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Unique features of early diastolic mitral annulus velocity in constrictive pericarditis

Dae-Won Sohn1, Yong-Jin Kim, Hyo-Soo Kim

  • 1Clinical Research Institute, Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, 20 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea. dwsohn@snu.ac.kr

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|February 26, 2004
PubMed

Insights

Early diastolic mitral annulus velocity (E') is elevated in constrictive pericarditis (CP), aiding diagnosis. This contrasts with cardiac tamponade (Tamp), where E' is reduced, highlighting distinct pathophysiologies.

Area of Science:

  • Cardiology
  • Echocardiography
  • Diastolic Function

Background:

  • Early diastolic mitral annulus velocity (E") typically decreases in primary myocardial diseases.
  • Constrictive pericarditis (CP) is unique as E" does not decrease with disease progression.

Purpose of the Study:

  • To assess the diagnostic utility of mitral annulus velocity in constrictive pericarditis.
  • To elucidate the pathophysiologic role of mitral annulus velocity in CP.

Main Methods:

  • Echocardiographic assessment of mitral annulus velocity (E") in 17 CP patients, 8 cardiac tamponade (Tamp) patients, and controls.
  • Measurements were repeated post-intervention (pericardiectomy or pericardiocentesis) in a subset of patients.

Main Results:

  • E" was significantly higher in CP patients compared to controls (12.9 vs 9.8 cm/s).
  • An E" increase of 2 cm/s above normal predicted values showed 76% sensitivity and 82% specificity for CP.
  • In contrast, Tamp patients exhibited significantly lower E" (6.8 vs 10.2 cm/s) which improved post-pericardiocentesis.

Conclusions:

  • Elevated E" is a characteristic finding in CP, valuable for diagnosis.
  • Reduced E" in Tamp, with improvement post-treatment, suggests different hemodynamic mechanisms compared to CP.
Abstract

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