title: Mitral and tricuspid annular velocities before and after pericardiectomy in patients with constrictive pericarditis.
abstract: BACKGROUND
  Previous studies have demonstrated that mitral annulus early diastolic (e') velocity is increased in constrictive pericarditis (CP) and reduced in restrictive cardiomyopathy. However, those studies did not comprehensively evaluate mitral and tricuspid annular velocities before and after pericardiectomy.
  
  
  RESULTS
  We performed comprehensive echocardiography before and after pericardiectomy in 99 patients with CP, 52 with primary (idiopathic or postpericarditis etiology) and 47 with secondary CP (due to surgery or radiation). Overall, mean ± SD mitral medial, mitral lateral, and tricuspid lateral e' velocities were 12.2 ± 4.2, 10.0 ± 5.4, and 11.6 ± 3.5 cm/s, respectively; annular late diastolic velocities were 10.3 ± 4.3, 12.2 ± 4.9, and 11.7 ± 5.4 cm/s, respectively; and annular systolic (s') velocities were 7.8 ± 2.8, 8.2 ± 2.1, and 11.2 ± 3.8 cm/s, respectively. Medial e' was equal to or greater than mitral lateral e' in 74% of analyzable cases. With the exception of tricuspid s', there were significant differences in all s' and e'velocities between primary and secondary CP before pericardiectomy. After pericardiectomy, all annular velocities decreased significantly (P < 0.02 for all comparisons). The reduction in medial e' velocity was greater than that of mitral lateral e' velocity (P < 0.0001 and P = 0.0004, respectively), and the mitral lateral/medial e' ratio normalized (P = 0.0002).
  
  
  CONCLUSIONS
  The mitral lateral/medial e' ratio is reversed in three fourths of patients with CP. All annular velocities are lower in secondary compared to primary CP before pericardiectomy. After pericardiectomy, there is reduction of all annular velocities and normalization of the mitral lateral/medial e' ratio.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Veress
authors.forename: Lieng H
authors.initials: LH
authors.lastname: Ling
authors.forename: Kye-Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Dal-Bianco
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
authors.forename: Raul E
authors.initials: RE
authors.lastname: Espinosa
authors.forename: Rowlens M
authors.initials: RM
authors.lastname: Melduni
authors.forename: Jamil A
authors.initials: JA
authors.lastname: Tajik
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
mesh_terms: D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*