Abstract 10687: Counter-Clockwise Longitudinal Rotation Increases After Pericardiectomy Due to Improved Cardiac Motion
Background: Pericardiectomy is the effective intervention for the patients with constrictive pericarditis. Speckle tracking imaging can provide quantitative information not only about longitudinal strain (ε) but also displacement (LD) and rotation (LR). The aim of this study was to investigate whether pericardiectomy improves myocardial mechanics, using speckle tracking analysis.
Methods: Sixty-one patients with constrictive pericarditis who underwent echocardiography on a Vivid 7 or E 9 (GE Medical) were enrolled and divided into two groups; surgically treated group (Group S (n=28); age 58±11, 26 male, 18 idiopathic, 6 post-operative, 4 others) and medically (Group Med (n=33); age 56±13, 27 male, 16 idiopathic, 10 post-operative, 7 others). Speckle tracking analysis (EchoPAC PC, GE medical) was applied to apical 4-chamber image to obtain ε, LD and LR.
Results: Between Group Med and Group S, septal-/lateral- ε and LR were homogenous (ε; septum/lateral -20.9±3.9/ -15.2±4.3 and -20.4±.9/ -14.6±5.8, p=0.669 (septum), p=0.529 (lateral)) (LR; -0.35±2.6 vs. -0.8±3.3, p=0.520). Among Groups S, septal and lateral LDs were almost identical (13.6±4.7, 13.3±5.4; p=0.673) before pericardiectomy, however, lateral wall LD increased and septal decreased after surgery (9.3±3.5, 16.8±4.7; p<0.0001), although the difference in ε between opposing walls decreased (5.62±5.29, 2.48±4.18; p=0.008). In addition, LR significantly increased after surgery (-0.8±3.3 vs. 2.1±3.0, p=0.001). The change in LR after pericardiectomy was significantly higher in pts who had less diuretics after surgery compared with who did not (4.00±0.91 vs. 0.27±1.47 p=0.027).
Conclusions: After the surgical removal of pericardium, longitudinal displacement of septal and lateral walls become significantly different and counter-clockwise longitudinal rotation increases. These findings suggest that LV myocardial mechanics assessed by speckle tracking improve post pericardiectomy.
- © 2011 by American Heart Association, Inc.