Copyright © 1995 by the European Society of Cardiology.
© 1995 The European Society of Cardiology
Clinical relevance of Doppler pulmonary venous flow characteristics in constrictive pericarditis
Departments of Cardiology, Heart Lung Institute, University Hospital Utrecht The Netherlands
Free University Hospital Amsterdam The Netherlands
*Cardiothoracic Surgery, Heart Lung Institute, University Hospital Utrecht The Netherlands
revised 25 August 1994; accepted 26 August 1994.
Huub W J. Meijburg, MD, Department of Cardiology, Room F02.352, University Hospital Utrecht, P.O. Box 85.500, 3508 GA Utrecht, The Netherlands.
Abstract
The purpose of this study was to determine the diagnostic value of Doppler pulmonary venous flow in constrictive pericarditis, as assessed by transoesophageal echocardiography. It has been demonstrated previously that increased respiratory variation in Doppler pulmonary venous, but not in transmitral flow velocities, can identify patients with constrictive pericarditis, when transoesophageal echocardiography is used. In the present study we compared a group of 10 patients with constrictive pericarditis and a control group of 15 normal subjects with respect to pulmonary venous and transmitral flow velocities and their respiratory variation. Peak velocities and velocity time integrals of the systolic, early diastolic and late diastolic reversed pulmonary venous flow waves were measured. Peak velocities and velocity time integrals of the early and late diastolic transmitral flow waves were also measured Measurements were made irrespective of the respiratory cycle, at the onset of inspiration and at the onset of expiration. Values for inspiration and expiration were expressed as percent difference of those obtained irrespective of the respiratory cycle. Peak velocity and velocity time integral of the pulmonary venous systolic and diastolic waves were significantly lower than in normal subjects. Furthermore, the difference between peak velocities of the diastolic wave obtained at the onset of inspiration and obtained irrespective of the respiratory cycle was significantly larger in constrictive pericarditis than in the control group (–20% vs –9%, P<0.05). This also applied to the difference between velocity time integrals of the diastolic wave obtained at the onset of inspiration and obtained irrespective of the respiratory cycle (–22% vs –12%, P<0.05). Accordingly, the differences between peak velocities and velocity time integrals of the diastolic wave obtained at the onset of expiration and obtained irrespective of the respiratory cycle were significantly larger (19% vs 4%, P<0.05 and 34% vs 8%, P<0.001, respectively). Respiratory variation of transmitral flow velocities was less pronounced, only the difference between velocity time integrals of the early wave obtained at the onset of inspiration and obtained irrespective of the respiratory cycle was significantly larger in constrictive pericarditis (–19% vs –7%, P<0.05).
In conclusion, in this transoesophageal Doppler echocardiographic study, patients with constrictive pericarditis had significantly lower forward pulmonary venous peak velocities and exhibited a significantly larger respiratory variation in the diastolic flow wave as compared to normal subjects. Respiratory variation of transmitral flow velocities was less pronounced.
Key Words: Constrictive pericarditis • transoesophageal echocardiography • pulmonary venous flow
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