AUTHOR=Giliomee L. J. , Doubell A. F. , Robbertse P. S. , John T. J. , Herbst P. G. 

TITLE=Novel role of cardiovascular MRI to contextualise tuberculous pericardial inflammation and oedema as predictors of constrictive pericarditis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1329767

DOI=10.3389/fcvm.2024.1329767

ISSN=2297-055X

ABSTRACT=Tuberculosis (TB) and Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) have reached epidemic proportions and have a predilection for vulnerable populations in especially the low-and middle-income countries of sub-Saharan Africa. [1,2]    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. [3,4] Unpacking the complex mechanisms underpinning constrictive haemodynamics in TB pericarditis have proven challenging and various basic and clinical research questions remain unanswered. [5] Subsequently, risk stratification strategies for constrictive outcomes have remained unsatisfactory.Unique pericardial tissue characteristics, as identified on cardiovascular magnetic resonance (CMR) 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 assist in determining the ideal timing for surgical pericardiectomy.