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Pericarditis restrictiva en 26 pacientes con un grosor pericárdico histológicamente normal
Deepak R Talreja1, William D Edwards, Gordon K Danielson
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Circulation
|October 1, 2003
Resumen
La pericarditis restrictiva puede ocurrir con un grosor pericárdico normal, incluso con hallazgos microscópicos anormales. La pericardiectomía sigue siendo efectiva para el alivio de los síntomas, independientemente del grosor pericárdico.
Área de la Ciencia:
- Cardiología Cardiología.
- Patología Patología Patología.
- Cirugía torácica cirugía torácica.
Sus antecedentes:
- El diagnóstico de pericarditis restrictiva tradicionalmente se basa en el aumento del grosor pericárdico.
- El grosor pericárdico normal en la pericarditis constrictiva se ha observado de manera no invasiva, pero faltan detalles clínico patológicos.
Objetivo del estudio:
- Para investigar los correlatos clínico patológicos de la pericarditis constrictiva en pacientes con espesor pericárdico normal.
Principales métodos:
- Revisión retrospectiva de 143 pacientes sometidos a una pericardictomía por pericarditis constrictiva (1993-1999).
- Análisis de las características basales, datos operativos y muestras histopatológicas.
- Categoría en grupos pericárdicos normales (< o = 2 mm) y engrosados (> 2 mm).
Principales resultados:
- El 18% (26/143) de los pacientes tenía un grosor pericárdico normal.
- Las causas comunes en el grupo de grosor normal incluyeron cirugía previa, irradiación, infarto y enfermedad idiopática.
- La histopatología reveló anomalías focales leves en todos los casos de espesor normal; los resultados de la pericardictomía fueron similares entre los grupos.
Conclusiones:
- El grosor pericárdico no siempre aumenta en la pericarditis constrictiva, a pesar de las anomalías histopatológicas focales.
- Se debe considerar la pericardiectomía en pacientes con insuficiencia cardíaca con sospecha de constricción, independientemente de las imágenes no invasivas que muestren un grosor pericárdico normal.
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