Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Curr Cardiol Rep. 2019 Nov 22;21(11):144. doi: 10.1007/s11886-019-1243-4.
To review the echo-Doppler findings in effusive-constrictive pericarditis (ECP). ECP corresponds to the coexistence of a hemodynamically significant pericardial effusion and markedly reduced compliance of the pericardium, manifested by constrictive physiology post-pericardiocentesis.
We summarize herein the recent observations regarding the prevalence of ECP based on echocardiography as well as the pre- and post-pericardiocentesis echo-Doppler features of ECP. ECP diagnosed by echocardiography was seen in approximately 15% of patients with ECP pre- and post-pericardiocentesis echo-Doppler findings sharing features with both cardiac tamponade and constrictive pericarditis. ECP post-pericardiocentesis is common but its natural history in the current era might be better than previously reported. Further studies and (particularly simultaneous echocardiography-cardiac catheterization) are still critically needed to better understand the underlying hemodynamics of ECP. Moreover, it remains to be determined whether pre- and post-pericardiocentesis echo-Doppler findings can be used to prognosticate or to guide therapy of those undergoing pericardiocentesis.
探讨渗出性缩窄性心包炎(effusive-constrictive pericarditis,ECP)的超声心动图-多普勒表现。ECP 是指在发生心包积液的同时伴有心包顺应性显著降低,其特征为心包穿刺后出现缩窄性生理改变。
本文总结了心包积液患者心包穿刺前后超声心动图-多普勒检查中 ECP 的发生率,以及心包穿刺前后 ECP 的超声心动图-多普勒特征。心包穿刺前后超声心动图诊断为 ECP 的患者约占 15%,心包穿刺前后的超声心动图-多普勒特征既有心脏压塞又有缩窄性心包炎的特征。心包穿刺后 ECP 很常见,但在当前时代,其自然病程可能比以前报道的要好。仍需要进一步的研究,特别是同时进行超声心动图和心导管检查,以更好地了解 ECP 的血流动力学基础。此外,仍需要确定心包穿刺前后的超声心动图-多普勒表现是否可用于预测或指导心包穿刺患者的治疗。