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Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis
BACKGROUND: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. OBJECTIVE: To assess the clinical characteristics, sensitivity of imaging tests and factors related...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cardiologia - SBC
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729782/ https://www.ncbi.nlm.nih.gov/pubmed/28977057 http://dx.doi.org/10.5935/abc.20170147 |
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author | Fernandes, Fábio de Melo, Dirceu Thiago Pessoa Ramires, Felix José Alvarez Dias, Ricardo Ribeiro Tonini, Marcio Fernandes, Vinicius dos Santos Rochitte, Carlos Eduardo Moreira, Carlos Henrique Valente Mady, Charles |
author_facet | Fernandes, Fábio de Melo, Dirceu Thiago Pessoa Ramires, Felix José Alvarez Dias, Ricardo Ribeiro Tonini, Marcio Fernandes, Vinicius dos Santos Rochitte, Carlos Eduardo Moreira, Carlos Henrique Valente Mady, Charles |
author_sort | Fernandes, Fábio |
collection | PubMed |
description | BACKGROUND: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. OBJECTIVE: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. METHODS: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant. RESULTS: We studied 84 patients (mean age, 44 ± 17.9 years; 67% male). Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%). Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL) were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%), and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation. CONCLUSIONS: Magnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death. |
format | Online Article Text |
id | pubmed-5729782 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Sociedade Brasileira de Cardiologia - SBC |
record_format | MEDLINE/PubMed |
spelling | pubmed-57297822017-12-18 Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis Fernandes, Fábio de Melo, Dirceu Thiago Pessoa Ramires, Felix José Alvarez Dias, Ricardo Ribeiro Tonini, Marcio Fernandes, Vinicius dos Santos Rochitte, Carlos Eduardo Moreira, Carlos Henrique Valente Mady, Charles Arq Bras Cardiol Original Articles BACKGROUND: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. OBJECTIVE: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. METHODS: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant. RESULTS: We studied 84 patients (mean age, 44 ± 17.9 years; 67% male). Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%). Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL) were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%), and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation. CONCLUSIONS: Magnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death. Sociedade Brasileira de Cardiologia - SBC 2017-11 /pmc/articles/PMC5729782/ /pubmed/28977057 http://dx.doi.org/10.5935/abc.20170147 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Fernandes, Fábio de Melo, Dirceu Thiago Pessoa Ramires, Felix José Alvarez Dias, Ricardo Ribeiro Tonini, Marcio Fernandes, Vinicius dos Santos Rochitte, Carlos Eduardo Moreira, Carlos Henrique Valente Mady, Charles Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis |
title | Importance of Clinical and Laboratory Findings in the Diagnosis and
Surgical Prognosis of Patients with Constrictive Pericarditis |
title_full | Importance of Clinical and Laboratory Findings in the Diagnosis and
Surgical Prognosis of Patients with Constrictive Pericarditis |
title_fullStr | Importance of Clinical and Laboratory Findings in the Diagnosis and
Surgical Prognosis of Patients with Constrictive Pericarditis |
title_full_unstemmed | Importance of Clinical and Laboratory Findings in the Diagnosis and
Surgical Prognosis of Patients with Constrictive Pericarditis |
title_short | Importance of Clinical and Laboratory Findings in the Diagnosis and
Surgical Prognosis of Patients with Constrictive Pericarditis |
title_sort | importance of clinical and laboratory findings in the diagnosis and
surgical prognosis of patients with constrictive pericarditis |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729782/ https://www.ncbi.nlm.nih.gov/pubmed/28977057 http://dx.doi.org/10.5935/abc.20170147 |
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