Comparison of mitral inflow and superior vena cava Doppler velocities in chronic obstructive pulmonary disease and constrictive pericarditis

Boonyaratavej, Smonporn; Oh, Jae K.; Tajik, A. Jamil; Appleton, Christopher P.; Seward, James B.

doi:10.1016/s0735-1097(98)00472-0

Cited by 72 publications

(49 citation statements)

References 16 publications

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“…67 Wide swings in the E wave velocity may also occur in patients with respiratory disease, but these are associated with marked respiratory variation in the superior vena caval flow velocity (typically Ͼ20 cm/s), whereas the variation with pericardial constriction is less. 46,68 Other findings in constrictive pericarditis include preserved diastolic mitral annular velocity, rapid diastolic flow propagation to the apex, and diastolic mitral regurgitation. 69 …”

Section: Clinical Manifestationsmentioning

confidence: 99%

Pericardial Disease

2006

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Section: Clinical Manifestationsmentioning

confidence: 99%

Pericardial Disease

2006

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“…We did not routinely perform preload reduction to unmask Doppler respiratory variation. 10 However, a recent study by Shimizu et at 26 showed that MVG is relatively independent of loading conditions. Therefore, we can assume that MVG measurements should be similar to those obtained with preload reduction.…”

Section: Limitationsmentioning

confidence: 97%

“…5,6 However, respiratory variation can also be observed in patients with chronic obstructive airway disease. 10 Also, a considerable percentage of CP patients do not demonstrate respiratory variation in their blood-flow velocities. 6 Oh et al 11 proposed that in this group of patients, additional echocardiographic tests to reduce preload may help unmask or enhance respiratory variation on transmitral Doppler flow.…”

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confidence: 99%

Differentiation Between Restrictive Cardiomyopathy and Constrictive Pericarditis by Early Diastolic Doppler Myocardial Velocity Gradient at the Posterior Wall

et al. 2000

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Background-The differential diagnosis between restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) is challenging and, despite combined information from different diagnostic tests, surgical exploration is often necessary. Methods and Results-A group of 55 subjects (mean age, 63Ϯ11 years; 36 men and 19 women) were enrolled in the study; 15 had RCM, 10 had CP, and 30 were age-matched, normal controls. The diagnosis of RCM was supported by a biopsy; in the CP group, the diagnosis was confirmed either surgically or at autopsy. All patients underwent a transthoracic echocardiogram that included the assessment of Doppler myocardial velocity gradient (MVG), as measured from the left ventricular posterior wall during the predetermined phases of the cardiac cycle. MVG was lower (PϽ0.01) in RCM patients compared with both CP patients and normal controls during ventricular ejection (2.8Ϯ1.2 versus 4.4Ϯ1.0 and 4.7Ϯ0.8 s Ϫ1 , respectively) and rapid ventricular filling (1.9Ϯ0.8 versus 8.7Ϯ1.7 and 3.7Ϯ1.4 s Ϫ1 , respectively). Additionally, during isovolumic relaxation, MVG was positive in RCM patients and negative in both CP patients and normal controls (0.7Ϯ0.4 versus Ϫ1.0Ϯ0.6 and Ϫ0.4Ϯ0.3 s Ϫ1 , respectively; PϽ0.01). During atrial contraction, MVG was similarly low (PϽ0.01) in both RCM and CP patients compared with normal controls (1.6Ϯ1.7 and 1.7Ϯ1.8 versus 3.8Ϯ0.9 s Ϫ1 , respectively). Conclusions-Doppler

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“…This stands in contrast to greater (>35%) changes in superior vena cava forward flow velocity in patients with obstructive lung physiology in whom there is ventricular interdependence and ventricular septal shift because of pronounced respiratory swings in intrathoracic pressure. 14 Because severe obstructive lung disease or other conditions associated with increased respiratory effort may lead to abnormal ventricular septal wall motion and respiratory variation in mitral inflow velocity similar to that seen in constrictive pericarditis, this differentiating feature is clinically useful.…”

Section: Other Echocardiographic Findingsmentioning

confidence: 99%

Echocardiographic Diagnosis of Constrictive Pericarditis

Welch

Ling

Espinosa

et al. 2014

Circ: Cardiovascular Imaging

251

162

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Background-Constrictive pericarditis is a potentially reversible cause of heart failure that may be difficult to differentiate from restrictive myocardial disease and severe tricuspid regurgitation. Echocardiography provides an important opportunity to evaluate for constrictive pericarditis, and definite diagnostic criteria are needed. Methods and Results-Patients with surgically confirmed constrictive pericarditis (n=130) at Mayo Clinic (2008)(2009)(2010) were compared with patients (n=36) diagnosed with restrictive myocardial disease or severe tricuspid regurgitation after constrictive pericarditis was considered but ruled out. Comprehensive echocardiograms were reviewed in blinded fashion. Five principal echocardiographic variables were selected based on prior studies and potential for clinical use: (1) respiration-related ventricular septal shift, (2) variation in mitral inflow E velocity, (3) medial mitral annular e' velocity, (4) ratio of medial mitral annular e' to lateral e', and (5) hepatic vein expiratory diastolic reversal ratio. All 5 principal variables differed significantly between the groups. In patients with atrial fibrillation or flutter (n=29), all but mitral inflow velocity remained significantly different. Three variables were independently associated with constrictive pericarditis:(1) ventricular septal shift, (2) medial mitral e', and (3) hepatic vein expiratory diastolic reversal ratio. The presence of ventricular septal shift in combination with either medial e'≥9 cm/s or hepatic vein expiratory diastolic reversal ratio ≥0.79 corresponded to a desirable combination of sensitivity (87%) and specificity (91%). The specificity increased to 97% when all 3 factors were present, but the sensitivity decreased to 64%. Conclusions-Echocardiography allows differentiation of constrictive pericarditis from restrictive myocardial disease and severe tricuspid regurgitation. Respiration-related ventricular septal shift, preserved or increased medial mitral annular e' velocity, and prominent hepatic vein expiratory diastolic flow reversals are independently associated with the diagnosis of constrictive pericarditis. (Circ Cardiovasc Imaging. 2014;7:526-534.)

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Comparison of mitral inflow and superior vena cava Doppler velocities in chronic obstructive pulmonary disease and constrictive pericarditis

Cited by 72 publications

References 16 publications

Pericardial Disease

Pericardial Disease

Differentiation Between Restrictive Cardiomyopathy and Constrictive Pericarditis by Early Diastolic Doppler Myocardial Velocity Gradient at the Posterior Wall

Echocardiographic Diagnosis of Constrictive Pericarditis

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