title: Effects of pericardiectomy on early diastolic mitral annular velocity in patients with constrictive pericarditis.
abstract: BACKGROUND
  In patients with constrictive pericarditis (CP), early diastolic mitral annular velocity (E') is usually normal or exaggerated due to limitation of lateral expansion by the constricting pericardium. Although pericardiectomy is the treatment of choice for CP, it is difficult to evaluate its effectiveness. Theoretically, E' may decrease after successful pericardiectomy. However, little data are available regarding the effect of pericardiectomy on E'. The purpose of this study was to assess the change in E' after pericardiectomy in patients with CP.
  
  
  METHODS
  We studied 16 patients (12 males, mean age 62.3+/-7.0 years) with surgically confirmed CP for changes in pre-discharge Doppler parameters following pericardiectomy. CP was secondary to previous cardiac surgery in 4 patients, tuberculosis in 4 patients, radiation-induced in 1 patient, and idiopathic in 7 patients. Ten patients underwent complete pericardiectomy (62.5%). E' was measured at the septal annulus before pericardiectomy and a mean duration of 10 (+/-6) days after.
  
  
  RESULTS
  E' significantly decreased from 9.2+/-2.7 cm/s to 7.4+/-2.6 after pericardiectomy (p=0.013). The mean percent change of E' after pericardiectomy was 17.9+/-25.9%. The decrement of E' was significantly higher in patients with complete pericardiectomy than in patients who underwent a partial pericardiectomy (2.7+/-2.3 vs. 0.4+/-2.1, p=0.042). Also, more than 15% decrease of E' was significantly higher in patients with improvement of symptom after pericardiectomy (9 (100.0%) vs. 3 (42.9%), p=0.019).
  
  
  CONCLUSIONS
  E' decreased following pericardiectomy in most of the patients with CP. The change of E' after pericardiectomy may be useful in evaluating the effectiveness of pericardiectomy.
authors.affiliation: Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Shinchon-dong, Seoul, South Korea.
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Eui
authors.initials: E
authors.lastname: Im
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Yun-Hyeong
authors.initials: YH
authors.lastname: Cho
authors.forename: Jin-Mi
authors.initials: JM
authors.lastname: Kim
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.forename: Young Nam
authors.initials: YN
authors.lastname: Yoon
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Chang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D016009:Chi-Square Distribution; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D010494:Pericarditis, Constrictive / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome