Document Detail


Comparison of new Doppler echocardiographic methods to differentiate constrictive pericardial heart disease and restrictive cardiomyopathy.
MedLine Citation:
PMID:  11137840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study assesses how the newer modalities of tissue Doppler echocardiography and color M-mode flow propagation compare with respiratory variation of Doppler flow in distinguishing between constrictive pericarditis and restrictive cardiomyopathy. We studied 30 patients referred for further evaluation of diastolic function who had a diagnosis of constrictive pericarditis or restrictive cardiomyopathy established by diagnostic tests, including clinical assessment, magnetic resonance imaging, cardiac catheterization, endomyocardial biopsy, and surgical findings. Nineteen patients had constrictive pericarditis and 11 had restrictive cardiomyopathy. We performed 2-dimensional transesophageal echocardiography combined with pulsed-wave Doppler of the pulmonary veins and mitral inflow with respiratory monitoring, tissue Doppler echocardiography of the lateral mitral annulus, and color M-mode flow propagation of left ventricular filling. Respiratory variation of the mitral inflow peak early (peak E) velocity of > or =10% predicted constrictive pericarditis with 84% sensitivity and 91% specificity and variation in the pulmonary venous peak diastolic (peak D) flow velocity of > or =18% distinguished constriction with 79% sensitivity and 91% specificity. Using tissue Doppler echocardiography, a peak early velocity of longitudinal expansion (peak Ea) of > or =8.0 cm/s differentiated patients with constriction from restriction with 89% sensitivity and 100% specificity. A slope of > or =100 cm/s for the first aliasing contour in color M-mode flow propagation predicted patients with constriction with 74% sensitivity and 91% specificity. Thus, the newer methods of tissue Doppler echocardiography and color M-mode flow propagation are equivalent and complimentary with Doppler respiratory variation in distinguishing between constrictive pericarditis and restrictive cardiomyopathy. The additive role of the new methods needs to be established in difficult cases of constrictive pericarditis where respiratory variation may be absent or decreased.
Authors:
N Rajagopalan; M J Garcia; L Rodriguez; R D Murray; C Apperson-Hansen; M Stugaard; J D Thomas; A L Klein
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  87     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-30     Completed Date:  2001-02-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-94     Citation Subset:  AIM; IM; S    
Affiliation:
Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiomyopathy, Restrictive / ultrasonography*
Coronary Circulation / physiology
Diagnosis, Differential
Echocardiography, Doppler / methods*
Echocardiography, Transesophageal / methods
Female
Humans
Male
Middle Aged
Pericarditis, Constrictive / ultrasonography*
Pulmonary Circulation / physiology
Respiration
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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