Abstract
Background: This study was designed to prospectively evaluate the changes in tissue Doppler imaging (TDI) at mitral and tricuspid annuli and two dimensional speckle tracking echocardiography in patients undergoing pericardiectomy for chronic constrictive pericarditis and identify the relationship if any of the tissue Doppler imaging and speckle echocardiographic derived variables with patient’s symptomatic status following surgery. Patients and Methods: Twelve patients undergoing pericardiectomy for constrictive pericarditis aged 7 years to 70 years (median 21; IQR: 19.75-26.5 years) were studied for 2-36 months (median 19 months). They underwent Doppler flow velocity, TDI, and 2D-speckle echocardiographic studies. Friedman’ test was used to test the changes in TDI-derived mitral and tricuspid annular velocities and speckle derived parameters in postoperative period from baseline. Results: Despite congestive heart failure, all patients had normal left ventricular ejection fraction and increased medial mitral and tricuspid early diastolic septal velocity (e¢) with “annulus reversus”. This pattern of annular velocity improved maximally in the immediate postoperative period. At closing interval, 2 (16.7%) patients continued to be in New York Heart Association class II and both of them continued to remain in atrial fibrillation. There was statistical significant improvement in the Global cirumferential strain than in global longitudinal and global radial strain after pericardiectomy. Conclusions: We conclude that tissue Doppler imaging and speckle tracking echocardiography are useful investigative modalities for serial evaluation of patients undergoing pericardiectomy. It can be performed serially with a high degree of reproducibility.
Highlights
IntroductionJ Clinical Cardiology and Cardiovascular Interventions heterogeneous disease and some patients have concomitant myocarditis or myocardial fibrosis
Pericardiectomy is usually the only accepted curative treatment for constrictive pericarditis and several studies including ourselves have shown its efficacy in improving symptoms with normalization of hemodynamics in the majority of cases. [1,2,3,4,5,6,7]the outcome after pericardiectomy is variable for multifactorial reasons. [6,7] This could be because constrictive pericarditis is a Auctores Publishing – Volume 4(2)-114 www.auctoresonline.org ISSN: 2641-0419J Clinical Cardiology and Cardiovascular Interventions heterogeneous disease and some patients have concomitant myocarditis or myocardial fibrosis
The outcome after pericardiectomy is variable for multifactorial reasons. [6,7] This could be because constrictive pericarditis is a Auctores Publishing – Volume 4(2)-114 www.auctoresonline.org
Summary
J Clinical Cardiology and Cardiovascular Interventions heterogeneous disease and some patients have concomitant myocarditis or myocardial fibrosis. Another reason could be due to incomplete pericardiectomy due to its severity and calcification. This study was designed to prospectively evaluate the changes in tissue Doppler imaging (TDI) at mitral and tricuspid annuli and two dimensional speckle tracking echocardiography in patients undergoing pericardiectomy for chronic constrictive pericarditis and identify the relationship if any of the tissue Doppler imaging and speckle echocardiographic derived variables with patient’s symptomatic status following surgery
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