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Jamil A Tajik - One of the best experts on this subject based on the ideXlab platform.
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Constrictive Pericarditis and restrictive cardiomyopathy in the modern era
Future Cardiology, 2011Co-Authors: Farouk Mookadam, Panupong Jiamsripong, Serageldin F Raslan, Prasad M Panse, Jamil A TajikAbstract:The differentiation between Constrictive Pericarditis and restrictive cardiomyopathy can be clinically challenging. Pericardial constriction results from scarring and consequent loss of pericardial elasticity leading to impaired ventricular filling. Restrictive cardiomyopathy is characterized by a nondilated rigid ventricle, severe diastolic dysfunction and restrictive filling producing hemodynamic changes, similar to those in Constrictive Pericarditis. While Constrictive Pericarditis is usually curable by surgical treatment, restrictive cardiomyopathy requires medical therapy and in appropriate patients, the definitive treatment is cardiac transplantation. Sufficient differences exist between the two conditions to allow noninvasive differentiation, but no single diagnostic tool can be relied upon to make this distinction. Newer echocardiographic techniques such as speckle-track imaging, velocity vector imaging, as well as cardiac computed tomography and cardiac MRI can help differentiate constriction fro...
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using mitral annulus reversus to diagnose Constrictive Pericarditis
European Journal of Echocardiography, 2009Co-Authors: Christina S Reuss, Susan Wilansky, Steven J Lester, Joan Lusk, Diane E Grill, Jamil A TajikAbstract:Aims To characterize mitral medial and lateral annular velocities in Constrictive Pericarditis or restrictive cardiomyopathy compared with normal subjects. Methods and results Tissue Doppler imaging peak systolic velocity (S′), peak early diastolic annular velocity (e′), and timing difference between mitral early flow and early annular movement were measured in 14 patients with Constrictive Pericarditis, 10 with restrictive cardiomyopathy, and 17 normal subjects using the apical four-chamber view lateral and medial mitral annulus. In controls, mitral lateral e′ velocity was 25% higher than medial e′ velocity (13.0 ± 3.1 vs. 10.7 ± 2.8 cm/s; P = 0.02), whereas with Constrictive Pericarditis, averaged lateral e′ velocity was 2% lower than medial e′ velocity (10.7 ± 2.5 vs. 11.2 ± 3.1 cm/s; P > 0.05). This relationship represented a reversal of lateral and medial e′ velocities compared with normal subjects ( P = 0.004). Differences in S′, E/e′, and timing intervals between normal subjects and patients with Constrictive Pericarditis were not statistically significant; however, restrictive cardiomyopathy could be distinguished from Constrictive Pericarditis and controls with all other parameters (S′, E/e′, medial and lateral e′ velocities, and timing interval differences; all P < 0.05). Conclusion Practical applications of tissue Doppler imaging for evaluation of possible Constrictive Pericarditis include reversal of the relationship between lateral and medial e′ velocities (i.e. ‘annulus reversus’).
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue doppler echocardiography
American Journal of Cardiology, 2004Co-Authors: Jongwon Ha, Steve R Ommen, Jamil A Tajik, Marion E Barnes, Naser M Ammash, Morie A Gertz, James B Seward, Jae K OhAbstract:Abstract This study evaluated the diagnostic role of early diastolic mitral annular velocity (E′) by tissue Doppler echocardiography for differentiating Constrictive Pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed Constrictive Pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E′ at the septal annulus. E′ was significantly higher in patients with Constrictive Pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue doppler echocardiography
American Journal of Cardiology, 2004Co-Authors: Steve R Ommen, Jamil A Tajik, Marion E Barnes, Naser M Ammash, Morie A Gertz, James B SewardAbstract:This study evaluated the diagnostic role of early diastolic mitral annular velocity (E') by tissue Doppler echocardiography for differentiating Constrictive Pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed Constrictive Pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E' at the septal annulus. E' was significantly higher in patients with Constrictive Pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p or =8 cm/second resulted in 95% sensitivity and 96% specificity for the diagnosis of Constrictive Pericarditis. There was no overlap of E' between patients who had Constrictive Pericarditis and those who had cardiac amyloidosis. In a subgroup analysis of restrictive cardiomyopathy, E' of patients who had cardiac amyloidosis was significantly lower than that of patients who had primary restrictive cardiomyopathy (4.6 vs 6.3 cm/second, p <0.001). Thus, E' velocity can distinguish between Constrictive Pericarditis and restrictive cardiomyopathy with a specific cut-off value in patients with clinical and echocardiographic evidence of diastolic heart failure.
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transient Constrictive Pericarditis causes and natural history
Journal of the American College of Cardiology, 2004Co-Authors: John H Haley, Jamil A Tajik, Hartzell V. Schaff, Gordon K. Danielson, Sharon L MulvaghAbstract:Abstract Objectives This study was designed to elucidate the causes and natural history of transient Constrictive Pericarditis (CP). Background In some patients with acute CP, the symptoms and Constrictive physiologic features resolve with medical therapy alone, a phenomenon that has been labeled “transient Constrictive Pericarditis.” No large studies have examined the causes or natural history of transient CP. Methods Review of the Mayo Clinic echocardiogram database identified 212 patients who had echocardiographic findings of CP from 1988 through 1999. Demographic, clinical, and echocardiographic findings were identified in all patients. In 36 of these patients, follow-up echocardiograms showed resolution of the Constrictive hemodynamics without pericardiectomy. Results The average age of the patients was 49 ± 21 years, and 72% were men. The causes for the CP were diverse, the most common being prior cardiovascular surgery (25%). In a subset of 22 patients who were followed serially during the course of their illness, resolution of the Constrictive physiologic features occurred at an average of 8.3 weeks after diagnosis. Conclusions A subset of patients with CP experience resolution of the disorder without requiring pericardiectomy.
Hartzell V. Schaff - One of the best experts on this subject based on the ideXlab platform.
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outcomes of pericardiectomy for Constrictive Pericarditis following mediastinal irradiation
Journal of Cardiac Surgery, 2021Co-Authors: Siddharth Pahwa, John M. Stulak, Joseph A. Dearani, Hartzell V. Schaff, William R. Miranda, Juan A Crestanello, Annalisa Bernabei, Andreas Polycarpou, Alberto Pochettino, Richard C. DalyAbstract:BACKGROUND Pericardiectomy for postradiation Constrictive Pericarditis has been reported to generally have unfavorable outcomes. This study sought to evaluate surgical outcomes in a large cohort of patients undergoing pericardiectomy for radiation-associated pericardial constriction. METHODS A retrospective analysis of all patients (≥18 years) who underwent pericardiectomy for a diagnosis of Constrictive Pericarditis with a prior history of mediastinal irradiation from June 2002 to June 2019 was conducted. There were 100 patients (mean age 57.2 ± 10.1 years, 49% females) who met the inclusion criteria. Records were reviewed to look at the surgical approach, the extent of resection, early mortality, and late survival. RESULTS The overall operative mortality was 10.1% (n = 10). The rate of operative mortality decreased over the study period; however, the test of the trend was not statistically significant (p = .062). Hodgkin's disease was the most common malignancy (64%) for which mediastinal radiation had been received. Only 27% of patients had an isolated pericardiectomy, and concomitant pericardiectomy and valve surgery were performed in 46% of patients. Radical resection was performed in 50% of patients, whereas 47% of patients underwent subtotal resection. Prolonged ventilation (26%), atrial fibrillation (21%), and pleural effusion (16%) were the most common postoperative complications. The overall 1, 5-, and 10-years survival was 73.6%, 53.4%, and 32.1%, respectively. Increasing age (hazard ratio, 1.044, 95% confidence interval 1.017-1.073) appeared to have a significant negative effect on overall survival in the univariate model. CONCLUSION Pericardiectomy performed for radiation-associated Constrictive Pericarditis has poor long-term outcomes. The early mortality, though high (~10%), has been showing a decreasing trend in the test of time.
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meld and meld xi scores as predictors of mortality after pericardiectomy for Constrictive Pericarditis
Mayo Clinic proceedings, 2021Co-Authors: Juan Diaz C Soto, Hartzell V. Schaff, Brian D Lahr, William J Mauermann, Sushil A Luis, Mark M SmithAbstract:Abstract Objective To assess the association between the preoperative model for end-stage liver disease (MELD) and MELD-XI (exclude international normalized ratio) score and outcomes in patients undergoing pericardiectomy for Constrictive Pericarditis. Patients and Methods Patients >18 years of age undergoing pericardiectomy for Constrictive Pericarditis between January 1, 2007, and October 12, 2017, were analyzed with data for MELD and MELD-XI score calculation within 30 days preoperatively. The association between the MELD and MELD-XI scoring systems and risk of postoperative outcomes was assessed in regression models adjusting for relevant covariates. The primary outcome was operative mortality (death within 90 days or in hospital). Secondary outcomes included various measures of postoperative morbidity. Results A total of 175 and 226 patients had data for MELD/MELD-XI, respectively. Ninety-day mortality was 8.7%. When stratified into tertiles of MELD-XI, the unadjusted risk of 90-day mortality was 2.7%, 8.2%, and 16.0%, respectively. In Cox regression models fitted for MELD-XI and MELD, higher scores associated with increased risk of mortality (P Conclusion Among patients undergoing pericardiectomy for Constrictive Pericarditis, MELD-XI and MELD were associated with increased postoperative morbidity and mortality. Although the simpler MELD-XI score generally performed as well or better than MELD as a correlate of various outcomes, both scores can serve as a simple yet robust risk stratification tool for patients undergoing pericardiectomy for Constrictive Pericarditis.
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Tricuspid valve regurgitation in patients undergoing pericardiectomy for Constrictive Pericarditis
Seminars in Thoracic and Cardiovascular Surgery, 2020Co-Authors: Rolando Calderon-rojas, John M. Stulak, Kevin L. Greason, Katherine S. King, Richard C. Daly, Joseph A. Dearani, Hartzell V. SchaffAbstract:We hypothesized that tricuspid valve regurgitation was associated with increased risk of mortality after pericardiectomy for Constrictive Pericarditis. We reviewed the records of 518 patients who received pericardiectomy for Constrictive Pericarditis between January 2000 and December 2016. We excluded cases of radiation induced Constrictive Pericarditis, tuberculous-related Constrictive Pericarditis, and concomitant tricuspid valve intervention. Patients were classified according to preoperative transthoracic echocardiography tricuspid regurgitation grade: none/trivial in 276 (53%) patients, mild in 191 (37%), and moderate/severe in 51 (10%). A multivariable Cox proportional hazards regression model was used to determine an association between tricuspid valve regurgitation grade and mortality. Primary endpoint of this study was mortality. Median patient age was 62 years (interquartile range 51–69), sex was male in 409 (79%) patients, and left ventricular ejection fraction was 60% (54–65). Clinical follow-up was obtained in all patients at a median of 7.6 years (3.6–11.3). Kaplan-Meier estimates of mortality were 10.6% at 1 year, 23.5% at 5 years, and 39.0% at 10 years. Multivariable analysis demonstrated increased mortality risk with mild tricuspid valve regurgitation vs none/trivial (hazard ratio 1.64; 95% confidence interval 1.11–2.43; P = 0.012) and moderate/severe tricuspid valve regurgitation vs none/trivial (hazard ratio 2.27; 95% confidence interval 1.39–3.69; P = 0.001). These findings were independent of right ventricular function. Tricuspid valve regurgitation is a common and clinically important comorbidity in patients operated with pericardiectomy for Constrictive Pericarditis. Mild or greater tricuspid valve regurgitation is associated with an increased risk of mortality following operation.
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experience with pericardiectomy for Constrictive Pericarditis over eight decades
The Annals of Thoracic Surgery, 2017Co-Authors: Takashi Murashita, John M. Stulak, Katherine S. King, Richard C. Daly, Joseph A. Dearani, Hartzell V. Schaff, Kevin L. GreasonAbstract:Background The purpose of this study was to review the surgical outcomes of pericardiectomy for Constrictive Pericarditis and to examine risk factors for overall mortality in a contemporary period. Methods We reviewed all patients who underwent pericardiectomy for constriction from 1936 through 2013. The investigation included Constrictive Pericarditis cases confirmed intraoperatively, all other types of Pericarditis were excluded; 1,071 pericardiectomies were performed in 1,066 individual patients. Patients were divided into two intervals: a historical (pre-1990) group (n = 259) and a contemporary (1990–2013) group (n = 807). Results Patients in the contemporary group were older (61 versus 49 years; p p p p p p p p = 0.014). Conclusions There was a significant change in disease etiology over the study period. Long-term survival after pericardiectomy is affected by patient characteristics including etiology of constriction and severity of symptoms.
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Constrictive Pericarditis a curable diastolic heart failure
Nature Reviews Cardiology, 2014Co-Authors: Faisal F Syed, Hartzell V. SchaffAbstract:Constrictive Pericarditis can result from a stiff pericardium that prevents satisfactory diastolic filling. The distinction between Constrictive Pericarditis and other causes of heart failure, such as restrictive cardiomyopathy, is important because pericardiectomy can cure Constrictive Pericarditis. Diagnosis of Constrictive Pericarditis is based on characteristic haemodynamic and anatomical features determined using echocardiography, cardiac catheterization, cardiac MRI, and CT. The Mayo Clinic echocardiography and cardiac catheterization haemodynamic diagnostic criteria for Constrictive Pericarditis are based on the unique features of ventricular interdependence and dissociation of intrathoracic and intracardiac pressures seen when the pericardium is constricted. A complete pericardiectomy can restore satisfactory diastolic filling by removing the Constrictive pericardium in patients with Constrictive Pericarditis. However, if inflammation of the pericardium is the predominant Constrictive mechanism, anti-inflammatory therapy might alleviate this transient condition without a need for surgery. Early diagnosis of Constrictive Pericarditis is, therefore, of paramount clinical importance. An improved understanding of how Constrictive Pericarditis develops after an initiating event is critical to prevent this diastolic heart failure. In this Review, we discuss the aetiology, pathophysiology, and diagnosis of Constrictive Pericarditis, with a specific emphasis on how to differentiate this disease from conditions with similar clinical presentations.
Allan L Klein - One of the best experts on this subject based on the ideXlab platform.
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transient Constrictive Pericarditis current diagnostic and therapeutic strategies
Current Cardiology Reports, 2016Co-Authors: James L Gentry, Allan L Klein, Christine JellisAbstract:Transient Constrictive Pericarditis is increasingly recognized as a distinct sub-type of Constrictive Pericarditis. The underlying pathophysiology typically relates to impaired pericardial distensibility, associated with acute or sub-acute inflammation, rather than the fibrosis or calcification often seen in chronic pericardial constriction. Accordingly, patients may present clinically with concomitant features of Pericarditis and Constrictive physiology. Non-invasive multimodality imaging is advocated for diagnosis of transient Constrictive Pericarditis. Echocardiography remains the mainstay for initial evaluation of the dynamic features of constriction. However, cardiac magnetic resonance imaging can provide complimentary functional information, with the addition of dedicated sequences to assess for active pericardial edema and inflammation. Although transient pericardial constriction can spontaneously resolve, institution of anti-inflammatory therapy may hasten resolution or even prevent progression to chronic pericardial constriction. Non-steroidal anti-inflammatory agents remain the initial treatment of choice, with subsequent consideration of colchicine, steroids, and other immune-modulating agents in more refractory cases.
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Constrictive Pericarditis etiology and cause specific survival after pericardiectomy
Journal of the American College of Cardiology, 2004Co-Authors: Stefan C Bertog, Senthil Thambidorai, Kapil Parakh, Paul Schoenhagen, Volkan Ozduran, Penny L Houghtaling, Bruce W Lytle, Eugene H Blackstone, Michael S Lauer, Allan L KleinAbstract:OBJECTIVES We sought to determine the association of etiology of Constrictive Pericarditis (CP), pericardial calcification (CA), and other clinical variables with long-term survival after pericardiectomy. BACKGROUND Constrictive Pericarditis is the result of a spectrum of primary cardiac and noncardiac conditions. Few data exist on the cause-specific survival after pericardiectomy. The impact of CA on survival is unclear. METHODS A total of 163 patients who underwent pericardiectomy for CP over a 24-year period at a single surgical center were studied. Constrictive Pericarditis was confirmed by the surgical report. Vital status was obtained from the Social Security Death Index. RESULTS Etiology of CP was idiopathic in 75 patients (46%), prior cardiac surgery in 60 patients (37%), radiation treatment in 15 patients (9%), and miscellaneous in 13 patients (8%). Median follow-up among survivors was 6.9 years (range 0.8 to 24.5 years), during which time there were 61 deaths. Perioperative mortality was 6%. Idiopathic CP had the best prognosis (7-year Kaplan-Meier survival: 88%, 95% confidence interval [CI] 76% to 94%) followed by postsurgical (66%, 95% CI 52% to 78%) and postradiation CP (27%, 95% CI 9% to 58%). In bootstrap-validated proportional hazards analyses, predictors of poor overall survival were prior radiation, worse renal function, higher pulmonary artery systolic pressure (PAP), abnormal left ventricular (LV) systolic function, lower serum sodium level, and older age. Pericardial calcification had no impact on survival. CONCLUSIONS Long-term survival after pericardiectomy for CP is related to underlying etiology, LV systolic function, renal function, serum sodium, and PAP. The relatively good survival with idiopathic CP emphasizes the safety of pericardiectomy in this subgroup.
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diastolic heart failure restrictive cardiomyopathy Constrictive Pericarditis and cardiac tamponade clinical and echocardiographic evaluation
Cardiology in Review, 2002Co-Authors: Craig R Asher, Allan L KleinAbstract:An understanding of the basic principles of diastolic function is important in order to recognize diseases that may result in diastolic dysfunction and diastolic heart failure. Although uncommon, restrictive cardiomyopathy, Constrictive Pericarditis, and cardiac tamponade are among the disorders that may affect primarily diastolic function with preservation of systolic function. Diastolic heart failure may manifest with chronic nonspecific symptoms or may present with acute hemodynamic compromise. Echocardiography plays a vital role in the diagnosis of diastolic dysfunction and differentiation of these disease processes. It also provides a basis for clinical decisions regarding management and surgical referral. This review summarizes the clinical features, pathophysiology, and hemodynamic and echocardiographic signs of restrictive cardiomyopathy, Constrictive Pericarditis, and cardiac tamponade.
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy by doppler transesophageal echocardiographic measurements of respiratory variations in pulmonary venous flow
Journal of the American College of Cardiology, 1993Co-Authors: Allan L Klein, Gerald I Cohen, Joseph F Pietrolungo, Richard D White, Alexander S Bailey, Gregory L Pearce, William J Stewart, Ernesto E SalcedoAbstract:Abstract Objectives. The purpose of this study was to test the utility of measuring respiratory variation in pulmonary venous flow by transesophageal echocardiography. Background. Respiratory variation of atrioventricular and central venous flow velocities by Doppler echocardiography has been used to differentiate Constrictive Pericarditis from restrictive cardiomyopathy. Methods. We performed pulsed wave Doppler transesophageal echocardiography of the left or right pulmonary veins in 31 patients with diastolic dysfunction. Fourteen patients had Constrictive Pericarditis, and 17 had restrictive cardiomyopathy. We measured the pulmonary venous peak systolic and diastolic flow velocities and the systolic/diastolic flow ratio with transesophageal echocardiography during expiration and inspiration. The percent change in Doppler flow velocity from expiration to inspiration (%E) was calculated. Results. Pulmonary venous peak systolic flow in both inspiration and expiration was greater in Constrictive Pericarditis than in restrictive cardiomyopathy. The %E for peak systolic flow tended to be higher in Constrictive Pericarditis (19% vs. 10%, p = 0.09). In contrast, pulmonary venous peak diastolic flow during inspiration was lower in Constrictive Pericarditis than in restrictive cardiomyopathy. The %E for peak diastolic flow was larger in Constrictive Pericarditis (29% vs. 16%, p = 0.008). The pulmonary venous systolic/diastolic flow ratio was greater in Constrictive Pericarditis in both inspiration and expiration. The combination of pulmonary venous systolic/diastolic flow ratio ≥0.65 in inspiration and a %E for peak diastolic flow ≥40% correctly classified 86% of patients with Constrictive Pericarditis. Conclusions. The relatively larger pulmonary venous systolic/ diastolic flow ratio and greater respiratory variation in pulmonary venous systolic, and especially diastolic, flow velocities by transesophageal echocardiography can be useful signs in distinguishing Constrictive Pericarditis from restrictive cardiomyopathy.
James B Seward - One of the best experts on this subject based on the ideXlab platform.
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue doppler echocardiography
American Journal of Cardiology, 2004Co-Authors: Jongwon Ha, Steve R Ommen, Jamil A Tajik, Marion E Barnes, Naser M Ammash, Morie A Gertz, James B Seward, Jae K OhAbstract:Abstract This study evaluated the diagnostic role of early diastolic mitral annular velocity (E′) by tissue Doppler echocardiography for differentiating Constrictive Pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed Constrictive Pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E′ at the septal annulus. E′ was significantly higher in patients with Constrictive Pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue doppler echocardiography
American Journal of Cardiology, 2004Co-Authors: Steve R Ommen, Jamil A Tajik, Marion E Barnes, Naser M Ammash, Morie A Gertz, James B SewardAbstract:This study evaluated the diagnostic role of early diastolic mitral annular velocity (E') by tissue Doppler echocardiography for differentiating Constrictive Pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed Constrictive Pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E' at the septal annulus. E' was significantly higher in patients with Constrictive Pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p or =8 cm/second resulted in 95% sensitivity and 96% specificity for the diagnosis of Constrictive Pericarditis. There was no overlap of E' between patients who had Constrictive Pericarditis and those who had cardiac amyloidosis. In a subgroup analysis of restrictive cardiomyopathy, E' of patients who had cardiac amyloidosis was significantly lower than that of patients who had primary restrictive cardiomyopathy (4.6 vs 6.3 cm/second, p <0.001). Thus, E' velocity can distinguish between Constrictive Pericarditis and restrictive cardiomyopathy with a specific cut-off value in patients with clinical and echocardiographic evidence of diastolic heart failure.
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calcific Constrictive Pericarditis is it still with us
Annals of Internal Medicine, 2000Co-Authors: Lieng H Ling, James B Seward, Hartzell V. Schaff, Gordon K. Danielson, Jerome F Breen, Douglas W Mahoney, Jamil A TajikAbstract:In contrast to common belief, pericardial calcification was noted to be a frequent finding in patients with Constrictive Pericarditis. It is often associated with idiopathic disease and other marke...
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Diagnostic role of Doppler echocardiography in Constrictive Pericarditis
Journal of the American College of Cardiology, 1994Co-Authors: Liv Hatle, James B Seward, Hartzell V. Schaff, Gordon K. Danielson, Guy S. Reeder, A. Jamil TajikAbstract:Abstract Objectives . This study was conducted to assess the diagnostic role of Doppler echocardiography in Constrictive Pericarditis. Background . It has been observed that ptients with Constrictive Pericarditis have a characteristic Doppler pattern of respiratory variation in ventricular filling and central venous flow velocities. However, the observation was based on a small number of patients with known diagnosis. Methods . We reviewed the echocardiographic features of 28 patients (21 mem and 7 women; mean age ± SD 55 ± 15 years) with suspected Constrictive Pericarditis who underwent exploratory thoracotomy or pericardiectomy. Results . At operation, Constrictive Pericarditis was diagnosed in 25 patients, restriction in 1 and normal pericardium in 2. Of the 25 patients with constriction, correct preoperative Doppler diagnosis was made in 22 (88%) and Doppler echocardiography showed restriction in 3. In two patients with a normal pericardium, Doppler features were consistent with constriction in one patient and were normal in the other. In the one patient with restriction, Doppler echocardiography showed restriction. In 19 patients with surgically proved constriction, repeat Doppler study after pericardiectomy showed normal findings in 14 and restriction in 5. Twelve of the 14 patients with normalized Doppler findings became asymptomatic, whereas all 5 with restrictive Doppler features remained symptomatic. Conclusions . Doppler echocardiography performed simultaneously with respiratory recording is highly sensitive for diagnosing Constrictive Pericarditis, and it appears to predict functional response to pericardiectomy.
Steve R Ommen - One of the best experts on this subject based on the ideXlab platform.
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue doppler echocardiography
American Journal of Cardiology, 2004Co-Authors: Jongwon Ha, Steve R Ommen, Jamil A Tajik, Marion E Barnes, Naser M Ammash, Morie A Gertz, James B Seward, Jae K OhAbstract:Abstract This study evaluated the diagnostic role of early diastolic mitral annular velocity (E′) by tissue Doppler echocardiography for differentiating Constrictive Pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed Constrictive Pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E′ at the septal annulus. E′ was significantly higher in patients with Constrictive Pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p
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differentiation of Constrictive Pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue doppler echocardiography
American Journal of Cardiology, 2004Co-Authors: Steve R Ommen, Jamil A Tajik, Marion E Barnes, Naser M Ammash, Morie A Gertz, James B SewardAbstract:This study evaluated the diagnostic role of early diastolic mitral annular velocity (E') by tissue Doppler echocardiography for differentiating Constrictive Pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed Constrictive Pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E' at the septal annulus. E' was significantly higher in patients with Constrictive Pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p or =8 cm/second resulted in 95% sensitivity and 96% specificity for the diagnosis of Constrictive Pericarditis. There was no overlap of E' between patients who had Constrictive Pericarditis and those who had cardiac amyloidosis. In a subgroup analysis of restrictive cardiomyopathy, E' of patients who had cardiac amyloidosis was significantly lower than that of patients who had primary restrictive cardiomyopathy (4.6 vs 6.3 cm/second, p <0.001). Thus, E' velocity can distinguish between Constrictive Pericarditis and restrictive cardiomyopathy with a specific cut-off value in patients with clinical and echocardiographic evidence of diastolic heart failure.