Effusive-Constrictive Pericarditis: Doppler Findings

Development of rapid evaluation scale for pericardiectomy of tuberculous constrictive pericarditis by 12-lead electrocardiogram

AIM

We developed a rapid evaluation scale for pericardiectomy through a 12-lead electrocardiogram (ECG), in order to improve the diagnostic accuracy of pericardiectomy of tuberculous constrictive pericarditis.

METHOD

In this study, 262 patients with tuberculous constrictive pericarditis (102 patients) and non-tuberculous constrictive pericarditis (160 patients) were selected by convenience sampling method as participants in Hangzhou Red Corss Hospital from January 2018 to April 2023. The expert validity analysis was carried out by cross-sectional investigation combined with the results of the previous expert questionnaire to establish 12-lead ECG-based the rapid evaluate scale for pericardiectomy of tuberculous constrictive pericarditis. Cronbach'α coefficient and Spearman-Brown coefficient were used for the internal consistency reliability of the scale. Exploratory factor analysis was used for structural validity. Receiver operating characteristic (ROC) was used to analyze the sensitivity and specificity of this scale.

RESULTS

After preliminary verification, the cronbach'α coefficient and Spearman-Brown coefficient were 0.830 and 0.800, respectively. Three factors with feature roots greater than 1.0 were extracted by principal component analysis and maximum variance orthogonal rotation, and the cumulative contribution rate was 57.77%. Each loading factor ranges from 0.427 to 0.863. The sensitivity of the scale was 96.1%, the specificity was 96.9% and the Yorden Index was 93.0%.

CONCLUSIONS

The 12-lead ECG-based rapid evaluation scale for pericardiectomy of tuberculous constrictive pericarditis has high sensitivity, specificity and accuracy, and has certain scientific research and clinical application value.

Pseudomonas aeruginosa-related effusive-constrictive pericarditis diagnosed with echocardiography: A case report

BACKGROUND

Effusive-constrictive pericarditis (ECP) is an uncommon pericardial syndrome. Careful echocardiographic examination may provide helpful information not only for diagnosing but also for managing ECP. ECP has various etiologies; however, Pseudomonas aeruginosa (P. aeruginosa) infection has not been reported as a cause to date. Herein, we present a rare case of ECP caused by P. aeruginosa infection, which was followed up using echocardiography.

CASE SUMMARY

A 30-year-old man was admitted to our hospital with a 2-mo history of cough, dyspnea, bloating, palpitations, and lower-extremity edema. The patient was initially diagnosed with pericardial effusion by transthoracic echocardiography. Drainage of pericardial effusion was performed to relieve the clinical symptoms. A follow-up echocardiogram showed that the pericardial effusion had decreased; however, the right atrial pressure continued to increase, and signs of constrictive pericarditis were observed upon a more comprehensive inspection. Therefore, the diagnosis of ECP was established based on the comprehensive pre- and post-pericardiocentesis echocardiographic findings. An urgent pericardectomy was subsequently performed, which significantly relieved the patient's clinical symptoms, and the signs of pericardial constriction on echocardiography improved. Pericardial effusion and pericardial culture showed growth of P. aeruginosa.

CONCLUSION

ECP induced by P. aeruginosa infection remains a rare disease. The presence of echocardiographic features of constrictive pericarditis after pericardiocentesis therapy is highly indicative of ECP.

The Clinical Efficacy of Cedilanid and Isosorbide Dinitrate plus Pericardial Dissection for Chronic Constrictive Pericarditis in the Elderly and Its Influence on Plasma Endothelin, Atrial Natriuretic Peptide, and Systemic Immune-Inflammation Index

Objective

To investigate the clinical efficacy of cedilanid and isosorbide dinitrate plus pericardial dissection for chronic constrictive pericarditis in the elderly.

Methods

Ninety elderly patients with chronic constrictive pericarditis admitted to our hospital from March 2018 to October 2020 were recruited and assigned to receive either cedilanid and isosorbide dinitrate (control group A), pericardial dissection (control group B), or cedilanid and isosorbide dinitrate plus pericardial dissection (combination group) via random number table method, with 30 patients in each group. Outcome measures included plasma endothelin, atrial natriuretic peptide, system immune-inflammation indices, treatment effect, quality of life, mental state, and treatment satisfaction.

Results

The combination group had significantly higher treatment satisfaction and treatment efficacy than control groups A and B (P > 0.05). The combination group showed the lowest levels of atrial natriuretic peptide and endothelin, followed by control group A, and group B (P < 0.001). The combined therapy resulted in significantly lower levels of system immunity index, lower Hospital Anxiety and Depression Scale (HAD) scores, and better General Quality of Life Inventory-74 (GQOLI-74) scores than those of the control group B, followed by group A (P < 0.001).

Conclusion

Cedilanid and isosorbide dinitrate plus pericardial dissection for elderly patients with chronic constrictive pericarditis enhances the level of plasma endothelin, atrial natriuretic peptide, and systemic immune-inflammation indexes of patients and improves their quality of life, which shows great potential for clinical promotion.

Post cardiac injury syndromes: diagnosis and management

Post cardiac injury syndromes (PCIS) are becoming increasingly common, due to the growing number of cardiovascular procedures (cardiac surgery, percutaneous interventions) and the high burden of cardiovascular diseases such as acute coronary syndromes. This review aims to provide an overview of the main clinical characteristics of PCIS, along with their management in clinical practice.