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Pericardiectomy is associated with improvement in longitudinal displacement of left ventricular free wall due to increased counterclockwise septal-to-lateral rotational displacement


Negishi, K and Popovic, ZB and Negishi, T and Motoki, H and Alraies, MC and Chirakarnjanakorn, S and Dahiya, A and Klein, AL, Pericardiectomy is associated with improvement in longitudinal displacement of left ventricular free wall due to increased counterclockwise septal-to-lateral rotational displacement, Journal of the American Society of Echocardiography, 28, (10) pp. 1204-1213. ISSN 0894-7317 (2015) [Refereed Article]

Copyright Statement

Copyright 2015 American Society of Echocardiography

DOI: doi:10.1016/j.echo.2015.05.011


Background: Pericardiectomy is an effective intervention for constrictive pericarditis. Speckle-tracking echocardiography can provide quantitative information not only about longitudinal strain (LS) but about longitudinal displacement (LD) and septal-to-lateral rotational displacement (SLRD). The aim of this study was to investigate whether pericardiectomy improves myocardial mechanics using speckle-tracking analysis.

Methods: Eighty-three patients with constrictive pericarditis who underwent echocardiography were retrospectively assessed (mean age, 58 ± 12 years; 72 men; 50 idiopathic, 20 postoperative, four viral, three radiation, and six others) and compared with 20 healthy volunteers. LD and SLRD were measured from the apical four-chamber view and global LS from three apical views.

Results: LD was less in the constrictive pericarditis group compared with control subjects (P < .001). Only lateral LS was significantly less than that of control subjects (P < .001), but septal LS was similar (P = .48). In pre- and post–pericardial surgery comparisons (n = 27), values of septal and lateral LD were almost identical (mean, 13.6 ± 4.7 vs 13.3 ± 5.4 mm; P = .70) before pericardiectomy, but septal LD decreased (mean, 9.3 ± 3.5 mm; P < .001) and lateral LD increased (mean, 16.8 ± 4.7 mm; P = .0106) after the surgery, even though the difference in LS between the septal and lateral walls decreased (from 5.6 ± 5.3% to 2.5 ± 4.2%, P = .008). Systolic whole-heart swinging motion significantly increased to a counterclockwise direction after surgery (mean SLRD, −0.8 ± 3.3° vs 2.1 ± 3.0°; P = .001). Although the change in SLRD after pericardiectomy was not different between patients with decreases and increases in New York Heart Association class, SLRD change was significantly greater in patients who received fewer diuretics after surgery (mean, 4.00 ± 0.91 vs 0.27 ± 1.47; P = .027).

Conclusions: After surgical removal of the pericardium, LD of the septal and lateral walls became significantly different, and counterclockwise SLRD increased, reflecting loss of pericardial support.

Item Details

Item Type:Refereed Article
Keywords:constrictive pericarditis, displacement, longitudinal rotation, pericardiectomy, strain
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
UTAS Author:Negishi, K (Dr Kazuaki Negishi)
UTAS Author:Negishi, T (Dr Tomoko Negishi)
ID Code:102140
Year Published:2015
Web of Science® Times Cited:8
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-07-30
Last Modified:2017-11-02

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