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Related Experiment Videos

What should be called a brisk 'Y' descent?

B Dalvi1, P Kerkar, A Vora

  • 1Dept of Cardiology, KEM Hospital, Parel, Bombay, Maharashtra.

Journal of Postgraduate Medicine
|October 1, 1992
PubMed
Summary

Quantifying the negative slope of the 'y' descent (-dy/dt) in hemodynamic traces can help diagnose constrictive pericarditis. This measurement is significantly elevated in constrictive pericarditis patients compared to healthy individuals.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Diagnostic Imaging

Background:

  • Constrictive pericarditis is characterized by a prominent 'y' descent in pressure tracings.
  • Previous descriptions of the 'y' descent have been qualitative ('brisk', 'sharp', 'rapid').
  • Objective quantification of the 'y' descent has been lacking.

Purpose of the Study:

  • To objectively evaluate and quantify the 'y' descent in constrictive pericarditis.
  • To measure the negative slope (-dy/dt) of the 'y' descent at its steepest point.
  • To assess the diagnostic utility of -dy/dt for pericardial constriction.

Main Methods:

  • Hemodynamic assessment of 41 patients (9 constrictive pericarditis, 32 normal).
  • Measurement of the negative slope (-dy/dt) of the 'y' descent.

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  • Discriminant analysis to determine sensitivity, specificity, and accuracy.
  • Correlation analysis with right ventricular end-diastolic pressure.

    • Main Results:

    • The negative slope of the 'y' descent was significantly greater in constrictive pericarditis patients (69.95 +/- 23.04 mm Hg/sec) than in normals (35.13 +/- 7.84 mm Hg/sec, p < 10(-6)).
    • A threshold of >= 45 mm Hg/sec demonstrated the highest overall diagnostic accuracy (0.88).
    • Fair correlation was observed between right ventricular end-diastolic pressure and -dy/dt in both groups.

    Conclusions:

    • The -dy/dt parameter is significantly different in constrictive pericarditis compared to normal individuals.
    • This quantitative measure holds potential for diagnosing pericardial constriction.
    • Further evaluation is warranted in cases with equivocal data, occult disease, and post-surgery.