CARDIAC-TAMPONADE IN LEFT-VENTRICULAR DYSFUNCTION

被引:40
作者
HOIT, BD
GABEL, M
FOWLER, NO
机构
[1] University of Cincinnati, Medical Center, Division of Cardiology, Cincinnati, OH
[2] University of Cincinnati, Medical Center, Division of Cardiology, Cincinnati, OH 45267
关键词
Cardiac tamponade; Echocardiography; Left ventricular dysfunction;
D O I
10.1161/01.CIR.82.4.1370
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Echocardiographic and hemodynamic data were measured in closed-chest dogs during graded cardiac tamponade (pericardial pressure 5,10, and 15 mm Hg) before and after production of diffuse ischemic left ventricular dysfunction. Left ventricular dysfunction was produced by intracoronary injection of nonradioactive microspheres (54±3.9 mm diameter). Changes in left atrial pressure with cardiac tamponade were influenced by coexisting left ventricular dysfunction. Left atrial pressure increased with tamponade and was equal to pericardial pressure before left ventricular dysfunction was produced. However, after left ventricular dysfunction was produced, left atrial pressure was significantly higher than pericardial pressure before tamponade, but it fell toward pericardial pressure when tamponade was produced. Pulsus paradoxus (>10 mm Hg) was present in all animals with cardiac tamponade before left ventricular dysfunction but in only one animal afterward. During each level of tamponade, the inspiratory fall of aortic systolic pressure was greater before than with left ventricular dysfunction. The slope of the linear regression between pericardial pressure and millimeters of mercury of inspiratory fall in aortic systolic pressure was significantly greater before than with left ventricular dysfunction (0.74±0.12 versus 0.32±0.12, p<0.05). Left ventricular dysfunction caused a leftward and upward shift of the pericardial pressure-volume relation. As a result, right atrial and ventricular collapse occurred with significantly smaller volumes of pericardial fluid after than before left ventricular dysfunction. We conclude that pulsus paradoxus may be absent in cardiac tamponade with coexisting left ventricular dysfunction and unequal filling pressures. Echocardiographic signs of cardiac tamponade may occur with small effusions in the presence of left ventricular dysfunction.
引用
收藏
页码:1370 / 1376
页数:7
相关论文
共 20 条
  • [1] A TRANSDUCER FOR RECORDING INSTANTANEOUS RESPIRATORY WAVEFORMS IN ANIMALS AND MAN
    ADOLPH, RJ
    FROMMER, JC
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1966, 21 (02) : 737 - +
  • [2] [Anonymous], 1971, STAT PRINCIPLES EXPT
  • [3] LOW-PRESSURE CARDIAC-TAMPONADE
    ANTMAN, EM
    CARGILL, V
    GROSSMAN, W
    [J]. ANNALS OF INTERNAL MEDICINE, 1979, 91 (03) : 403 - 406
  • [4] THE SHIFT IN THE RELATIONSHIP BETWEEN INTRAPERICARDIAL FLUID PRESSURE AND VOLUME INDUCED BY ACUTE LEFT-VENTRICULAR PRESSURE OVERLOAD DURING CARDIAC-TAMPONADE
    COGSWELL, TL
    BERNATH, GA
    KEELAN, MH
    WANN, LS
    KLOPFENSTEIN, HS
    [J]. CIRCULATION, 1986, 74 (01) : 173 - 180
  • [5] ABSENCE OF PULSUS PARADOXUS IN A PATIENT WITH CARDIAC-TAMPONADE AND COEXISTING PULMONARY-ARTERY OBSTRUCTION
    CUNNINGHAM, MJ
    SAFIAN, RD
    COME, PC
    LORELL, BH
    [J]. AMERICAN JOURNAL OF MEDICINE, 1987, 83 (05) : 973 - 976
  • [6] PULSUS PARADOXUS - DEFINITION AND RELATION TO THE SEVERITY OF CARDIAC-TAMPONADE
    CURTISS, EI
    REDDY, PS
    URETSKY, BF
    CECCHETTI, AA
    [J]. AMERICAN HEART JOURNAL, 1988, 115 (02) : 391 - 398
  • [7] FRIEDMAN HS, 1980, J THORAC CARDIOV SUR, V79, P74
  • [8] HYDRODYNAMIC COMPRESSION OF THE RIGHT ATRIUM - A NEW ECHOCARDIOGRAPHIC SIGN OF CARDIAC-TAMPONADE
    GILLAM, LD
    GUYER, DE
    GIBSON, TC
    KING, ME
    MARSHALL, JE
    WEYMAN, AE
    [J]. CIRCULATION, 1983, 68 (02) : 294 - 301
  • [9] CARDIAC-TAMPONADE IN MEDICAL PATIENTS
    GUBERMAN, BA
    FOWLER, NO
    ENGEL, PJ
    GUERON, M
    ALLEN, JM
    [J]. CIRCULATION, 1981, 64 (03) : 633 - 640
  • [10] THE RELATIVE MERITS OF PULSUS PARADOXUS AND RIGHT VENTRICULAR DIASTOLIC COLLAPSE IN THE EARLY DETECTION OF CARDIAC-TAMPONADE - AN EXPERIMENTAL ECHOCARDIOGRAPHIC STUDY
    KLOPFENSTEIN, HS
    SCHUCHARD, GH
    WANN, LS
    PALMER, TE
    HARTZ, AJ
    GROSS, CM
    SINGH, S
    BROOKS, HL
    [J]. CIRCULATION, 1985, 71 (04) : 829 - 833