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Left ventricular systolic and diastolic function after pericardiectomy in patients with constrictive pericarditis

Doppler echocardiographic findings and correlation with clinical status

Michele Senni, MD^*, Margaret M. Redfield, MD, FACC^*, Lieng H. Ling, MB, BS, MRCP^*, Gordon K. Danielson, MD, FACC, A. Jamil Tajik, MD, FACC^* and Jae K. Oh, MD, FACC^*

^* Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
Division of Thoracic and Cardiovascular Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

View larger version (14K): [in a new window]   Figure 1 Study population of 58 patients with constrictive pericarditis who had pericardiectomy, by time at which postoperative Doppler echocardiography (DE) was performed. Postop., postoperative; pts, patients.

View larger version (13K): [in a new window]   Figure 2 Changes in characterization of diastolic function in 19 patients with serial postoperative Doppler echocardiography (DE).

View larger version (85K): [in a new window]   Figure 3 (A) Pulsed-wave Doppler recording of mitral inflow velocities with simultaneous respirometer recording in a 64-year-old man with constrictive pericarditis before pericardiectomy. Average early (E) velocity with inspiration was 0.95 m/s and increased to 1.20 m/s with expiration (26% change). (B) After pericardiectomy, late postoperative Doppler echocardiography showed normal diastolic filling pattern (E/A [late] = 1.3; DT = 205 ms). Average E velocity with inspiration was 0.80 m/s and 0.85 m/s with expiration. DT, deceleration time; Exp, expiration; Insp, inspiration.

View larger version (82K): [in a new window]   Figure 4 (A) Pulsed-wave Doppler recording of mitral inflow velocities with simultaneous respirometer recording in a 48-year-old man with constrictive pericarditis before pericardiectomy. Average early (E) velocity with inspiration was 0.75 m/s and increased to 1.0 m/s with expiration (33% change). (B) After pericardiectomy, late postoperative Doppler echocardiography showed restrictive diastolic filling pattern (E/A [late] = 2.6; DT = 130 ms) with no change in E velocity with respiration. DT = deceleration time; Exp = expiration; Insp = inspiration.

View larger version (38K): [in a new window]   Figure 5 Relationship between New York Heart Association (NYHA) functional class and diastolic function in patients with late postoperative Doppler echocardiography (DE).