VALUE OF DYNAMIC RESPIRATORY CHANGES IN LEFT AND RIGHT-VENTRICULAR PRESSURES FOR THE DIAGNOSIS OF CONSTRICTIVE PERICARDITIS

Background Conventional cardiac catheterization criteria for the diagn osis of constrictive pericarditis (CP) rely on equalization of intraca rdiac pressures and have many recognized limitations. Recently, Dopple r echocardiographic methods have been used to examine dynamic respirat ory changes of increased ventricular interdependence and dissociation of intrathoracic and intracardiac pressures for the diagnosis of CP. T hese pathophysiological features may be best delineated by cardiac cat heterization. Therefore, we studied the accuracy of these dynamic resp iratory changes in left ventricular and right ventricular pressure for the diagnosis of CP at cardiac catheterization. Methods and Results H igh-fidelity manometric catheters and respirometry were used to study 36 patients: 15 patients with surgically proven CP (group 1) and 21 pa tients with other causes of heart failure (group 2). Conventional card iac catheterization variables used to establish the diagnosis of CP la cked sensitivity and specificity and failed to distinguish between the se groups. However, the finding of discordance between right ventricul ar and left ventricular pressures during inspiration, a sign of increa sed ventricular interdependence, accurately distinguished patients in group 1 from those in group 2 (P<.05). Conclusions Examination of dyna mic respiratory changes indicating increased ventricular interdependen ce may be helpful in the diagnosis of CP in the cardiac catheterizatio n laboratory.