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缩窄性心包炎心包切除术的短期临床及超声心动图结果

Short term clinical and echocardiography outcomes of pericardiectomy in constrictive pericarditis.

作者信息

Kumar Madhur, Padhy Ajit, Munjal Ridhika, Gupta Anubhav

机构信息

Department of Cardiothoracic & Vascular Surgery Safdarjung Hospital & Vardhman Mahavir Medical College, New Delhi, India.

出版信息

J Cardiovasc Thorac Res. 2021;13(2):169-173. doi: 10.34172/jcvtr.2021.23. Epub 2021 Apr 26.

Abstract

Tuberculous pericarditis continues to be a leading cause of chronic constrictive pericarditis (CCP) in developing countries. Echocardiography plays a key role in the assessment and diagnosis. Twelve patients who underwent pericardiectomy for CCP in last 18 months of the study period were subjected to clinical and New York Heart Association (NYHA) functional class assessment along with comprehensive echocardiographic evaluation. The data were compared with their preprocedural status. Significant reduction was noted in the incidence of inferior vena cava (IVC) congestion( < 0.001) and mean left atrial (LA) size from 43.75 ± 4.43 mm to 31.58 ± 3.03 mm ( < 0.001), post pericardiectomy.Respiratory variation of 34.17 ± 8.76 % in the mitral E velocity was significantly reduced to 17 ± 3.69 % ( < 0.001) after surgery. Similarly, respiratory variation in tricuspid E velocities showed significant reduction from 62.17 ± 13.16 % to 32.58 ± 4.7 % ( < 0.001).Prior to pericardiectomy, medial e' and lateral e' mitral annular velocities was 15.5±1.24 cm/sec and13.08 ± 1.08 cm/sec, respectively. Following surgery, the medial e' and lateral e' was 12.5±1.17 cm/sec( = 0.001) and 15.42±1.83 ( = 0.004), respectively. Echocardiography provides useful insight in pericardial constriction hemodynamics and worthwhile effects of pericardiectomy.

摘要

在发展中国家,结核性心包炎仍然是慢性缩窄性心包炎(CCP)的主要病因。超声心动图在评估和诊断中起着关键作用。在研究期间的最后18个月,对12例因CCP接受心包切除术的患者进行了临床和纽约心脏协会(NYHA)功能分级评估,并进行了全面的超声心动图评估。将数据与其术前状态进行比较。心包切除术后,下腔静脉(IVC)淤血发生率显著降低(<0.001),平均左心房(LA)大小从43.75±4.43mm降至31.58±3.03mm(<0.001)。二尖瓣E峰速度的呼吸变异率从术前的34.17±8.76%显著降低至术后的17±3.69%(<0.001)。同样,三尖瓣E峰速度的呼吸变异率也从62.17±13.16%显著降低至32.58±4.7%(<0.001)。心包切除术前,二尖瓣环内侧e'和外侧e'速度分别为15.5±1.24cm/秒和13.08±1.08cm/秒。术后,内侧e'和外侧e'速度分别为12.5±1.17cm/秒(P = 0.001)和15.42±1.83(P = 0.004)。超声心动图为心包缩窄的血流动力学及心包切除术的有益效果提供了有用的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad52/8302898/02c0abab40c4/jcvtr-13-169-g001.jpg

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