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Mitral and tricuspid annular velocities before and after pericardiectomy in patients with constrictive pericarditis

Gabriella Veress1, Lieng H Ling, Kye-Hun Kim

  • 1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.

Circulation. Cardiovascular Imaging
|May 6, 2011
PubMed

Insights

Mitral annulus early diastolic (e’) velocity is altered in constrictive pericarditis (CP). Echocardiography before and after pericardiectomy showed reduced annular velocities post-surgery, with normalization of the mitral lateral/medial e

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Physiology

Background:

  • Mitral annulus early diastolic (e') velocity differs between constrictive pericarditis (CP) and restrictive cardiomyopathy.
  • Previous studies lacked comprehensive evaluation of mitral and tricuspid annular velocities before and after pericardiectomy.

Purpose of the Study:

  • To comprehensively evaluate mitral and tricuspid annular velocities before and after pericardiectomy in patients with CP.
  • To assess changes in annular velocities and the mitral lateral/medial e' ratio following pericardiectomy.

Main Methods:

  • Comprehensive echocardiography performed on 99 patients with CP (52 primary, 47 secondary) before and after pericardiectomy.
  • Analysis of mitral medial, mitral lateral, and tricuspid lateral early diastolic (e') and systolic (s') velocities.
  • Comparison of pre- and post-pericardiectomy annular velocities and the mitral lateral/medial e' ratio between primary and secondary CP.

Main Results:

  • Before pericardiectomy, mitral medial e' was equal to or greater than mitral lateral e' in 74% of cases.
  • Significant differences in annular velocities (except tricuspid s') were observed between primary and secondary CP.
  • After pericardiectomy, all annular velocities significantly decreased, with a greater reduction in medial e' velocity compared to lateral e', leading to normalization of the mitral lateral/medial e' ratio.

Conclusions:

  • The mitral lateral/medial e' ratio is reversed in a majority of CP patients.
  • Secondary CP exhibits lower annular velocities compared to primary CP pre-pericardiectomy.
  • Pericardiectomy results in a reduction of all annular velocities and normalization of the mitral lateral/medial e' ratio.
Abstract

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