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Advances in multi-modality imaging for constrictive pericarditis and pericardial inflammation: role of imaging-guided

Tahir S Kafil1, Tom Kai Ming Wang1, Ankit Agrawal1

  • 1Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.

Expert Review of Cardiovascular Therapy
|April 18, 2023
PubMed

Insights

Constrictive pericarditis (CP) is caused by pericardial inflammation and can lead to heart failure. Advanced cardiac imaging aids early diagnosis and management of CP, potentially preventing or reversing the condition.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Constrictive pericarditis (CP) arises from uncontrolled pericardial inflammation, leading to heart failure and reduced quality of life.
  • Early recognition of CP is crucial for effective management and mitigating adverse outcomes.

Approach:

  • This review covers CP pathophysiology, etiologies, clinical presentation, and diagnostic/management advances.
  • Multimodality cardiac imaging, including echocardiography and cardiac magnetic resonance (CMR), is central to evaluating CP.
  • Computed tomography and FDG-positron emission tomography offer complementary diagnostic information.

Key Points:

  • Advances in multimodality imaging enable precise diagnosis of constrictive pericarditis.
  • Cardiac magnetic resonance (CMR) is pivotal in detecting subacute and chronic pericardial inflammation.
  • Imaging-guided therapy (IGT) is emerging as a strategy to prevent or reverse CP.

Conclusions:

  • Multimodality imaging has transformed constrictive pericarditis management.
  • Early and accurate diagnosis through advanced imaging facilitates timely intervention.
  • IGT holds promise for improving outcomes in patients with constrictive pericarditis.
Abstract

Keywords:
EchocardiographyImaging-Guided therapycardiac computed tomographycardiac magnetic resonanceconstrictive pericarditisdelayed hyperenhancementlate gadolinium enhancementpericardium

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