Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis
Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome have reached epidemic proportions, particularly affecting vulnerable populations in low- and middle-income countries of sub-Saharan Africa. TB pericarditis is the commonest cardiac manifestation of TB and is the le...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-03-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1329767/full |
| _version_ | 1827315495894777856 |
|---|---|
| author | L. J. Giliomee A. F. Doubell P. S. Robbertse T. J. John P. G. Herbst |
| author_facet | L. J. Giliomee A. F. Doubell P. S. Robbertse T. J. John P. G. Herbst |
| author_sort | L. J. Giliomee |
| collection | DOAJ |
| description | Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome have reached epidemic proportions, particularly affecting vulnerable populations in low- and middle-income countries of sub-Saharan Africa. TB pericarditis is the commonest cardiac manifestation of TB and is the leading cause of constrictive pericarditis, a reversible (by surgical pericardiectomy) cause of diastolic heart failure in endemic areas. Unpacking the complex mechanisms underpinning constrictive haemodynamics in TB pericarditis has proven challenging, leaving various basic and clinical research questions unanswered. Subsequently, risk stratification strategies for constrictive outcomes have remained unsatisfactory. Unique pericardial tissue characteristics, as identified on cardiovascular magnetic resonance imaging, enable us to stage and quantify pericardial inflammation and may assist in identifying patients at higher risk of tissue remodelling and pericardial constriction, as well as predict the degree of disease reversibility, tailor medical therapy, and determine the ideal timing for surgical pericardiectomy. |
| first_indexed | 2024-04-24T22:56:17Z |
| format | Article |
| id | doaj.art-b10fc4d3a56a462fb2d6a6be88419b54 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-24T22:56:17Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-b10fc4d3a56a462fb2d6a6be88419b542024-03-18T04:51:12ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-03-011110.3389/fcvm.2024.13297671329767Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditisL. J. Giliomee0A. F. Doubell1P. S. Robbertse2T. J. John3P. G. Herbst4Division of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville, South AfricaDivision of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville, South AfricaDivision of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville, South AfricaHeart Unit, Mediclinic Panorama, Cape Town, South AfricaDivision of Cardiology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville, South AfricaTuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome have reached epidemic proportions, particularly affecting vulnerable populations in low- and middle-income countries of sub-Saharan Africa. TB pericarditis is the commonest cardiac manifestation of TB and is the leading cause of constrictive pericarditis, a reversible (by surgical pericardiectomy) cause of diastolic heart failure in endemic areas. Unpacking the complex mechanisms underpinning constrictive haemodynamics in TB pericarditis has proven challenging, leaving various basic and clinical research questions unanswered. Subsequently, risk stratification strategies for constrictive outcomes have remained unsatisfactory. Unique pericardial tissue characteristics, as identified on cardiovascular magnetic resonance imaging, enable us to stage and quantify pericardial inflammation and may assist in identifying patients at higher risk of tissue remodelling and pericardial constriction, as well as predict the degree of disease reversibility, tailor medical therapy, and determine the ideal timing for surgical pericardiectomy.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1329767/fullTB pericarditisconstrictive pericarditispericardial inflammationpericardial oedemaCMRpericardial effusion |
| spellingShingle | L. J. Giliomee A. F. Doubell P. S. Robbertse T. J. John P. G. Herbst Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis Frontiers in Cardiovascular Medicine TB pericarditis constrictive pericarditis pericardial inflammation pericardial oedema CMR pericardial effusion |
| title | Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis |
| title_full | Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis |
| title_fullStr | Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis |
| title_full_unstemmed | Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis |
| title_short | Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis |
| title_sort | novel role of cardiovascular mri to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis |
| topic | TB pericarditis constrictive pericarditis pericardial inflammation pericardial oedema CMR pericardial effusion |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1329767/full |
| work_keys_str_mv | AT ljgiliomee novelroleofcardiovascularmritocontextualisetuberculouspericardialinflammationandoedemaaspredictorsofconstrictivepericarditis AT afdoubell novelroleofcardiovascularmritocontextualisetuberculouspericardialinflammationandoedemaaspredictorsofconstrictivepericarditis AT psrobbertse novelroleofcardiovascularmritocontextualisetuberculouspericardialinflammationandoedemaaspredictorsofconstrictivepericarditis AT tjjohn novelroleofcardiovascularmritocontextualisetuberculouspericardialinflammationandoedemaaspredictorsofconstrictivepericarditis AT pgherbst novelroleofcardiovascularmritocontextualisetuberculouspericardialinflammationandoedemaaspredictorsofconstrictivepericarditis |