Evaluation Of The Cardiac Function In Patients With Constrictive Pericarditis With Two-dimensional Speckle Tracking Echocardiography

Part IEvaluation of the cardiac function in patient with ConstrictivePericarditis by two-dimensional speckle trackingEchocardiographyObjective: To evaluate the cardiac function of patient with Constrictive Pericarditis bytwo-dimensional speckle tracking Imaging.Methods:41controls and40constrictive pericarditis patients were enrolled.Echocardiography was performed to collect the imaging clips of two cavity, four cavity,long axis at apex, short axis imaging at mitral valve, papillary muscle and apex levels. Thegloble longitudinal strain, circumferential strain and radial strain of each imaging clip weremeasured by two-dimensional speckle tracking software. The globle circumferential andradial strain of short axis at different levels was defined as the average peak strain of sixsegments of each level.Results:(1)Standard ultrasonography: the left and right atrium of CP patients were largerand the diameter of left ventricular was smaller than controls. Meanwhile, the ejectionfraction and peak velocity of mitral valve during early diastole of CP patients were lowercompared with controls.(2) Two-dimensional speckle tracking imaging: globle longitudinalstrain of two cavity, four cavity and long axis at apex were lower than controls, meanwhilethe globle circumferential and radial strain of short axis at mitral valve, papillary muscleand apex levels were also lower than that of controls.Conclusion: The lower globle longitudinal strain, circumferential strain and radial strain ofeach imaging clip of constrictive pericarditis patients showed an injury of myocardium which indicated a decreased left ventricular function in constrictive pericarditis patients,two-dimensional speckle tracking imaging was more sensitive than ejection fraction tofind the injury of myocardium and provided us a more accurate way to evaluate thefunction of CP patients. Part IIEvaluation of The Cardiac Function in Patients withConstrictive Pericarditis after Pericardiectomy byTwo-dimensional Speckle Tracking EchocardiographyObjective: To evaluate the change of cardiac function in constrictive pericarditis afterpericardiectomy by two-dimensional speckle tracking Imaging.Methods:22patients with the diagnosis of CP that decided to undergo pericardiectomywere enrolled. Echocardiography was performed before pericardiectomy to collect theimaging clips of two cavity, four cavity, long axis at apex, short axis imaging at mitralvalve, papillary muscle and apex levels. The globle longitudinal strain, circumferentialstrain and radial strain of each imaging clip were measured by two-dimensional speckletracking software. The globle circumferential and radial strain of short axis at differentlevels was defined as the average peak strain of six segments of each level. The processwas repeated one month later after pericardiectomy.Results:(1)Standard echocardiography: The diameter and ejection fraction of leftventricular were increased while left and right atrium were decreased at different degreesafter pericardiectomy. Meanwhile, peak velocity of mitral valve during early diastole was elevated.(2) Two-dimensional speckle tracking imaging: the globle longitudinal strain oftwo cavity, four cavity and long axis at apex were increased at different degrees, the globlecircumferential and radial strain of short axis at different levels were elevated afterpericardiectomy.Conclusion:(1)After pericardiectomy, the ejection fraction of CP patients was higher, theatriums and left ventricular tend to be normal.(2) the increased globle longitudinal strain oftwo cavity, four cavity, long axis at apex at different degrees showed a significant recoveryof longitudinal function after removing the sicken pericardium.(3) The globlecircumferential and radial strain of short axis at different levels was elevated afterpericardiectomy showed an increased axis movement function in the absence of limitationof sicken pericardium.（4） Two-dimensional speckle tracking imaging can quantitativelyassess the cardiac change of constrictive pericarditis patients after pericardiectomy, andprovided us a more accurate way to evaluate the efficiency of the operation.