Sanae Kaga1, Taisei Mikami2, Yuka Takamatsu3, Ayumu Abe4, Kazunori Okada3, Masahiro Nakabachi5, Hisao Nishino5, Shinobu Yokoyama5, Mutsumi Nishida5, Chikara Shimizu5, Hiroyuki Iwano6, Satoshi Yamada6, Hiroyuki Tsutsui6. 1. Faculty of Health Sciences, Hokkaido University, Sapporo, Japan; Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 2. Faculty of Health Sciences, Hokkaido University, Sapporo, Japan. Electronic address: mikami@hs.hokudai.ac.jp. 3. Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan. 4. Faculty of Health Sciences, Hokkaido University, Sapporo, Japan. 5. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan. 6. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Abstract
BACKGROUND: Many echocardiographic features of constrictive pericarditis (CP) have been reported, but each alone has a limitation either in sensitivity or in specificity. Continuous-wave Doppler-derived flow velocity of pulmonary regurgitation can reflect the diastolic right ventricular pressure pattern characteristic of CP and be useful for its detection. METHODS: Fifteen patients with CP, 18 patients with restrictive cardiomyopathy, and 20 normal subjects were studied retrospectively. Using continuous-wave Doppler echocardiography, pulmonary regurgitation velocities were measured at the early diastolic peak (VMAx), mid-diastolic inflection point (VIFL), and late diastolic minimal point (VMIN). RESULTS: VIFL, VIFL/VMAx, VMIN, and VMIN/VMAx were significantly lower in the CP group compared with the restrictive cardiomyopathy and normal groups. Prevalence rates of patients with early mid-diastolic inflection, VIFL/VMAx < 0.5, VMIN < 50 cm/sec, and VMIN/VMAx < 0.33 were significantly greater in the CP group compared with the other groups. Sensitivity and specificity for the diagnosis of CP were 93% and 74%, respectively, for the presence of early mid-diastolic inflection, 73% and 100% for VIFL/VMAx < 0.5, 73% and 97% for VMIN < 50 cm/sec, and 93% and 92% for VMIN/VMAx < 0.33. CONCLUSIONS: The quantitative and pattern analyses of continuous-wave Doppler-derived pulmonary regurgitation velocity could enhance the accuracy of echocardiographic detection of CP.
BACKGROUND: Many echocardiographic features of constrictive pericarditis (CP) have been reported, but each alone has a limitation either in sensitivity or in specificity. Continuous-wave Doppler-derived flow velocity of pulmonary regurgitation can reflect the diastolic right ventricular pressure pattern characteristic of CP and be useful for its detection. METHODS: Fifteen patients with CP, 18 patients with restrictive cardiomyopathy, and 20 normal subjects were studied retrospectively. Using continuous-wave Doppler echocardiography, pulmonary regurgitation velocities were measured at the early diastolic peak (VMAx), mid-diastolic inflection point (VIFL), and late diastolic minimal point (VMIN). RESULTS: VIFL, VIFL/VMAx, VMIN, and VMIN/VMAx were significantly lower in the CP group compared with the restrictive cardiomyopathy and normal groups. Prevalence rates of patients with early mid-diastolic inflection, VIFL/VMAx < 0.5, VMIN < 50 cm/sec, and VMIN/VMAx < 0.33 were significantly greater in the CP group compared with the other groups. Sensitivity and specificity for the diagnosis of CP were 93% and 74%, respectively, for the presence of early mid-diastolic inflection, 73% and 100% for VIFL/VMAx < 0.5, 73% and 97% for VMIN < 50 cm/sec, and 93% and 92% for VMIN/VMAx < 0.33. CONCLUSIONS: The quantitative and pattern analyses of continuous-wave Doppler-derived pulmonary regurgitation velocity could enhance the accuracy of echocardiographic detection of CP.
Authors: Sathish Parasuraman; Seamus Walker; Brodie L Loudon; Nicholas D Gollop; Andrew M Wilson; Crystal Lowery; Michael P Frenneaux Journal: Int J Cardiol Heart Vasc Date: 2016-07-04