Impact of pericardiectomy on exercise capacity and sleep of patients with chronic constrictive pericarditis

Author(s):Show less -

Pessoa de Melo, Dirceu Thiago ^[1] ; Nerbass, Flavia Baggio ^[2] ; Carrari Sayegh, Ana Luiza ^{[3, 4]} ; de Souza, Francis Ribeiro ^{[3, 4]} ; Hotta, Viviane Tiemi ^[1] ; Curi Salemi, Vera Maria ^[5] ; Alvarez Ramires, Felix Jose ^[1] ; Dias, Ricardo Ribeiro ^[6] ; Lorenzi-Filho, Geraldo ^[2] ; Mady, Charles ^[1] ; Fernandes, Fabio ^[1]

Affiliation

^[1] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Cardiomyopathy Clin Unit, Cardiol Div, Heart Inst I, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Sleep Lab, Pulm Div, Heart Inst InCor, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Heart Inst InCor, Unit Cardiovasc Rehabil, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Heart Inst InCor, Exercise Physiol Cardiol Div, Sao Paulo, SP - Brazil

^[5] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Heart Failure Unit, Cardiol Div, Heart Inst InCor, Sao Paulo, SP - Brazil

^[6] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Unit Cardiac Surg, Cardiol Div, Heart Inst InCor, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: PLoS One; v. 14, n. 10 OCT 11 2019.
• Web of Science Citations: 0

Abstract

Background Heart failure is associated with exercise intolerance and sleep-disordered breathing; however, studies in patients with chronic constrictive pericarditis are scarce. The purpose of our study was to assess exercise capacity and sleep in patients with chronic constrictive pericarditis (CCP) undergoing a pericardiectomy. Methods We studied consecutive patients scheduled for pericardiectomy due to symptomatic CCP. Were performed quality of life (Minnesota Living with Heart Failure Questionnaire-MLHFQ) and sleep questionnaires (Epworth, Pittsburgh Sleep Quality Index-PSQI), serum B-type natriuretic peptide (BNP), serum C-reactive protein, transthoracic echocardiography, cardiopulmonary exercise test and overnight polysomnography immediately before and six months after pericardiectomy. Results Twenty-five patients (76% males, age: 45.5 +/- 13.8 years, body mass index: 24.9 +/- 3.7 kg/m(2), left ventricular ejection fraction: 60 +/- 6%) with CCP (76% idiopathic, 12% tuberculosis) were studied. As compared to the preoperative period, pericardiectomy resulted in reduction in BNP (143 (83.5-209.5) vs 76 (40-117.5) pg/mL, p = 0.011), improvement in VO2 peak (18.7 +/- 5.6 vs. 25.2 +/- 6.3 mL/kg/min, p<0.001), quality of life (MLHFQ score 62 (43,5-77,5) vs. 18 (8,5-22), p<0,001) and sleep (PSQI score 7.8 +/- 4.1 vs. 4.7 +/- 3.7, p<0.001) and no significant change in sleep disordered breathing (apnea hypopnea index-AHI 15.6 (8.3-31.7) vs. 14.6 (5.75-29.9) events/h, p = 0.253). Conclusion Patients with symptomatic CCP showed reduced exercise capacity and sleep-disordered breathing. After pericardiectomy, there was improvement in exercise capacity and neutral effect on sleep-disordered breathing. (AU)

• FAPESP's process: 12/10819-4 - Sleep apnea and morphofunctional aspects in patients with constrictive pericarditis undergoing pericardiectomy
• Grantee: Fabio Fernandes
• Support Opportunities: Regular Research Grants