Prognostic importance of mitral e' velocity in constrictive pericarditis

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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

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Jeong Hoon Yang1,2, William R Miranda1, Rick A Nishimura1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

European Heart Journal. Cardiovascular Imaging
|June 10, 2020
PubMed

Insights

Increased medial mitral annulus early diastolic velocity (e') predicts better outcomes in constrictive pericarditis (CP) patients after pericardiectomy. Higher e' velocity indicates improved long-term survival following this surgical procedure for CP.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Surgery

Background:

  • Medial mitral annulus early diastolic velocity (e") is a key echocardiographic marker in constrictive pericarditis (CP).
  • Mitral e" velocity also reflects underlying myocardial disease, impacting patient prognosis.
  • Pericardiectomy is a surgical intervention for advanced CP.

Purpose of the Study:

  • To evaluate the prognostic significance of mitral e" velocity for long-term mortality in CP patients post-pericardiectomy.
  • To determine the association between echocardiographic parameters and survival outcomes after CP surgery.

Main Methods:

  • A cohort of 104 surgically confirmed CP patients underwent echocardiography and cardiac catheterization.
  • Patients were categorized into primary CP and mixed CP groups based on myocardial disease presence.
  • Multivariable analysis identified predictors of long-term mortality, including medial e" velocity and pulmonary artery pressure.

Main Results:

  • Medial e" velocity and mean pulmonary artery pressure were independent predictors of long-term mortality post-pericardiectomy.
  • Survival rates differed significantly based on cut-off values for medial e" (9.0 cm/s) and mean pulmonary artery pressure (29 mmHg).
  • A paradoxical relationship was observed between E/e" ratio and pulmonary artery wedge pressure (PAWP), with no direct correlation.

Conclusions:

  • Increased mitral e" velocity is associated with better long-term outcomes in patients with CP.
  • The findings suggest that medial e" velocity is a valuable prognostic marker for CP patients undergoing pericardiectomy.
  • A unique distribution of E/e" and PAWP exists in CP patients, highlighting complex cardiac dynamics.
Abstract

Keywords:
annulus paradoxusconstrictive pericarditisfilling pressure

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