Mitral and Tricuspid Annular Velocities Before and After Pericardiectomy in Patients With Constrictive Pericarditis

Gabriella Veress, Lieng H. Ling, Kye-Hun Kim, Jacob P. Dal-Bianco, Hartzell V. Schaff, Raul E. Espinosa, Rowlens M. Melduni, Jamil A. Tajik, Thoralf M. Sundt, Jae K. Oh
2011 Circulation Cardiovascular Imaging  
Background-Previous studies have demonstrated that mitral annulus early diastolic (eЈ) velocity is increased in constrictive pericarditis (CP) and reduced in restrictive cardiomyopathy. However, those studies did not comprehensively evaluate mitral and tricuspid annular velocities before and after pericardiectomy. Methods and Results-We performed comprehensive echocardiography before and after pericardiectomy in 99 patients with CP, 52 with primary (idiopathic or postpericarditis etiology) and
more » ... 7 with secondary CP (due to surgery or radiation). Overall, meanϮSD mitral medial, mitral lateral, and tricuspid lateral eЈ velocities were 12.2Ϯ4.2, 10.0Ϯ5.4, and 11.6Ϯ3.5 cm/s, respectively; annular late diastolic velocities were 10.3Ϯ4.3, 12.2Ϯ4.9, and 11.7Ϯ5.4 cm/s, respectively; and annular systolic (sЈ) velocities were 7.8Ϯ2.8, 8.2Ϯ2.1, and 11.2Ϯ3.8 cm/s, respectively. Medial eЈ was equal to or greater than mitral lateral eЈ in 74% of analyzable cases. With the exception of tricuspid sЈ, there were significant differences in all sЈ and eЈvelocities between primary and secondary CP before pericardiectomy. After pericardiectomy, all annular velocities decreased significantly (PϽ0.02 for all comparisons). The reduction in medial eЈ velocity was greater than that of mitral lateral eЈ velocity (PϽ0.0001 and Pϭ0.0004, respectively), and the mitral lateral/medial eЈ ratio normalized (Pϭ0.0002). Conclusions-The mitral lateral/medial eЈ ratio is reversed in three fourths of patients with CP. All annular velocities are lower in secondary compared to primary CP before pericardiectomy. After pericardiectomy, there is reduction of all annular velocities and normalization of the mitral lateral/medial eЈ ratio. (Circ Cardiovasc Imaging. 2011; 4:399-407.)
doi:10.1161/circimaging.110.959619 pmid:21543641 fatcat:zkfhnab7dzhubl2go4w4dwikxm