Diagnosis of constrictive pericarditis by quantitative tissue Doppler imaging

Abstract

Objectives To observe the motion of pericardium and myocardium in patients with constrictive pericarditis (CP) and normal subjects using two-dimensional (2D) echocardiography and quantitative tissue Doppler imaging (QTDI), and to investigate the value of this echocardiographic approach in the diagnosis of pericardial adhesion in CP. Background The relationship of the motion of pericardium and myocardium in CP has not been investigated by QTDI. Methods The motions of pericardium and myocardium and the difference between them were investigated using 2D echocardiography combined with QTDI technique in 20 patients with CP and 20 age- and sex-matched normal subjects. Systolic peak displacements of pericardium ( D 1), outer-layer myocardium ( D 2) and inner-layer myocardium ( D 3) were measured from quantitative tissue displacement curves. The ratios of ( D 3– D 2)/( D 2– D 1) were then calculated. Results In normal subjects, the motion of myocardium was found to be stronger than that of pericardium, but the motions of outer-layer and inner-layer myocardium were virtually identical. However, in patients with CP, the motion of outer-layer myocardium was significantly reduced approaching that of pericardium, while the motion of inner-layer myocardium was stronger than that of outer-layer myocardium. The ratios of ( D 3– D 2)/( D 2– D 1) were significantly higher in patients with CP than those in normal subjects (5.0 ± 4.7 vs 0.6 ± 0.7, P < 0.05). Conclusions Obvious differences exist in the motion of pericardium and myocardium between normal subjects and patients with CP; observations of these differences using 2D echocardiography and QTDI provide a new and sensitive method in the diagnosis of pericardial adhesion in CP.