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Role of tissue characterization by Cardiac Magnetic Resonance in the diagnosis of constrictive pericarditis

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Abstract

Cardiac Magnetic Resonance (CMR) allows evaluation of the functional and flow changes in pericardial constriction as well as detection of acute pericardial inflammation, fusion and thickening of pericardial layers and pericardial effusion. We sought to evaluate the diagnostic role of tissue characterization by CMR in constrictive pericarditis (CP). We performed a CMR exam in 70 patients (mean age 58 ± 16) with clinical suspicion of constrictive pericarditis and constrictive pattern at echocardiography and/or catheterization. A multiparametric CMR approach was used to evaluate the initial diagnostic suspicion. A clinical follow-up was performed in all patients for a median of 551 days. The diagnosis of CP was confirmed in 53 patients while 12 patients presented signs of predominant pericardial active inflammation suggesting a diagnosis of transient constrictive pericarditis and five presented effusive-constrictive pericarditis. Patients with a final diagnosis of CP had worse prognosis than those with transient constrictive or effusive constrictive pericarditis. The presence of myocardial late gadolinium enhancement was associated to adverse events. Results of the current study confirmed the value of CMR in the differential diagnosis of pericardial disease. A multiparametric CMR approach allowed to distinguish between active inflammation, chronic pericarditis with constriction and effusion without inflammation.

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Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Fondazione Toscana G.Monasterio, Fondazione CNR-Regione Toscana, Via Moruzzi, 1, 56124, Pisa, Italy

    Giovanni Donato Aquaro, Andrea Barison, Alessandro Cagnolo, Giancarlo Todiere & Michele Emdin

  2. Multimodality Cardiac Imaging Section, San Donato, Milan, Italy

    Massimo Lombardi

Authors
  1. Giovanni Donato Aquaro
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  2. Andrea Barison
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  3. Alessandro Cagnolo
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  4. Giancarlo Todiere
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  5. Massimo Lombardi
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  6. Michele Emdin
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Corresponding author

Correspondence to Giovanni Donato Aquaro.

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10554_2015_648_MOESM1_ESM.avi

Movie 1 in supplemental data: short axis SSFP cine-loop of the case reported in Fig. 3. The sigmoidal shaped diastolic septal movement is evident suggesting a constrictive pattern

Movie 2 in supplemental data: horizontal long axis SSFP cine-loop of the case reported in Fig. 3

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Aquaro, G.D., Barison, A., Cagnolo, A. et al. Role of tissue characterization by Cardiac Magnetic Resonance in the diagnosis of constrictive pericarditis. Int J Cardiovasc Imaging 31, 1021–1031 (2015). https://doi.org/10.1007/s10554-015-0648-4

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  • DOI: https://doi.org/10.1007/s10554-015-0648-4

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