Strain Reversus Sign: Diagnostic Role and Correlation With Cardiac Magnetic Resonance Findings in Constrictive Pericarditis

IF 6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography Pub Date : 2025-09-01 DOI:10.1016/j.echo.2025.05.010

Fabio Fazzari MD , Francesco Cannata MD, PhD , Luigi Tassetti MD , Davide Garattini MD , Filippo Pensotti MD , Romina Milanese MD , Martina Cellamare MD , Andrea Baggiano MD, PhD , Fabrizio Celeste MD , Alberico Del Torto MD , Antonio Frappampina MD , Laura Fusini MD , Paola Gripari MD , Sarah Ghulam Alì MD , Andrea Igoren Guaricci MD, PhD , Daniele Junod MD , Anna Maltagliati MD , Valentina Mantegazza MD, PhD , Riccardo Maragna MD , Saima Mushtaq MD , Gianluca Pontone MD, PhD

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引用次数: 0

Abstract

Background

A typical echocardiographic longitudinal strain (LS) pattern of the left ventricle called strain reversus (SR) has been described in patients with constrictive pericarditis (CP). The aim of this study was to evaluate the prevalence of SR among pericardial diseases, its diagnostic role in CP, and its correlation with pericardial involvement assessed using cardiac magnetic resonance (CMR).

Methods

Eighty-five patients (mean age, 57 ± 17 years; 32.8% women) with pericardial diseases who underwent clinically indicated echocardiography and CMR were retrospectively enrolled.

Results

According to right heart catheterization findings, CP and nonconstrictive pericarditis were found in 24 and 61 patients, respectively. The prevalence of SR was higher in patients with CP compared with those with nonconstrictive pericarditis (91% vs 25%, P < .001) and was correlated with CP diagnosis (odds ratio [OR], 3.43; 95% CI, 1.39-5.49; P = .001). The addition of SR to the traditional Mayo Clinic criteria significantly improved the diagnostic accuracy of echocardiographic assessment of pericarditis, increasing the C statistic from 0.82 to 0.92 (P = .004), with a net reclassification improvement index of 0.198. SR was associated with pericardial thickening (OR, 2.30; 95% CI, 1.21-3.41; P = .001) and pericardial late gadolinium enhancement (OR, 1.55; 95% CI, 1.07-2.04; P = .036), but it was not linked to pericardial edema.

Conclusions

SR is an echocardiographic sign associated with CP and pericardial involvement detected on CMR that provides additional diagnostic value to the traditional Mayo Clinic criteria.

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应变反转征象：在缩窄性心包炎中的诊断作用及与心脏磁共振表现的相关性

在缩窄性心包炎（CP）患者中出现了一种典型的超声心动图左心室纵向应变（LS）模式，称为应变逆转（SR）。本研究的目的是评估SR在心包疾病中的患病率，其在CP中的诊断作用，以及心脏磁共振（CMR）评估其与心包受累的相关性。方法回顾性分析85例经临床超声心动图和CMR检查的心包疾病患者（平均年龄57±17岁，女性32.8%）。结果经右心导管检查发现CP 24例，非缩窄性心包炎61例。与非缩窄性心包炎患者相比，CP患者的SR患病率更高（91% vs 25%, P < 001），并与CP诊断相关（优势比[OR]， 3.43; 95% CI, 1.39-5.49; P = .001）。在梅奥诊所传统标准的基础上增加SR，可显著提高超声心动图对心包炎的诊断准确率，C统计值由0.82提高到0.92 (P = 0.004)，净重分类改善指数为0.198。SR与心包增厚（OR, 2.30; 95% CI, 1.21-3.41; P = .001）和心包晚期钆增强（OR, 1.55; 95% CI, 1.07-2.04; P = .036）相关，但与心包水肿无关。结论ssr是CMR检测到的与CP和心包受累相关的超声心动图征象，为传统的梅奥诊断标准提供了额外的诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Society of Echocardiography 医学-心血管系统

CiteScore

9.50

自引率

12.30%

发文量

257

审稿时长

66 days

期刊介绍： The Journal of the American Society of Echocardiography(JASE) brings physicians and sonographers peer-reviewed original investigations and state-of-the-art review articles that cover conventional clinical applications of cardiovascular ultrasound, as well as newer techniques with emerging clinical applications. These include three-dimensional echocardiography, strain and strain rate methods for evaluating cardiac mechanics and interventional applications.