Updates on the Global Prevalence and Etiology of Constrictive Pericarditis: A Systematic Review

Abstract

Constrictive pericarditis is a rare disease with poorly understood epidemiology. A systematic literature search was adopted to assess the region-and period-specific traits of constrictive pericarditis through Pubmed, EMBASE, and Scopus. Case reports and studies including less than 20 patients were excluded. The risk of bias was assessed through the Study Quality Assessment Tools developed by the National Heart Lung Blood Institute by 4 reviewers. Patient demographics, disease etiology, and mortality were the primary assessed outcomes. One hundred thirty studies with 11,325 patients have been included in this systematic review and meta-analysis. The age at diagnosis of constrictive pericarditis has markedly increased after 1990. Patients from Africa and Asia are considerably younger compared with those from Europe and North America. Moreover, there are differences in etiology, as tuberculosis remains the dominant cause of constrictive pericarditis in Africa and Asia but has been surpassed by history of previous chest surgery in North America and Europe. The human immunodeficiency virus affects 29.1% of patients from Africa diagnosed with constrictive pericarditis, a feature that is not observed on any other continent. The early mortality rate after hospitalization has improved. The variances of age at diagnosis and etiology of constrictive pericarditis should be considered by the clinician during the work-up of cardiac and pericardial diseases. An underlying human immunodeficiency virus infection complicates a significant portion of constrictive pericarditis cases in Africa. Early mortality has improved across the world but remains high.

Constrictive Pericarditis induced by Human Herpes Virus Infection: A Case Report

“…For instance, the inci-dence of CP attributed to tuberculosis in India was 61% during the period of 1954-1985 and 93% during the period of 1985-2004, respectively [9]. A recent systematic review including 30 studies and over 11000 patients showed that tuberculosis remains the most frequent cause in Asia and Africa while previous cardiac surgery has become the predominant cause in North America and Europe [4]. Regardless, a part of CP patients remained idiopathic.…”

“…There was a regional heterogeneity regarding etiologies worldwide. Tuberculosis was the predominant cause of CP in developing countries, while prior cardiac surgery was most frequent in North America and Europe [4]. Additionally, other potential causes encompassed asbestosis, trauma, malignancy, rheumatologic disease, and infection.…”

Diagnostic procedure for localized constrictive pericarditis leading to bilateral pleural effusion: two case reports

“…Constrictive pericarditis is an uncommon disease caused by several conditions, such as tuberculous pericarditis and nonspecific pericarditis. 1 Inflammation affects the visceral layer and parietal layer of the pericardium, leading to fibrosis, scarring, adhesion, thickening, calcification, and contracture of the pericardium, which restricts ventricular diastole and impairs ventricular function. 2,3 This also causes compression of the heart and the roots of large blood vessels, leading to restricted diastolic filling and resulting in several circulatory dysfunctions in the right atrium, including elevated vena cava pressure and reduced cardiac output.…”

“…Constrictive pericarditis is an uncommon disease caused by several conditions, such as tuberculous pericarditis and nonspecific pericarditis 1 . Inflammation affects the visceral layer and parietal layer of the pericardium, leading to fibrosis, scarring, adhesion, thickening, calcification, and contracture of the pericardium, which restricts ventricular diastole and impairs ventricular function 2,3 .…”