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


Autoři: Dirceu Thiago Pessoa de Melo aff001;  Flavia Baggio Nerbass aff002;  Ana Luiza Carrari Sayegh aff003;  Francis Ribeiro de Souza aff003;  Viviane Tiemi Hotta aff001;  Vera Maria Curi Salemi aff004;  Félix José Alvarez Ramires aff001;  Ricardo Ribeiro Dias aff005;  Geraldo Lorenzi-Filho aff002;  Charles Mady aff001;  Fábio Fernandes aff001
Působiště autorů: Cardiomyopathy Clinical Unit, Cardiology Division, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil aff001;  Sleep Laboratory, Pulmonary Divison, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil aff002;  Unit of Cardiovascular Rehabilitation and Exercise Physiology Cardiology Division, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil aff003;  Heart Failure Unit, Cardiology Division, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil aff004;  Unit of Cardiac Surgery, Cardiology Division, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223838

Souhrn

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/m2, 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.

Klíčová slova:

Echocardiography – Exercise – Heart failure – Quality of life – Sleep – Sleep disorders – Sleep apnea – Polysomnography


Zdroje

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PLOS One


2019 Číslo 10

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