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Echocardiography with Elevated Central Venous Pressure Diagnosing Constrictive Pericarditis More Accurately Than
Liwen Bao1, Jiechun Huang1, Fangrui Wang1
1Department of Cardiothoracic surgery, Huashan Hospital of Fudan University, 12th Wulumuqi Road, Shanghai, 200040, PR, China.
Insights
Constrictive pericarditis diagnosis is often delayed. Early detection and surgical treatment, like pericardiectomy, significantly improve cardiac function and quality of life for patients.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Constrictive pericarditis (CP) involves impaired diastolic function due to a thickened, calcified pericardium.
- The study focuses on clinical characteristics, diagnostic timelines, and prognosis following pericardiectomy for CP.
Purpose of the Study:
- To assess clinical features, time to diagnosis, and outcomes of constrictive pericarditis patients undergoing pericardiectomy.
- To evaluate the effectiveness of pericardiectomy in restoring cardiac function and quality of life.
Main Methods:
- Retrospective analysis of 36 constrictive pericarditis patients who underwent pericardiectomy (2012-2015).
- Evaluation of clinical manifestations, diagnostic imaging, laboratory parameters, and post-operative quality of life using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
Main Results:
- All patients presented with shortness of breath, polyserous effusion, elevated pro-BNP, and thickened pericardium.
- Mean diagnostic delay was 9.5 months; pericardiectomy occurred within one week of diagnosis.
- Post-surgery, central venous pressure significantly decreased (19.92 to 8.5 mmHg), and patients maintained good quality of life (MLHFQ score 0.9).
Conclusions:
- Constrictive pericarditis diagnosis is frequently delayed after symptom onset.
- Early diagnosis via echocardiography and elevated central venous pressure, followed by timely pericardiectomy, is crucial for improved prognosis and cardiac function recovery.
Background:
Constrictive pericarditis (CP) is defined as impaired diastolic cardiac function caused by a calcified and thickened pericardium. We assessed the clinical characteristics and time to diagnosis, as well as patient prognosis after pericardiectomy. Methods: We analyzed the records of 36 CP patients who underwent pericardiectomy at Huashan Hospital, China, between 2012 and 2015. Clinical manifestations, length of time to diagnosis, laboratory parameters, and diagnostic imaging results were examined. All patients underwent pericardiectomy, and were assessed post-operatively for quality of life and improvement of cardiac function using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results: All patients displayed shortness of breath and polyserous effusion, as well as elevated pro B-type natriuretic peptide and thickened pericardium. Mean time between onset of symptoms and a definitive diagnosis of CP was 9.5 ± 2.1 months. Pericardiectomy was performed within one week of diagnosis. Mean central venous pressure decreased from a pre-operative 19.92 ± 6.6 mmHg to a post-operative 8.5 ± 2.7 mmHg. Within 1.5 ± 0.7 years of surgery, all patients maintained good quality of life and cardiac function, which resulted in a mean score of 0.9 ± 0.6 on the MLHFQ. Conclusion: A definitive diagnosis of CP is usually made long after the onset of symptoms. Early detection and diagnosis by echocardiography with elevated central venous pressure and early treatment by surgery are key to an improved prognosis and resumption of good cardiac function.
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