“Hot Septum” Sign of Constrictive Pericarditis

Argulian, Edgar; Halpern, Dan

doi:10.1016/j.jaccas.2019.12.024

Cited by 9 publications

(14 citation statements)

References 5 publications

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“…This phenomenon is analogous to the annulus reversus seen by TDI and hence has been named strain reversus [ 44 , 45 ]. This has also been described as “hot septum” sign of CP [ 46 ]. In addition to tissue Doppler imaging, improvement in lateral/septal (medial) strain ratio on serial monitoring has also been identified as a marker of clinical improvement after anti-inflammatory treatment [ 37 •].…”

Section: Role Of Multimodality Imaging In Diagnosis Of Cpmentioning

confidence: 99%

Multimodality Imaging of Constrictive Pericarditis: Pathophysiology and New Concepts

et al. 2022

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Purpose of Review The unique pathophysiological changes of constrictive pericarditis (CP) can now be identified with better imaging modalities, thereby helping in its early diagnosis. Through this review, we outline the pathophysiology of CP and its translation into symptomology and various imaging findings which then are used for both diagnosis and guiding treatment options for CP. Recent Findings Multimodality imaging has provided us with the capability to recognize early stages of the disease and identify patients with a potential for reversibility and can be treated with medical management. Additionally, peri-procedural planning and prediction of post-operative complications has been made possible with the use of advanced imaging techniques. Summary Advanced imaging has the potential to play a greater role in identification of patients with reversible disease process and provide peri-procedural risk stratification, thereby improving outcomes for patients with CP.

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Section: Role Of Multimodality Imaging In Diagnosis Of Cpmentioning

confidence: 99%

Multimodality Imaging of Constrictive Pericarditis: Pathophysiology and New Concepts

et al. 2022

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“…Furthermore, this constriction-like behavior is also reinforced by the phenomenon that the SF seems to be enhanced by inspiration and becomes the most prominent during early diastole ( Figure 1 ) ( 26 ). Regarding STE-markers, in our post-COVID athletes with SF, the characteristic “hot septum” sign can be seen as shown by the STE-derived FWLS/SLS ratio ( Figure 3 ) ( 27 , 28 ). Of note, it is important to mention that other, less specific markers of constrictive physiology, such as increased E/A ratio and PADP, can also be measured in this subpopulation.…”

Section: Discussionmentioning

confidence: 69%

Frequent Constriction-Like Echocardiographic Findings in Elite Athletes Following Mild COVID-19: A Propensity Score-Matched Analysis

Lakatos

Tokodi

Fábián

et al. 2022

Front. Cardiovasc. Med.

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Background: The cardiovascular effects of SARS-CoV-2 in elite athletes are still a matter of debate. Accordingly, we sought to perform a comprehensive echocardiographic characterization of post-COVID athletes by comparing them to a non-COVID athlete cohort.Methods: 107 elite athletes with COVID-19 were prospectively enrolled (P-CA; 23 ± 6 years, 23% female) 107 healthy athletes were selected as a control group using propensity score matching (N-CA). All athletes underwent 2D and 3D echocardiography. Left (LV) and right ventricular (RV) end-diastolic volumes (EDVi) and ejection fractions (EF) were quantified. To characterize LV longitudinal deformation, 2D global longitudinal strain (GLS) and the ratio of free wall vs. septal longitudinal strain (FWLS/SLS) were also measured. To describe septal flattening (SF—frequently seen in P-CA), LV eccentricity index (EI) was calculated.Results: P-CA and N-CA athletes had comparable LV and RVEDVi (P-CA vs. N-CA; 77 ± 12 vs. 78 ± 13mL/m2; 79 ± 16 vs. 80 ± 14mL/m2). P-CA had significantly higher LVEF (58 ± 4 vs. 56 ± 4%, p < 0.001), while LVGLS values did not differ between P-CA and N-CA (−19.0 ± 1.9 vs. −18.8 ± 2.2%). EI was significantly higher in P-CA (1.13 ± 0.16 vs. 1.01 ± 0.05, p < 0.001), which was attributable to a distinct subgroup of P-CA with a prominent SF (n = 35, 33%), further provoked by inspiration. In this subgroup, the EI was markedly higher compared to the rest of the P-CA (1.29 ± 0.15 vs. 1.04 ± 0.08, p < 0.001), LVEDVi was also significantly higher (80 ± 14 vs. 75 ± 11 mL/m2, p < 0.001), while RVEDVi did not differ (82 ± 16 vs. 78 ± 15mL/m2). Moreover, the FWLS/SLS ratio was significantly lower in the SF subgroup (91.7 ± 8.6 vs. 97.3 ± 8.2, p < 0.01). P-CA with SF experienced symptoms less frequently (1.4 ± 1.3 vs. 2.1 ± 1.5 symptom during the infection, p = 0.01).Conclusions: Elite athletes following COVID-19 showed distinct morphological and functional cardiac changes compared to a propensity score-matched control athlete group. These results are mainly driven by a subgroup, which presented with some echocardiographic features characteristic of constrictive pericarditis.

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“…• Presence of a septal leap with respirophasic deviation of the interventricular septum toward the left ventricular cavity during inspiration (two-dimensional mode: S 62% and E 93%; M-mode: S 93% and E 69%) 9,11 (Video 1);…”

Section: Rocha Et Al Constrictive Pericarditis Assessmentmentioning

confidence: 99%

“…The three independent criteria most associated with the diagnosis of CP were: ventricular septal deviation related to breathing, preserved or increased e' velocity of the medial mitral annulus, and prominent reversal of the expiratory diastolic flow of the hepatic vein. 2,11 Each of these criteria was significantly associated with CP in the subgroup of patients with atrial fibrillation. 11 According to the American Society of Echocardiography (2016), when the medial e' velocity of the mitral annulus is > 8 cm/s, mitral annulus reversus and hepatic vein expiratory flow reversal are present, RCM can be excluded and CP diagnosis can be established with confidence.…”

Section: How To Differentiate Cp and Rcmmentioning

confidence: 99%

My Approach to Echocardiographic Assessment for Constrictive Pericarditis

Rocha¹,

Oliveira²,

Silva³

et al. 2023

ABC Imagem Cardiovascular

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Constrictive pericarditis (CP) is a condition in which scarring and loss of elasticity of the pericardium result in impaired ventricular filling, diastolic dysfunction, and right heart failure. The diagnosis of this pathology is challenging, with frequent need for multimodal imaging techniques, among which echocardiography represents the initial imaging modality for the diagnostic evaluation, in addition to allowing the differentiation of CP from restrictive cardiomyopathy (RCM) and other conditions that mimic constriction.

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“Hot Septum” Sign of Constrictive Pericarditis

Cited by 9 publications

References 5 publications

Multimodality Imaging of Constrictive Pericarditis: Pathophysiology and New Concepts

Multimodality Imaging of Constrictive Pericarditis: Pathophysiology and New Concepts

Frequent Constriction-Like Echocardiographic Findings in Elite Athletes Following Mild COVID-19: A Propensity Score-Matched Analysis

My Approach to Echocardiographic Assessment for Constrictive Pericarditis

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