Etiology of constrictive pericarditis strongly predicted 7-year survival after pericardiectomy, with rates of 88% for idiopathic, 66% for postsurgical, and 27% for postradiation causes.
Cohort (n=163)
No
Does the etiology of constrictive pericarditis affect long-term survival after pericardiectomy?
Long-term survival after pericardiectomy for constrictive pericarditis is strongly dependent on the underlying etiology, with idiopathic cases having the best prognosis and post-radiation cases the worst.
OBJECTIVES: We sought to determine the association of etiology of constrictive pericarditis (CP), pericardial calcification (CA), and other clinical variables with long-term survival after pericardiectomy. BACKGROUND: Constrictive pericarditis is the result of a spectrum of primary cardiac and noncardiac conditions. Few data exist on the cause-specific survival after pericardiectomy. The impact of CA on survival is unclear. METHODS: A total of 163 patients who underwent pericardiectomy for CP over a 24-year period at a single surgical center were studied. Constrictive pericarditis was confirmed by the surgical report. Vital status was obtained from the Social Security Death Index. RESULTS: Etiology of CP was idiopathic in 75 patients (46%), prior cardiac surgery in 60 patients (37%), radiation treatment in 15 patients (9%), and miscellaneous in 13 patients (8%). Median follow-up among survivors was 6.9 years (range 0.8 to 24.5 years), during which time there were 61 deaths. Perioperative mortality was 6%. Idiopathic CP had the best prognosis (7-year Kaplan-Meier survival: 88%, 95% confidence interval CI 76% to 94%) followed by postsurgical (66%, 95% CI 52% to 78%) and postradiation CP (27%, 95% CI 9% to 58%). In bootstrap-validated proportional hazards analyses, predictors of poor overall survival were prior radiation, worse renal function, higher pulmonary artery systolic pressure (PAP), abnormal left ventricular (LV) systolic function, lower serum sodium level, and older age. Pericardial calcification had no impact on survival. CONCLUSIONS: Long-term survival after pericardiectomy for CP is related to underlying etiology, LV systolic function, renal function, serum sodium, and PAP. The relatively good survival with idiopathic CP emphasizes the safety of pericardiectomy in this subgroup.
Bertog et al. (Thu,) conducted a cohort in Constrictive pericarditis (n=163). Etiology of constrictive pericarditis was evaluated on 7-year survival. Etiology of constrictive pericarditis strongly predicted 7-year survival after pericardiectomy, with rates of 88% for idiopathic, 66% for postsurgical, and 27% for postradiation causes.