Key result
Constrictive pericarditis shows a 13% inspiratory increase in TR velocity versus controls.
Why the study?
Enhanced ventricular interdependence in constrictive pericarditis produces reciprocal changes during respiration; the study examined whether analyzing Doppler-derived tricuspid regurgitation signals could detect these changes to assist in noninvasive diagnosis.
Does the analysis of respiratory changes in Doppler-derived tricuspid regurgitation signals differentiate constrictive pericarditis from other causes of heart failure?
Case-Control (n=17)
Does the analysis of respiratory changes in Doppler-derived tricuspid regurgitation signals differentiate constrictive pericarditis from other causes of heart failure?
Respiratory changes in Doppler-derived tricuspid regurgitation peak velocity and duration are significantly increased in constrictive pericarditis, providing a noninvasive method to differentiate it from other causes of heart failure.
Answers are grounded in this paper and cite their sources.
May support noninvasive diagnosis of constrictive pericarditis; leaves open prospective validation against invasive hemodynamics.
OBJECTIVES: This study sought to examine the value of analyzing Doppler echocardiographically derived tricuspid regurgitation signals during respiration in relation to the diagnosis of constrictive pericarditis. BACKGROUND: A physiologic hallmark of constrictive pericarditis is enhanced ventricular interdependence, which produces reciprocal changes in right and left ventricular filling and ejection dynamics during the respiratory cycle. It was hypothesized that these changes could be detected noninvasively by analyzing Doppler echocardiographically derived tricuspid regurgitation signals and that this information could assist in noninvasively diagnosing constrictive pericarditis. METHODS: Simultaneous Doppler echocardiography and catheterization studies of the right and left sides of the heart with high fidelity pressure manometers were performed in 5 patients with surgically confirmed constrictive pericarditis and 12 patients (control subjects) with heart failure due to other causes. RESULTS: Changes observed in tricuspid regurgitation Doppler echocardiographic variables from onset to peak inspiration in patients with constrictive pericarditis were significantly different from those in control subjects. Mean (+/- SD) percent change in maximal tricuspid regurgitation velocity was 13% +/- 6% and -8% +/- 7% in the constrictive pericarditis and control groups, respectively (p < 0.0001); mean percent change in tricuspid regurgitation signal duration was 18% +/- 2% and -2% +/- 7%, respectively (p < 0.0001); mean percent change in tricuspid regurgitation time velocity integral was 27% +/- 15% and -10% +/- 12%, respectively (p < 0.0001). CONCLUSIONS: Respiratory changes in Doppler echocardiographically derived tricuspid regurgitation peak velocity and velocity duration are increased in patients with constrictive pericarditis and may be helpful in diagnosing this condition noninvasively.
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Klodas et al. (1996) conducted a case-control in Constrictive pericarditis (n=17). Doppler echocardiographic evaluation of tricuspid regurgitation signals vs. Control subjects with heart failure due to other causes was evaluated on Percent change in maximal tricuspid regurgitation velocity from onset to peak inspiration (p=< 0.0001). Doppler evaluation of tricuspid regurgitation velocity during respiration showed a greater percent change in constrictive pericarditis patients compared to controls.
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