Landex Nadia Lander, Ihlemann Nikolaj, Olsen Peter Skov, Gustafsson Finn
Department of Cardiology and Cardiothoracic Surgery , Rigshospitalet, Copenhagen , Denmark.
Scand Cardiovasc J. 2015 Apr;49(2):101-8. doi: 10.3109/14017431.2015.1014406. Epub 2015 Mar 10.
The aetiology and outcome of constrictive pericarditis vary between geographic regions and has changed over time. We describe the diagnostic work-up and outcome in a contemporary cohort of Danish patients with constrictive pericarditis.
Hospital databases were searched for patients undergoing cardiac catheterisation for suspected constrictive pericarditis or for patients undergoing pericardiectomy or discharged with the diagnosis of constrictive pericarditis.
We identified 57 patients with constrictive pericarditis diagnosed from 1998 to 2012. Previous surgery and inflammatory disease were the most prevalent underlying conditions. Diagnosis was made primarily by echocardiography and right- and left-sided cardiac catheterisation. Echocardiography was particularly notable for dilated inferior caval vein, increased E/A ratio, and high septal tissue velocity in addition to the presence of septal bounce. Pericardiectomy was performed in 47 patients with a 30-day mortality of 8.5%. Clinical improvement was noted in 69% of cases. Several echocardiographic parameters normalised with time, including markers of diastolic function.
Long-term outcome after pericardiectomy is acceptable with clinical improvement and partial resolution of the echocardiographic parameters in the majority of patients.
缩窄性心包炎的病因和预后在不同地理区域有所不同，且随时间发生了变化。我们描述了一组当代丹麦缩窄性心包炎患者的诊断检查及预后情况。
在医院数据库中搜索因疑似缩窄性心包炎接受心导管检查的患者，或接受心包切除术或出院诊断为缩窄性心包炎的患者。
我们确定了1998年至2012年间诊断为缩窄性心包炎的57例患者。既往手术和炎症性疾病是最常见的基础疾病。诊断主要通过超声心动图以及左右心导管检查做出。超声心动图的显著表现除了有室间隔跳动外，还有下腔静脉扩张、E/A比值增加以及较高的室间隔组织速度。47例患者接受了心包切除术,30天死亡率为8.5%。69%的病例有临床改善。随着时间推移，多项超声心动图参数恢复正常，包括舒张功能指标。
心包切除术后的长期预后尚可，大多数患者临床症状改善，超声心动图参数部分恢复正常。
