Abstract 16713: Cardiopulmonary Exercise Testing Correlates With Functional Capacity in Patients With Constrictive Pericarditis: A New Tool in the Evaluation of Constrictive Pericarditis
Introduction: Patients with constrictive pericarditis (CP) show a spectrum of functional impairment. The role of cardiopulmonary exercise testing (CPX) in objectively evaluating the degree of functional limitation and guiding therapy in CP has not been studied. We sought to investigate the utility of CPX as a tool to correlate with baseline clinical and imaging findings as well as clinical outcomes in CP.
Methods and Results: We identified 29 consecutive patients (25 male; mean age, 59 ± 13 years) with confirmed CP between 2007 and 2012 who had CPX. Patients were evaluated using predicted peak oxygen consumption (Vo2%) in the total surgical (n=19) and non-surgical (n=10) groups. A significant difference was found between the two groups, with overall mean Vo2% of 59.6% ± 15.2%, and 54.7% ± 15.3% in the surgical group and 68.9% ± 9.9% in the non-surgical group (p=0.013). A peak Vo2<50% used as the standard cutoff for cardiac transplantation correlated with a surgical outcome (p=0.010) with all patients meeting cut off (n=9) having surgery. Patients with peak Vo2≥50% in the surgical (n=10) and non-surgical (n=10) groups had no significant differences in measured baseline clinical and imaging characteristics. Surgical patients with peak Vo2<50% had significantly poorer NYHA class (p=0.020) compared to the surgical patients with peak Vo2≥50% with no other significant differences in measured baseline clinical or imaging characteristics. Overall measure of peak Vo2% and NYHA class in all 29 patients was found to have a significant inverse correlation (r =-0.639, p=0.0002).
Conclusion: CPX correlates with functional capacity in patients with CP and can be used as a tool to guide clinical decision making and to risk-stratify patients who may benefit from pericardiectomy. Clinical application of CPX in evaluating the functional status, management, and outcomes in CP patients would benefit from further studies with larger sample sizes.
- © 2013 by American Heart Association, Inc.