Abstract 17756: Do Biventricular Mechanics in Transient Constrictive Pericarditis Improve After Medical Therapy?

Abstract

Introduction: Reversible constrictive pericarditis (CP) has been described with resolution of constriction after treatment with anti-inflammatory medications. In our study, we assessed the improvement of biventricular myocardial strain in CP patients treated medically compared to CP patients who underwent pericardiectomy. Methods and Results: We compared myocardial mechanics by 2-dimensional speckle tracking in 16 CP patients (age: 56±13; 75% males) who received anti-inflammatory medications to an age and sex matched CP group (age: 57±12; 75% males) who underwent pericardiectomy. At baseline, both treatment groups had depressed left ventricular (LV) anterolateral wall strain (LWS) and right ventricular (RV) free wall longitudinal systolic strain (FWS) but preserved LV septal wall systolic strain (SWS). In a median follow-up of 150 days the medically treated patients showed improvement of the depressed LVLWS/LVSWS (Pre: 0.61±0.17, Post: 0.89±0.21;P<0.001) and a trend in RVFWS/LVSWS (Pre:0.66±0.45, Post:0.89±0.38;P=0.12), that is similar to the improvement of the depressed LVLWS/LVSWS (Pre: 0.85±0.12, Post: 0.92±0.1;P<0.05) and trend in RVFWS/LVSWS (Pre: 0.77±0.32, Post: 0.86±0.18;P=0.09) of post pericardiectomy patients at a median follow-up of 74 days. Conclusions: Biventricular myocardial strain imaging is a robust technique for assessment of response to anti-inflammatory therapy in CP patients. Medical treatment of CP leads to systolic strain improvement that is more pronounced in the LV and RV free walls, hence having similar impact on the biventricular myocardial mechanics as pericardiectomy.