Lin Xue, Xu Rui-Yi, Liu Jian-Zhou, Chen Wei, Chen Lian-Feng, Yang Peng-Hua, Fang Li-Gang
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2016 Jan 20;129(2):154-61. doi: 10.4103/0366-6999.173463.
To determine the influence of right ventricular function in patients with constrictive pericarditis (CP) undergoing surgery and to compare the outcomes of patients who received surgery with those managed medically.
Patients with the diagnosis of CP and healthy volunteers were recruited from January 2006 to November 2011. Patients with CP chose to either receive pericardiectomy or medical management. Echocardiographic measurements were performed to evaluate heart function, and survival was recorded.
A total of 58 patients with CP (36 received pericardiectomy, 22 managed medically), and 43 healthy volunteers were included. CP patients who received surgery had a higher survival rate than those managed medically (P = 0.003), and higher survival was also seen in the subgroup of CP patients with severely impaired right systolic function. Albumin level, left ventricular end-diastolic dimension, and tricuspid regurgitation velocity were associated with survival in CP patients who received surgery.
Preoperative right heart function does not affect surgical outcomes. Patients with severely impaired preoperative right systolic function obtain a greater survival advantage with surgery than with medical treatment.
确定缩窄性心包炎（CP）患者手术时右心室功能的影响，并比较接受手术治疗的患者与接受药物治疗的患者的结局。
2006年1月至2011年11月招募了CP诊断患者和健康志愿者。CP患者选择接受心包切除术或药物治疗。进行超声心动图测量以评估心脏功能，并记录生存率。
共纳入58例CP患者（36例行心包切除术，22例接受药物治疗）和43名健康志愿者。接受手术治疗的CP患者生存率高于接受药物治疗的患者（P = 0.003），在右心室收缩功能严重受损的CP患者亚组中也观察到较高的生存率。白蛋白水平、左心室舒张末期内径和三尖瓣反流速度与接受手术治疗的CP患者的生存率相关。
术前右心功能不影响手术结局。术前右心室收缩功能严重受损的患者手术治疗比药物治疗具有更大的生存优势。
