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Clinical significance of pulmonary hypertension in patients with constrictive pericarditis

Kyunghee Lim1, Jeong Hoon Yang2,3, William R Miranda4

  • 1Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea (the Republic of).

Heart (British Cardiac Society)
|July 21, 2021
PubMed

Insights

Patients with constrictive pericarditis and combined postcapillary and precapillary pulmonary hypertension (CPc-PH) face higher mortality. This PH subtype, linked to comorbidities, indicates a poorer prognosis post-pericardiectomy.

Area of Science:

  • Cardiology
  • Pulmonary Hypertension Research
  • Cardiac Surgery

Background:

  • Constrictive pericarditis (CP) with myocardial disease is increasing.
  • Pulmonary hypertension (PH) is more common in CP patients.
  • Limited data exists on PH hemodynamics and outcomes in CP.

Purpose of the Study:

  • To investigate hemodynamics and clinical outcomes in constrictive pericarditis (CP) patients with different types of pulmonary hypertension (PH).
  • To assess the prognostic impact of PH subtypes in CP.
  • To identify factors associated with long-term mortality in CP with PH.

Main Methods:

  • Retrospective cohort study of 150 patients with surgically confirmed CP.
  • Patients underwent echocardiography and cardiac catheterization.
  • Groups: no-PH, isolated postcapillary PH (Ipc-PH), and combined postcapillary and precapillary PH (Cpc-PH).
  • Primary outcome: all-cause mortality.

Main Results:

  • 110 patients (73.3%) had PH.
  • 18 patients (12%) had Cpc-PH, associated with more comorbidities and mixed CP etiology.
  • Cpc-PH group showed significantly lower survival rates compared to no-PH and Ipc-PH groups.
  • Pulmonary vascular resistance correlated with medial E/e' by Doppler echocardiography.

Conclusions:

  • Combined postcapillary and precapillary PH (Cpc-PH) occurs in a subset of CP patients.
  • Cpc-PH is significantly associated with increased long-term mortality after pericardiectomy.
  • Age, NYHA class IV, medial e' velocity, and PH type independently predict mortality.
Abstract

Keywords:
constrictive pericarditispulmonary hypertension

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