Alraies, M Chadi

Dahiya, Arun

Flamm, Scott

Klein, Allan

Kusunose, Kenya

Marwick, Thomas

Elsevier - Publisher Connector 

Pericardial/Myocardial Disease
E1577
JACC March 27, 2012
Volume 59, Issue 13
PERICARDIAL DELAYED ENHANCEMENT BY CARDIAC MR IN CONSTRICTIVE PERICARDITIS IS 
ASSOCIATED WITH LOWER REGIONAL LONGITUDINAL STRAIN
ACC Moderated Poster Contributions
McCormick Place South, Hall A
Sunday, March 25, 2012, 11:00 a.m.-Noon
Session Title: Pericardial/Myocardial Disease IV
Abstract Category: 12. Pericardial/Myocardial Disease
Presentation Number: 1126-122
Authors: Kenya Kusunose, Arun Dahiya, M Chadi Alraies, Scott Flamm, Thomas Marwick, Allan Klein, Cleveland Clinic, Cleveland, OH, USA
Background: We sought to assess the relationship of delayed pericardial enhancement by using cardiac MR delayed enhancement (DE) imaging 
and peri-myocardial tethering with 2D speckle tracking as the severity of peri-myocardial tethering influences myocardial function in constrictive 
pericarditis (CP) patients.
Methods: Methods: We performed echocardiography in 22 patients (age 61±14) with CP. All LV and RV free wall segments in CP patient were 
categorized as DE (+) or DE (-) based on the findings of DE imaging. Regional LV and RV free wall longitudinal strain (LS) by 4 chamber view was 
used to assess severity of peri-myocardial tethering. Pericardial
thickness measurements were made using turbo spin echo pulse sequences.
Results: Forty-two segments were categorized into the DE (+) segment. Ninety segments were categorized into the DE (-) segment. The DE (+) 
segments had significantly lower LV free wall LS than the DE (-) segments (-9.4±6.0% vs. -15.4±5.7%; P < 0.001) and there was lower RV free wall 
LS in the DE (+) segments than in the DE (-) segments (-9.9±6.5% vs. -14.0±4.6%; P = 0.002). When these groups were further subdivided into a 
pericardial thickness (>4mm) group and negative thickness group (<4mm), those with DE (+) and thickness (+) showed the lowest strain (figure).
Conclusions: Pericardial delayed enhancement by cardiac MR in CP is associated with lower LV and RV free wall LS which likely reflects increased 
severity of peri-myocardial tethering in the context of an inflamed pericardium.


PERICARDIAL DELAYED ENHANCEMENT BY CARDIAC MR IN CONSTRICTIVE PERICARDITIS IS ASSOCIATED WITH LOWER REGIONAL LONGITUDINAL STRAIN 

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PERICARDIAL DELAYED ENHANCEMENT BY CARDIAC MR IN CONSTRICTIVE PERICARDITIS IS ASSOCIATED WITH LOWER REGIONAL LONGITUDINAL STRAIN

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