Circulation, Vol 79, 357-370, Copyright © 1989 by American Heart Association
LK Hatle, CP Appleton and RL Popp
Doppler ultrasound recordings of mitral, tricuspid, aortic, and pulmonary
flow velocities, and their variation with respiration, were recorded in 12
patients with a restrictive cardiomyopathy and seven patients with
constrictive pericarditis. Twenty healthy adults served as controls. The
patients with constrictive pericarditis showed marked changes in left
ventricular isovolumic relaxation time and in early mitral and tricuspid
flow velocities at the onset of inspiration and expiration. These changes
disappeared after pericardiectomy and were not seen in patients with
restrictive cardiomyopathy or in normal subjects. The deceleration time of
early mitral and tricuspid flow velocity was shorter than normal in both
groups, indicating an early cessation of ventricular filling, but only
patients with restrictive cardiomyopathy showed a further shortening of the
tricuspid deceleration time with inspiration. Diastolic mitral and
tricuspid regurgitation was also more common in the patients with
restrictive cardiomyopathy. These results suggest that patients with
constrictive pericarditis and restrictive cardiomyopathy can be
differentiated by comparing respiratory changes in transvalvular flow
velocities. In addition, although baseline hemodynamics in the two groups
were similar, characteristic changes were seen with respiration that
suggest differentiation of these disease states may also be possible from
hemodynamic data.
ARTICLES
Differentiation of constrictive pericarditis and restrictive cardiomyopathy by Doppler echocardiography
Division of Cardiology, Stanford University School of Medicine, California.
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