Long-Term Effects of Pericardiectomy on Left Ventricular Mechanics Evaluated by Using Speckle Tracking Echocardiography in Patients with Constrictive Pericarditis

Ultrasound Med Biol. 2016 Feb;42(2):421-9. doi: 10.1016/j.ultrasmedbio.2015.10.025. Epub 2015 Nov 30.

Abstract

The aim of this study was to evaluate long-term changes in left ventricular (LV) mechanics after pericardiectomy in patients with constrictive pericarditis (CP) and to correlate post-operative LV mechanics with clinical status. A total of 24 patients with CP underwent serial speckle tracking echocardiography 1 wk before and 1, 6 and 12 mo after pericardiectomy. Global LV longitudinal, circumferential and radial strains, along with LV twist, were measured. Twenty-three healthy volunteers were served as control patients. Although global LV longitudinal, circumferential and radial strains obtained 6 mo after pericardiectomy increased compared with those for pre-pericardiectomy, they were still significantly lower than those for control patients. Further improvements occurred over time with normalization of global LV longitudinal and radial strains 12 mo after pericardiectomy, but global circumferential strain obtained 12 mo after pericardiectomy was still lower than that for control patients. LV twist remained unchanged after pericardiectomy. In addition, the improvements in global LV circumferential strain after pericardiectomy were associated with improvements in clinical symptoms (p < 0.001). These findings suggest that the global LV circumferential strain may be a promising parameter in the evaluation of the effectiveness of pericardiectomy.

Keywords: Constrictive pericarditis; Left ventricular function; Pericardiectomy; Speckle tracking echocardiography; Strain.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Echocardiography / methods
  • Elastic Modulus
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pericardiectomy / adverse effects*
  • Pericarditis, Constrictive / complications
  • Pericarditis, Constrictive / diagnostic imaging
  • Pericarditis, Constrictive / surgery*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology*