ventricular filling and of diastolic thinning of the LV free wall. A significant difference was observed between AM and CP but not between PC and NL. Amyloidosis was characterised by a reduction in the maximum velocity of endocavitary diameter lengthening (AM 0,84 +/- 0,56 cir/sec; PC 3,95 +/- 0,77, p less than 0,01), prolongation of the rapid filling phase (AM 0,42 +/- 0,17 sec; PC 0,16 +/- 0,06 sec, p less than 0,02) and a decrease in maximum velocity of free wall thinning (AM 0,45 +/- 0,23 th/syst/sec; PC 4,79 +/- 2,1, p less than 0,01). The diastolic thickness of the free wall was greater in the amyloidosis group (AM 1,73 +/- 0,61 cm; PC 1,05 +/- 0,21, p less than 0,05) and correlated with the reduction of maximum velocity of free wall thinning. Parameters of global diastolic filling did not distinguish the two conditions. The M mode recordings were therefore digitalised to provide graphs of chamber filling and wall thinning and their derivatives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Recurrent cardiac constriction after pericardiectomy.

Dependent edema, ascites, and exertional dyspnea developed in a patient seven months after pericardiectomy for constrictive pericarditis. Cardiac catheterization documented constrictive physiology. At the second operation, he was found to have extensive mediastinal fibrosis that encased the heart. Postmortem examination showed a fibrocartilagenous exoskeleton that encased both ventricles. Possible etiologies for this unusual reconstriction are discussed.

Aged↗
PubMed1984

Gallium-67 citrate localization in the heart secondary to constrictive pericarditis with myocardial fibrosis.

Scintigraphy has demonstrated gallium-67 accumulation within the heart in pericarditis and cardiomyopathies of various kinds. We present a case report of a 63-yr-old man with multisystem disease who showed extensive myocardial uptake of Ga-67 by scintigraphy. At autopsy, constrictive pericarditis with myocardial fibrosis was found. Gallium-67 localization has not been documented previously in myocardial fibrosis accompanying constrictive pericarditis.

Cardiomyopathies↗
PubMedDate not supplied

Total pericardiectomy for chronic constrictive pericarditis using femoro-femoral bypass.

A technique of total pericardiectomy for chronic constrictive pericarditis is presented. The authors have used a femoro-femoral cardiopulmonary bypass in nine cases of constrictive pericarditis to prevent the complications of the traditional approach. The advantages of this technique in comparison to the performance of pericardiectomy without the use of extracorporeal circulation (ECC) or with standard ECC are discussed.

Cardiopulmonary Bypass↗
PubMed1982

Acute renal artery constriction increases renal prostaglandin I2 biosynthesis and renin release in the conscious dog.

The relationship between renal prostaglandin (PG)I2 biosynthesis and renin release was examined in conscious dogs before and during renal artery constriction. Dogs were chronically instrumented with femoral vein, femoral artery and left renal vein catheters and an inflatable cuff and electromagnetic flow probe were positioned on the left renal artery. After 2 days, mean arterial blood pressure, heart rate, renal blood flow and renal secretion rates of renin and 6-keto-PGF1 alpha were determined before and 10 min after a reduction in renal blood flow. Plasma levels of 6-keto-PGF1 alpha, measured by a gas chromatographic-mass spectrometric assay, were used as an index of PGI2 synthesis. A 38% reduction in renal blood flow did not significantly alter mean arterial blood pressure, heart rate or arterial levels of plasma renin activity or 6-keto-PGF1 alpha. In contrast, renal artery constriction increased renal venous plasma levels of both renin activity and 6-keto-PGF1 alpha by 308% (P less than .002) and 132% (P less than .05), respectively. As a consequence, the renal secretion rate of renin was increased from 80 +/- 40 to 917 +/- 231 ng of angiotensin I . min-1 . hr-1 (P less than .02) and the renal secretion rate of 6-keto-PGF1 alpha was increased from -2.1 +/- 1.1 to 9.0 +/- 3.6 ng/min (P less than .05). In addition, there was a significant correlation between the renal secretion rates of renin and 6-keto-PGF1 alpha (r = 0.688; P less than .013; n = 12). These data indicate a close association between the renal biosynthesis and PGI2 and renin release and are consistent with the concept that PGI2 participates in the release of renin.

6-Ketoprostaglandin F1 alpha↗
PubMed1978

[Circulatory insufficiency and edema in experimental constriction of the thoracic segment of the vena cava inferior].

A method for reproducing circulatory insufficiency in rats by constriction of the intra thoracic portion of vena cava inferior is described. A sham operation on the control animals was restricted to thoracotomy. Rats which had been subjected to constriction of the vena cava consumed 0.85% sodium chloride solution intensively under conditions of free choice. This lead to rapid increase in mass with the development of subcutaneous edema, hydrothorax, and ascites within two to three days after the operation. Thinned out muscle fibres with decreased SDH activity were found in the myocardium of the both ventricles. Study of THO, 22Na, 36Cl, and thiocyanate distribution spaces showed that the total body water increase was consequent upon growth of the extracellular space with a constant intracellular volume.

Animals↗
PubMed1981

Chronic constrictive pericarditis in children - etiology, clinical picture and treatment. A report of 20 cases.

Twenty children with constrictive pericarditis are reported on. Tuberculous etiology was established in five, could not be excluded in 7, while the etiology could not be identified in 8 cases. The main symptoms were venous congestion involving the pulmonary and systemic circulation (hepatomegaly, pulmonary congestion), pericardial click at the apex, abnormalities of repolarization in the ECG. X-ray evidence of pericardial calcification and a "quiet heart" were occasionally found. Hypoproteinaemia, hypalbuminaemia and ascites, signs of an associated protein losing enteropathy may occur in constrictive pericarditis, but are not invariably present. Pericardiectomy is the most adequate form of treatment. Sixteen of the 17 cases in whom the operation was performed recovered completely; one child died.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of constrictive pericarditis and life-threatening pericardic effusions (author's transl)].

Total excision of both pericardic sac and epicardium is the basic surgical procedure for chronic constrictive pericarditis. Approach being through a vertical sternotomy. In case of either cardiac injury or poor haemodynamic of either cardiac injury or poor haemodynamic conditions, it is sometimes indicated to get help from an extracorporal circulation with femoro-femoral shunt. Surgery for acute pericarditis may vary according to local and general conditions. As soon as a pericardic effusion, whether or not infected, has occurred, drainage by means of an infraxiphoid incision seems to be a safe method. Where pericardic effusions relapse or densify to a constrictive pericarditis, pericardectomy is to be considered. Total pericardectomy is therefore regarded as the best procedure to prevent further disease.

Cardiac Tamponade↗