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Prognostic predictors in pericardiectomy for chronic constrictive pericarditis

Se Hun Kang1, Jong-Min Song1, Minsoo Kim1

  • 1Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

The Journal of Thoracic and Cardiovascular Surgery
|February 6, 2013
PubMed

Insights

High early diastolic mitral inflow velocity and diabetes mellitus predict poor prognosis after pericardiectomy for constrictive pericarditis. Echocardiography can help identify high-risk patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • Prognosis following pericardiectomy for constrictive pericarditis is not well-defined, particularly in Asian populations.
  • Causes of constrictive pericarditis vary geographically, necessitating region-specific prognostic factor identification.

Purpose of the Study:

  • To identify preoperative prognostic factors and clinical outcomes in patients undergoing pericardiectomy for chronic constrictive pericarditis.
  • To evaluate the utility of Doppler echocardiography in predicting outcomes after pericardiectomy.

Main Methods:

  • Retrospective analysis of 85 patients with chronic constrictive pericarditis undergoing pericardiectomy.
  • Evaluation of preoperative clinical, imaging, and echocardiographic data.
  • Follow-up for all-cause mortality over a median of 38.5 months.

Main Results:

  • Fifteen patients (17.6%) died during follow-up.
  • Higher aspartate aminotransferase, smaller left ventricular end-systolic dimension index, and higher early diastolic mitral inflow velocity were observed in non-survivors.
  • Diabetes mellitus (HR 4.610) and high early diastolic mitral inflow velocity (HR 1.050/cm/s) were independent predictors of mortality.

Conclusions:

  • Preoperative high early diastolic mitral inflow velocity and diabetes mellitus are associated with poor prognosis after pericardiectomy.
  • Doppler echocardiography, specifically early diastolic mitral inflow velocity, is valuable for predicting mortality risk in these patients.
  • These findings aid in risk stratification and patient management before pericardiectomy.
Abstract

Keywords:
32AFBCPCTCVPIVCLVacid-fast bacillicentral venous pressurecomputed tomographyconstrictive pericarditisinferior vena cavaleft ventricular

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