DIAGNOSTIC ROLE OF DOPPLER-ECHOCARDIOGRAPHY IN CONSTRICTIVE PERICARDITIS

Objectives. This study was conducted to assess the diagnostic role of Doppler echocardiography in constrictive pericarditis. Background. It has been observed that patients with constrictive pericarditis have a characteristic Doppler pattern of respiratory variation in ventricular filling and central venous flow velocities. However, the observation was based on a small number of patients with known diagnosis. Methods. We reviewed the echocardiographic features of 28 patients (21 men and 7 women; mean age +/- SD 55 +/- 15 years) with suspected constrictive pericarditis who underwent exploratory thoracotomy or pericardiectomy . Results. At operation, constrictive pericarditis was diagnosed in 25 patients, restriction in 1 and normal pericardium in 2. Of the 25 pat ients with constriction, correct preoperative Doppler diagnosis was ma de in 22 (88%) and Doppler echocardiography showed restriction in 3. I n two patients with a normal pericardium, Doppler features were consis tent with constriction in one patient and were normal in the other. In the one patient with restriction, Doppler echocardiography showed res triction. In 19 patients with surgically proved constriction, repeat D oppler study after pericardiectomy showed normal findings in 14 and re striction in 5. Twelve of the 14 patients with normalized Doppler find ings became asymptomatic, whereas all 5 with restrictive Doppler featu res remained symptomatic. Conclusions. Doppler echocardiography perfor med simultaneously with respiratory recording is highly sensitive for diagnosing constrictive pericarditis, and it appears to predict functi onal response to pericardiectomy.