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Diagnosis and Management of Pericardial Diseases
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Diagnosis and Management of Pericardial Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (25 October 2024) | Viewed by 6924

Special Issue Editors

Dr. Alessandro Andreis

E-Mail Website
Guest Editor
Cardiovascular And Thoracic Department, Città della Salute e della Scienza di Torino University Hospital, 10126 Torino, Italy
Interests: pericarditis; cardiovascular imaging; echocardiography; cardiac magnetic resonance; cardiovascular medicine; pericardial effusion
Prof. Dr. Massimo Imazio

E-Mail Website
Guest Editor
Cardiology, Cardiothoracic Department, and DAME, University of Udine, 33100 Udine, Italy
Interests: pericardial diseases; myocarditis; cardiomyopathies; heart failure; cardiac magnetic resonance; cardiac multimodality imaging; autoimmunity

Special Issue Information

Dear Colleagues,

Pericardial diseases, often referred to as the "Cinderella of heart disease", represent a challenging and contemporary issue for clinicians worldwide. Not only have we observed a constant rise in the number of cases in recent years, but patients are also showing increasing resistance to conventional treatments, especially after experiencing multiple pericarditis recurrences. The situation was exacerbated during the recent SARS-CoV-2 pandemic, with a significant upsurge in pericarditis cases, possibly linked to viral infections and, to a lesser extent, vaccination. This alarming trend has not only encouraged increased awareness but also ignited further research in this crucial clinical setting.

In the last few years, we have witnessed exciting developments, particularly with the advent of promising biological drugs, such as IL-1 inhibitors, which have been assessed in clinical studies. Additionally, researchers have delved into advanced diagnostic and prognostic assessments for pericardial diseases, enabling more precise and tailored patient care.

In light of these significant advancements, this Special Issue aims to gather and present the most recent breakthroughs in the diagnosis and management of pericardial diseases. Our goal is to equip clinicians with updated information that can be readily translated into their clinical practice, thus enhancing patient outcomes.

Dr. Alessandro Andreis
Prof. Dr. Massimo Imazio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pericarditis
  • pericardial effusion
  • multi-modality imaging
  • echocardiography
  • cardiac magnetic resonance
  • anakinra
  • rilonacept
  • anti IL-1
  • colchicine
  • constriction

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Published Papers (3 papers)

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Research

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15 pages, 2691 KiB  
Article
Aetiology, Treatment and Outcomes of Pericarditis: Long-Term Data from a Longitudinal Retrospective Single-Centre Cohort
by Andrea Silvio Giordani, Iris Bocaj, Cristina Vicenzetto, Anna Baritussio, Dario Gregori, Federico Scognamiglio, Honoria Ocagli, Renzo Marcolongo and Alida Linda Patrizia Caforio
J. Clin. Med. 2024, 13(22), 6900; https://doi.org/10.3390/jcm13226900 - 16 Nov 2024
Cited by 2 | Viewed by 1142
Abstract
Background. Pericarditis has a heterogeneous clinical spectrum and rate of relapse. Data on aetiology, real-life treatment strategies, and long-term course from contemporary pericarditis cohorts are lacking. Methods. Pericarditis patients referred to the Cardioimmunology Outpatient Clinic at Padua University Hospital in 2001–2020 [...] Read more.
Background. Pericarditis has a heterogeneous clinical spectrum and rate of relapse. Data on aetiology, real-life treatment strategies, and long-term course from contemporary pericarditis cohorts are lacking. Methods. Pericarditis patients referred to the Cardioimmunology Outpatient Clinic at Padua University Hospital in 2001–2020 were retrospectively included. Kaplan–Meier method was used for recurrence-free survival probability estimation. The appropriateness of treatment was assessed based on the European Society of Cardiology guidelines. Results. One-hundred forty-four patients (57% males, mean age 50 years) followed up for 18 months (IQR 7–45) were included; of those, 52% had acute, 35% recurrent, 8% incessant, and 5% chronic pericarditis; 9% had cardiac tamponade at diagnosis. Time to pericardial effusion resolution was 53 days (IQR 16–124); median medical treatment duration was 87 days (IQR 48–148). Treatment was readjusted following the ESC guidelines for nonsteroidal anti-inflammatory drugs in 29% of the cases, steroids in 12%, and colchicine in 25%. Eleven (8%) patients were treated with anti-IL1 agents. Recurrence-free survival probability was 86% at 1st-year follow-up, and 23 patients (16%) had at least one recurrence, with a mean of two relapses per patient. Compared to patients without recurrences, they had a higher frequency of cardiac tamponade (27% vs. 6%, p = 0.006) and left bundle branch block (14% vs. 1%, p = 0.034). Out of the 144 patients, 5 (3%) were diagnosed as having constrictive pericarditis at first evaluation at our clinic, underwent successful pericardiectomy, and are currently alive and asymptomatic. Conclusions. When treated following a guideline-based approach, pericarditis has a favourable evolution. A relevant quote of cases benefits from the treatment readjustment of previously prescribed medical therapy when not in line with ESC recommendations. Cases relapsing despite treatment readjustment should receive anti-IL1 therapies. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pericardial Diseases)
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11 pages, 440 KiB  
Article
Decrease in Hemoglobin Levels during Acute Attacks in Patients with Idiopathic Recurrent Pericarditis: A Model of Anemia in Acute Disease
by Francesca Casarin, Ruggiero Mascolo, Irene Motta, Maddalena Alessandra Wu, Emanuele Bizzi, Alice Pedroli, Giulia Dieguez, Giacomo Iacomelli, Lisa Serati, Lorena Duca, Silvia Maestroni, Enrico Tombetti, Maria Domenica Cappellini and Antonio Brucato
J. Clin. Med. 2024, 13(19), 5944; https://doi.org/10.3390/jcm13195944 - 6 Oct 2024
Cited by 2 | Viewed by 1106
Abstract
Background/Objectives: Anemia during acute inflammation is not well described in the literature. We aimed to study whether patients develop a transient hemoglobin decrease during an acute attack of recurrent pericarditis. Methods: We retrospectively analyzed patients with recurrent pericarditis. The primary endpoint was the [...] Read more.
Background/Objectives: Anemia during acute inflammation is not well described in the literature. We aimed to study whether patients develop a transient hemoglobin decrease during an acute attack of recurrent pericarditis. Methods: We retrospectively analyzed patients with recurrent pericarditis. The primary endpoint was the difference in hemoglobin levels during an acute attack and in the following remission. As secondary endpoints, we correlated this variation with laboratory and clinical features; we also evaluated the available baseline hemoglobin values. Results: Sixty-two patients, including thirty females (48.4%), with a median age of 39 years, were observed during an acute attack and remission. The attack indexed was the first in 21 patients and the second or the third in 41, with pre-attack hemoglobin levels available for the latter group. Median hemoglobin levels (IQR) were 13.8 (12.8–15.1) g/dL at baseline, 12.0 (11.2–13.4) during attacks and 13.6 (13.1–14.0) during remission (p < 0.001). The median hemoglobin reduction between an acute attack and remission was 1.4 g/dL. Their mean corpuscular volume remained in the normal range. Hb reduction significantly correlated with C-reactive protein (CRP) elevation, neutrophilia and the neutrophil-to-lymphocyte ratio, but not serosal involvement. Only CRP elevation remained associated with the variation of Hb in a multivariate analysis (p = 0.007). Conclusions: This study is a proof of concept: hemoglobin levels may decline rapidly during acute inflammation in correlation with CRP elevation, with transient normocytic anemia, followed by a rapid rebound. In this regard, idiopathic pericarditis may represent a pathogenetic model of this type of anemia. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pericardial Diseases)
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Review

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15 pages, 988 KiB  
Review
Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?
by Emilia Lazarou, Charalambos Vlachopoulos, Alexios Antonopoulos, Massimo Imazio, Antonio Brucato, Costas Tsioufis and George Lazaros
J. Clin. Med. 2024, 13(13), 3887; https://doi.org/10.3390/jcm13133887 - 2 Jul 2024
Cited by 1 | Viewed by 4177
Abstract
Pericardial effusions, especially large ones, have traditionally been regarded with concern by clinicians due to the sometimes unpredictable development of life-threatening cardiac tamponade. In the European Society of Cardiology Guidelines on pericardial diseases, the simplified algorithm for pericardial effusion triage and management recommends [...] Read more.
Pericardial effusions, especially large ones, have traditionally been regarded with concern by clinicians due to the sometimes unpredictable development of life-threatening cardiac tamponade. In the European Society of Cardiology Guidelines on pericardial diseases, the simplified algorithm for pericardial effusion triage and management recommends pericardial drainage in cases of cardiac tamponade and/or suspicion of bacterial or neoplastic etiology. In the presence of acute pericarditis, empiric anti-inflammatory treatment should be given, while when a specific indication known to be associated with pericardial effusion is found, then treatment of the underlying cause is indicated. Notably, the most challenging subgroup of patients includes those with large, asymptomatic, C-reactive-protein-negative, idiopathic effusions. In the latter subjects, pericardial drainage is proposed in cases of chronic effusions (lasting more than three months). However, this recommendation is based on scant data stemming from small-sized non-randomized studies. Nevertheless, recent evidence in a larger cohort of patients pointed out that a watchful waiting strategy is a safe option in terms of complication-free survival. This review summarizes the contemporary evidence on this challenging topic and provides recommendations for tailoring individual patient treatments. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pericardial Diseases)
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