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Assessment of the left ventricular diastolic function in constrictive pericarditis by digitised M-mode
J E Nordrehaug1, R Danielsen, H Vik-Mo
1Department of Clinical Physiology, Haukeland Hospital, University of Bergen, Norway.
Insights
Constrictive pericarditis increases early left ventricular diameter lengthening independent of heart rate and stroke volume. This noninvasive echocardiography method aids in diagnosing constrictive pericarditis, despite some overlap with normal ranges.
Area of Science:
- Cardiology
- Echocardiography
- Diastolic Function
Background:
- Constrictive pericarditis impairs diastolic function.
- Assessing diastolic function noninvasively is crucial for diagnosis.
Purpose of the Study:
- To investigate diastolic left ventricular function in constrictive pericarditis using M-mode echocardiography.
- To compare findings with matched controls.
Main Methods:
- Digitised M-mode echocardiography was performed on 10 patients with constrictive pericarditis and 10 matched controls.
- Cardiac catheterisation was conducted for all participants.
- Key diastolic parameters including peak diameter lengthening rate and rapid filling fraction were analyzed.
Main Results:
- Patients with constrictive pericarditis showed an increased left ventricular peak diameter lengthening rate (4.5 vs 2.9 s-1, p<0.01).
- The rapid filling period fraction of diastole was decreased in constrictive pericarditis (0.28 vs 0.37, p<0.05).
- Mitral valve E-F slope was significantly different between groups (20.1 vs 11.8 cm/s, p<0.05).
Conclusions:
- Early left ventricular diameter lengthening is accelerated in constrictive pericarditis, independent of heart rate and stroke volume.
- The duration of rapid filling is reduced in constrictive pericarditis.
- Noninvasive echocardiography provides valuable insights into constrictive pericarditis, aiding clinical diagnosis.
Abstract:
Digitised M-mode echocardiography was used to study the diastolic left ventricular function in ten patients with constrictive pericarditis. Each patient was matched for heart rate and stroke volume with a control patient who had normal left ventricular end-diastolic pressure and coronary arteries. All 20 patients underwent right and left cardiac catheterisation. In patients with constrictive pericarditis compared with controls, the median (range) left ventricular peak diameter lengthening rate, normalised for end-diastolic dimension, was 4.5 (2.5-8.0) s-1 and 2.9 (1.6-4.1) (p less than 0.01), and the rapid filling period fraction of diastole was 0.28 (0.18-0.37) and 0.37 (0.21-0.58) (p less than 0.05), while the mitral valve E-F slope was 20.1 (10.5-39.2) cm/s and 11.8 (7.6-14.5) (p less than 0.05), respectively. Thus, the early rate of left ventricular diameter lengthening is increased in constrictive pericarditis independent of heart rate and stroke volume, while the actual duration of the rapid filling period is decreased. These results, obtained noninvasively, extend the findings of previous invasive studies. The method may help in the difficult clinical diagnosis of constrictive pericarditis, although there is some overlap with the normal control range.