Clinical Characteristics and Treatment of Constrictive Pericarditis in Taiwan

Chen, Robert Fu Chean; Lai, Cha Po

doi:10.1253/circj.69.458

Cited by 20 publications

(9 citation statements)

References 15 publications

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“…In developing countries, the most common reason for the constrictive pericarditis is tuberculosis. 319 Constrictive pericarditis should be suspected in patients with unexplained RHF in whom there is a history of pericardial disease or predisposing pericardial injury. The most commonly reported symptoms are peripheral edema and exertional dyspnea.…”

Section: Constrictive Pericarditismentioning

confidence: 99%

2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure

Ezekowitz

O’Meara

McDonald

et al. 2017

Canadian Journal of Cardiology

571

496

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Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the major changes that have occurred, the Guidelines Committee believes that a comprehensive reassessment of the HF management recommendations is presently needed, with a view to producing a full and complete set of updated guidelines. The primary and secondary Canadian Cardiovascular Society HF panel members as well as external experts have reviewed clinically relevant literature to provide guidance for the practicing clinician. The 2017 HF guidelines provide updated guidance on the diagnosis and management (self-care, pharmacologic, nonpharmacologic, device, and referral) that should aid in day-to-day decisions for caring for patients with HF. Among specific issues covered are risk scores, the differences in management for HF with preserved vs reduced ejection fraction, exercise and rehabilitation, implantable devices, revascularization, right ventricular dysfunction, anemia, and iron deficiency, cardiorenal syndrome, sleep apnea, cardiomyopathies, HF in pregnancy, cardio-oncology, and myocarditis. We devoted attention to strategies and treatments to prevent HF, to the organization of HF care, comorbidity management, as well as practical issues around the timing of referral and follow-up care. Recognition and treatment of advanced HF is another important aspect of this update, including how to select advanced therapies as well as end of life considerations. Finally, we acknowledge the remaining gaps in evidence that need to be filled by future research.

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Section: Constrictive Pericarditismentioning

confidence: 99%

2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure

Ezekowitz

O’Meara

McDonald

et al. 2017

Canadian Journal of Cardiology

571

496

View full text Add to dashboard Cite

show abstract

“…Tuberculosis (TB) is a rare cause of CP in developed countries, whereas it is a major cause of CP in "developing" countries. 8, 9 Therefore, there may be ethnic differences in the etiology and prognosis of CP. 10 Long-Term Prognosis After Pericardiectomy ation with CABG.…”

Section: Study Populationmentioning

confidence: 99%

Long-Term Clinical Outcomes and Prognostic Factors After Pericardiectomy for Constrictive Pericarditis in a Japanese Population

Nishimura

Izumi

Amano

et al. 2017

Circ J

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Background: Constrictive pericarditis (CP) is characterized by impaired diastolic cardiac function leading to heart failure. Pericardiectomy is considered effective treatment for CP, but data on long-term clinical outcomes after pericardiectomy are limited. Methods and Results:We retrospectively investigated 45 consecutive patients (mean age, 59±14 years) who underwent pericardiectomy for CP. Preoperative clinical factors, parameters of cardiac catheterization, and cardiac events were examined. Cardiac events were defined as hospitalization owing to heart failure or cardiac death. Median follow-up was 5.7 years. CP etiology was idiopathic in 16 patients, post-cardiac surgery (CS) in 21, tuberculosis-related in 4, non-tuberculosis infection-related in 2, infarctionrelated in 1, and post-radiation in 1. The 5-year event-free survival was 65%. Patients with idiopathic CP and tuberculosis-related CP had favorable outcomes compared with post-CS CP (5-year event-free survival: idiopathic, 80%; tuberculosis, 100%; post-CS, 52%). Higher age (hazard ratio: 2.51), preoperative atrial fibrillation (3.25), advanced New York Heart Association class (3.92), and increased pulmonary artery pressure (1.06) were predictors of cardiac events. Patients with postoperative right-atrial pressure ≥9 mmHg had lower event-free survival than those with right-atrial pressure <9 mmHg (39% vs. 75% at 5 years, P=0.013).Conclusions: Long-term clinical outcomes after pericardiectomy among a Japanese population were related to the underlying etiology and the patient's preoperative clinical condition. Postoperative cardiac catheterization may be helpful in the prediction of prognosis after pericardiectomy.

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“…The use of surgical approaches in the treatment of chronic constrictive pericarditis is widely accepted 6‐10 . To date, there have been varying reports in favor of the median sternotomy, left anterolateral, as well as bilateral thoracotomy for pericardiectomy 3,10 .…”

Section: Discussionmentioning

confidence: 99%

“…The use of surgical approaches in the treatment of chronic constrictive pericarditis is widely accepted. [6][7][8][9][10] To date, there have been varying reports in favor of the median sternotomy, left anterolateral, as well as bilateral thoracotomy for pericardiectomy. 3,10 However, the choice of surgical approach, besides being determined by the existing pathology, is largely based on the surgeon's preference.…”

Section: Discussionmentioning

confidence: 99%

Pericardiectomy: A Functional Anatomical Perspective for the Choice of Left Anterolateral Thoracotomy

Lachman

Vanker²,

Christensen

et al. 2009

Journal of Cardiac Surgery

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Although pericardiectomy remains an established method for pericardial resection, the choice of surgical approach is not definitive. Within South Africa, surgical referral for tuberculosis-induced chronic constrictive pericarditis has not declined. Anecdotal reports have indicated good operative results that appear to show an association with choice of surgical technique used. This study aimed to provide a functional anatomical perspective for performance and recovery of the heart during pericardiectomy based on anatomical dissection and surgical notes. En bloc specimens were harvested from 16 fresh cadavers and pericardial segments were measured in terms of percentage cover over surface area of the myocardium. Retrospective analysis of 116 surgical reports of pericardiectomy performed over a period of 20 years was conducted. Surgical notes were compared for median sternotomy and anterolateral left thoracotomy. Results from anatomical study indicated that although the anterior pericardium between the phrenic nerves constitutes about 58% of total selected pericardial area, total pericardium accessible over left ventricle from that approach was only 26%. When orientated in left anterolateral position, total accessible area of left ventricular pericardium was 37%. Standard deviations were found to be comparable. Means were significantly different, indicating that the left anterolateral approach allows wider access to the left ventricle. This paper provides a functional anatomical perspective for the choice of left anterolateral thoracotomy as a surgical approach for pericardiectomy.

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Clinical Characteristics and Treatment of Constrictive Pericarditis in Taiwan

Cited by 20 publications

References 15 publications

2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure

2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure

Long-Term Clinical Outcomes and Prognostic Factors After Pericardiectomy for Constrictive Pericarditis in a Japanese Population

Pericardiectomy: A Functional Anatomical Perspective for the Choice of Left Anterolateral Thoracotomy

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