Echocardiography in patients with constrictive pericarditis before and after pericardiectomy: Are there predictors of surgical outcome?
Fifteen patients with constrictive pericarditis were prospectively evaluated with echocardiography and Doppler recordings during respiratory monitoring. Eleven who agreed to surgery also underwent right heart catheterization and a repeat echocardiography with Doppler 10 days after pericardiectomy. Preoperatively, there was a significant inspiratory decrease in the mitral E wave (P < 0.05) and increase in the tricuspid E wave velocities (P < 0.05), which both normalized after pericardiectomy. The mitral deceleration times increased from 110 +/- 40 to 149 +/- 46 msec (P < 0.05) postoperatively. The preoperative hepatic vein velocities showed an accentuated systolic flow pattern. The systolic to diastolic ratio of the hepatic vein velocities was higher in patients who improved with surgery (1.42 +/- 0.31 vs 0.65 +/- 0.13) (P < 0.05). Postoperatively the diastolic flow became more pronounced. There was a 100% expiratory diastolic flow reversal in eight patients preoperatively, which normalized after pericardiectomy. Clinically these patients improved significantly postoperatively. Left atrial size, ejection fraction, and mitral and tricuspid filling velocities during respiratory monitoring could not predict surgical outcome. Pericardiectomy improved Doppler filling dynamics in all patients although this was not parallel to clinical improvement.
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
S L
SL
Tokgözoğlu
S
S
Kes
A
A
Oram
M
M
Demircin
I
I
Paşaoğlu
S
S
Uğurlu
D000328:Adult; D006328:Cardiac Catheterization; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome