Calcific constrictive pericarditis: Is it still with us?

Lieng H. Ling, Jae Kuen Oh, Jerome F. Breen, Hartzell V Schaff, Gordon K. Danielson, Douglas W. Mahoney, James B. Seward, A. Jamil Tajik

Research output: Contribution to journalArticle

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Abstract

Background: The presence of pericardial calcification on a plain radiograph strongly suggests constrictive pericarditis in patients with heart failure. However, calcific constrictive pericarditis is considered rare in the United States since tuberculosis incidence has decreased, and doubt has therefore been raised about the importance of this radiologic finding in modern cardiovascular practice. Objective: To determine the clinical and prognostic significance of pericardial calcification on radiography in patients with constrictive pericarditis. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A consecutive series of 135 patients (mean age ± SD, 56 ± 16 years) who from 1985 through 1995 had constrictive pericarditis confirmed surgically (n = 133) or by autopsy (n = 2). Patients were divided into two groups: those with pericardial calcification on chest radiography (group I) and those without (group II). Measurements: Clinical and diagnostic findings were compared in both groups, and outcome was compared in 132 patients who had pericardiectomy. Results: Pericardial calcification was seen in 36 patients (27%). The cause of constrictive pericardial disease was indeterminate in 67% of patients in group I and in 21% of patients in group II (P < 0.001). Patients in group I had had symptoms for a longer period and were more likely to have pericardial knock, larger atrial size, and atrial arrhythmia. Significantly more perioperative deaths were seen in group I, but incidence of late survival and incidence of noncalcific disease were similar in both groups. Conclusions: Pericardial calcification is a common finding in patients with constrictive pericarditis. It is often associated with idiopathic disease and other markers of disease chronicity and is an independent predictor of increased perioperative mortality rates.

Original languageEnglish (US)
Pages (from-to)444-450
Number of pages7
JournalAnnals of Internal Medicine
Volume132
Issue number6
StatePublished - Mar 21 2000

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Constrictive Pericarditis
Radiography
Incidence
Pericardiectomy
Tertiary Care Centers
Cardiac Arrhythmias
Autopsy
Tuberculosis
Cohort Studies
Thorax
Heart Failure
Retrospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ling, L. H., Oh, J. K., Breen, J. F., Schaff, H. V., Danielson, G. K., Mahoney, D. W., ... Tajik, A. J. (2000). Calcific constrictive pericarditis: Is it still with us? Annals of Internal Medicine, 132(6), 444-450.

Calcific constrictive pericarditis : Is it still with us? / Ling, Lieng H.; Oh, Jae Kuen; Breen, Jerome F.; Schaff, Hartzell V; Danielson, Gordon K.; Mahoney, Douglas W.; Seward, James B.; Tajik, A. Jamil.

In: Annals of Internal Medicine, Vol. 132, No. 6, 21.03.2000, p. 444-450.

Research output: Contribution to journalArticle

Ling, LH, Oh, JK, Breen, JF, Schaff, HV, Danielson, GK, Mahoney, DW, Seward, JB & Tajik, AJ 2000, 'Calcific constrictive pericarditis: Is it still with us?', Annals of Internal Medicine, vol. 132, no. 6, pp. 444-450.
Ling LH, Oh JK, Breen JF, Schaff HV, Danielson GK, Mahoney DW et al. Calcific constrictive pericarditis: Is it still with us? Annals of Internal Medicine. 2000 Mar 21;132(6):444-450.
Ling, Lieng H. ; Oh, Jae Kuen ; Breen, Jerome F. ; Schaff, Hartzell V ; Danielson, Gordon K. ; Mahoney, Douglas W. ; Seward, James B. ; Tajik, A. Jamil. / Calcific constrictive pericarditis : Is it still with us?. In: Annals of Internal Medicine. 2000 ; Vol. 132, No. 6. pp. 444-450.
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abstract = "Background: The presence of pericardial calcification on a plain radiograph strongly suggests constrictive pericarditis in patients with heart failure. However, calcific constrictive pericarditis is considered rare in the United States since tuberculosis incidence has decreased, and doubt has therefore been raised about the importance of this radiologic finding in modern cardiovascular practice. Objective: To determine the clinical and prognostic significance of pericardial calcification on radiography in patients with constrictive pericarditis. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A consecutive series of 135 patients (mean age ± SD, 56 ± 16 years) who from 1985 through 1995 had constrictive pericarditis confirmed surgically (n = 133) or by autopsy (n = 2). Patients were divided into two groups: those with pericardial calcification on chest radiography (group I) and those without (group II). Measurements: Clinical and diagnostic findings were compared in both groups, and outcome was compared in 132 patients who had pericardiectomy. Results: Pericardial calcification was seen in 36 patients (27{\%}). The cause of constrictive pericardial disease was indeterminate in 67{\%} of patients in group I and in 21{\%} of patients in group II (P < 0.001). Patients in group I had had symptoms for a longer period and were more likely to have pericardial knock, larger atrial size, and atrial arrhythmia. Significantly more perioperative deaths were seen in group I, but incidence of late survival and incidence of noncalcific disease were similar in both groups. Conclusions: Pericardial calcification is a common finding in patients with constrictive pericarditis. It is often associated with idiopathic disease and other markers of disease chronicity and is an independent predictor of increased perioperative mortality rates.",
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AU - Ling, Lieng H.

AU - Oh, Jae Kuen

AU - Breen, Jerome F.

AU - Schaff, Hartzell V

AU - Danielson, Gordon K.

AU - Mahoney, Douglas W.

AU - Seward, James B.

AU - Tajik, A. Jamil

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N2 - Background: The presence of pericardial calcification on a plain radiograph strongly suggests constrictive pericarditis in patients with heart failure. However, calcific constrictive pericarditis is considered rare in the United States since tuberculosis incidence has decreased, and doubt has therefore been raised about the importance of this radiologic finding in modern cardiovascular practice. Objective: To determine the clinical and prognostic significance of pericardial calcification on radiography in patients with constrictive pericarditis. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A consecutive series of 135 patients (mean age ± SD, 56 ± 16 years) who from 1985 through 1995 had constrictive pericarditis confirmed surgically (n = 133) or by autopsy (n = 2). Patients were divided into two groups: those with pericardial calcification on chest radiography (group I) and those without (group II). Measurements: Clinical and diagnostic findings were compared in both groups, and outcome was compared in 132 patients who had pericardiectomy. Results: Pericardial calcification was seen in 36 patients (27%). The cause of constrictive pericardial disease was indeterminate in 67% of patients in group I and in 21% of patients in group II (P < 0.001). Patients in group I had had symptoms for a longer period and were more likely to have pericardial knock, larger atrial size, and atrial arrhythmia. Significantly more perioperative deaths were seen in group I, but incidence of late survival and incidence of noncalcific disease were similar in both groups. Conclusions: Pericardial calcification is a common finding in patients with constrictive pericarditis. It is often associated with idiopathic disease and other markers of disease chronicity and is an independent predictor of increased perioperative mortality rates.

AB - Background: The presence of pericardial calcification on a plain radiograph strongly suggests constrictive pericarditis in patients with heart failure. However, calcific constrictive pericarditis is considered rare in the United States since tuberculosis incidence has decreased, and doubt has therefore been raised about the importance of this radiologic finding in modern cardiovascular practice. Objective: To determine the clinical and prognostic significance of pericardial calcification on radiography in patients with constrictive pericarditis. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: A consecutive series of 135 patients (mean age ± SD, 56 ± 16 years) who from 1985 through 1995 had constrictive pericarditis confirmed surgically (n = 133) or by autopsy (n = 2). Patients were divided into two groups: those with pericardial calcification on chest radiography (group I) and those without (group II). Measurements: Clinical and diagnostic findings were compared in both groups, and outcome was compared in 132 patients who had pericardiectomy. Results: Pericardial calcification was seen in 36 patients (27%). The cause of constrictive pericardial disease was indeterminate in 67% of patients in group I and in 21% of patients in group II (P < 0.001). Patients in group I had had symptoms for a longer period and were more likely to have pericardial knock, larger atrial size, and atrial arrhythmia. Significantly more perioperative deaths were seen in group I, but incidence of late survival and incidence of noncalcific disease were similar in both groups. Conclusions: Pericardial calcification is a common finding in patients with constrictive pericarditis. It is often associated with idiopathic disease and other markers of disease chronicity and is an independent predictor of increased perioperative mortality rates.

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