Diagnostic role of Doppler echocardiography in constrictive pericarditis

• Published in: Journal of the American College of Cardiology Vol. 23; no. 1; pp. 154,157,162 - 155,160,162
• Main Authors: Oh, Jae K., Hatle, Liv K., Seward, James B., Danielson, Gordon K., Schaff, Hartzell V., Reeder, Guy S., Tajik, A.Jamil
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.01.1994; Elsevier Science
• Subjects: Adult; Aged; Biological and medical sciences; Blood Flow Velocity; Cardiology. Vascular system; Diseases of the pericardium; Echocardiography, Doppler; Female; Heart; Hemodynamics; Humans; Male; Medical sciences; Middle Aged; Pericardiectomy; Pericarditis, Constrictive - diagnostic imaging; Pericarditis, Constrictive - physiopathology; Pericarditis, Constrictive - surgery; Predictive Value of Tests; Prospective Studies; Sonography; Doppler ultrasound study; Human; Pericardial constriction; Associated technique; Echocardiography; Heart disease; Pericardial disease; Cardiovascular disease; Circulatory velocity; Diagnosis; Hemodynamics
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(94)90514-2

Objectives. This study was conducted to assess the diagnostic role of Doppler echocardiography in constrictive pericarditis. Background. It has been observed that ptients with constrictive pericarditis have a characteristic Doppler pattern of respiratory variation in ventricular filling and central venous flow velocities. However, the observation was based on a small number of patients with known diagnosis. Methods. We reviewed the echocardiographic features of 28 patients (21 mem and 7 women; mean age ± SD 55 ± 15 years) with suspected constrictive pericarditis who underwent exploratory thoracotomy or pericardiectomy. Results. At operation, constrictive pericarditis was diagnosed in 25 patients, restriction in 1 and normal pericardium in 2. Of the 25 patients with constriction, correct preoperative Doppler diagnosis was made in 22 (88%) and Doppler echocardiography showed restriction in 3. In two patients with a normal pericardium, Doppler features were consistent with constriction in one patient and were normal in the other. In the one patient with restriction, Doppler echocardiography showed restriction. In 19 patients with surgically proved constriction, repeat Doppler study after pericardiectomy showed normal findings in 14 and restriction in 5. Twelve of the 14 patients with normalized Doppler findings became asymptomatic, whereas all 5 with restrictive Doppler features remained symptomatic. Conclusions. Doppler echocardiography performed simultaneously with respiratory recording is highly sensitive for diagnosing constrictive pericarditis, and it appears to predict functional response to pericardiectomy.