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Differentiation of constrictive pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue

Jong-Won Ha1, Steve R Ommen, A Jamil Tajik

  • 1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.

The American Journal of Cardiology
|July 28, 2004
PubMed

Insights

Early diastolic mitral annular velocity (E') measured by tissue Doppler echocardiography effectively distinguishes constrictive pericarditis from restrictive cardiomyopathies. A specific E' cut-off value offers high accuracy for diagnosing these heart conditions.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Echocardiography

Background:

  • Differentiating constrictive pericarditis from restrictive cardiomyopathy is clinically challenging.
  • Both conditions can present with similar diastolic heart failure symptoms.
  • Accurate diagnosis is crucial for appropriate treatment and patient management.

Purpose of the Study:

  • To evaluate the diagnostic utility of early diastolic mitral annular velocity (E") using tissue Doppler echocardiography.
  • To differentiate constrictive pericarditis from primary restrictive cardiomyopathy and cardiac amyloidosis.
  • To establish a specific E" cut-off value for diagnosing constrictive pericarditis.

Main Methods:

  • Seventy-five patients were studied: 23 with constrictive pericarditis, 38 with cardiac amyloidosis, and 14 with primary restrictive cardiomyopathy.
  • Standard mitral inflow characteristics were measured.
  • Tissue Doppler echocardiography was employed to measure E" at the septal annulus.

Main Results:

  • E" velocity was significantly higher in constrictive pericarditis patients (12.3 cm/s) compared to restrictive cardiomyopathy (5.1 cm/s) and cardiac amyloidosis patients.
  • An E" cut-off value of >=8 cm/s demonstrated 95% sensitivity and 96% specificity for constrictive pericarditis.
  • E" values showed no overlap between constrictive pericarditis and cardiac amyloidosis, and were lower in cardiac amyloidosis than primary restrictive cardiomyopathy.

Conclusions:

  • Early diastolic mitral annular velocity (E") is a valuable parameter for distinguishing constrictive pericarditis from restrictive cardiomyopathies.
  • A specific E" cut-off value can reliably diagnose constrictive pericarditis in patients with diastolic heart failure.
  • Tissue Doppler echocardiography provides a non-invasive method to differentiate these cardiac conditions.

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