NEW ECHOCARDIOGRAPHY PARAMETERS IN MANAGEMENT OF PATIENTS WITH

CONSTRICTIVE PERICARDITIS

 

Sukmarova Z.N.1, Dobrovolskaya S.V.2, Shitov V.N.2, Saidova M.A.2

 

1 - V.A. Nasonova Research Institute of Rheumatology.

2 - E.I. Chazov National Medical Research Center of Cardiology. Moscow, Russia.

T

he actualization of the constrictive pericarditis problem is associated with the pandemic consequences.

Purpose. To consider the issue of the practical usefulness of various parameters of myocardial deformation in the diagnosis and treatment of pericarditis.

Materials and methods. The article presents the clinical cases of three selected patients without signs of myocardial pathology according to MRI and having successive stages of constrictive pericarditis. They determined the parameters of longitudinal and radial global and local strain of the left and right ventricles, the left atrium, as well as diastolic function, including a diastolic stress test.

Results. The most useful parameter for decision making was the violation of the longitudinal strain of the left ventricle. It had a specific pattern called the Pericardial Strangulation Strain sign (PSS) and represented disturbances in the strain of areas adherent to the pericardium. This parameter more sensitively reflected the degree of constriction and responded to conservative therapy. The remaining parameters of the deformation changed in accordance with the pathological process and provided additional illustration, but not support for decision-making. Another interesting observation was the dynamics of the e’lat/e’med parameter against the background of the stress test.

Discussion. Constrictive pericarditis diagnostics remains difficult due to the lack of typical clinical features. At the same time, there are methods of conservative therapy aimed at avoiding or delaying cardiac surgery. For this purpose, it is important to identify the problem at an early stage, when classical diagnostic criteria are largely absent. Among the variety of modern Echo parameters, the assessment of global and local longitudinal strain can be a guideline for use in clinical practice at any stage of this disease.

Conclusion. We presented the first analysis of all types of measured myocardial deformation in comparison with each other and standard echocardiographic parameters in constrictive pericarditis and noted the relationship of the severity of changes with the stages of constrictive pericarditis and the dynamics of indicators in response to therapy.

 

Keywords: constrictive pericarditis, left ventricular myocardial deformation, left atrium strain, right ventricular strain, diastolic stress test.

 


Corresponding author: Sukmarova Z.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Sukmarova Z.N., Dobrovolskaya S.V., Shitov V.N., Saidova M.A. New echocardiography parameters in management of patients with constrictive pericarditis . REJR 2024; 14(4):93-108. DOI: 10.21569/2222-7415-2024-14-4-93-108.

Received:        20.08.24 Accepted:       22.10.24