Quantitative and pattern analyses of continuous-wave Doppler-derived pulmonary regurgitant flow velocity for the diagnosis of constrictive pericarditis.
J Am Soc Echocardiogr 2014;
27:1223-9. [PMID:
25096415 DOI:
10.1016/j.echo.2014.07.002]
[Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Indexed: 11/20/2022]
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.
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