RIGHT AND LEFT-VENTRICULAR WALL-MOTION VELOCITIES AS DIAGNOSTIC INDICATORS OF CONSTRICTIVE PERICARDITIS

The purpose of this study was to examine the usefulness of pulsed tiss ue Doppler imaging for diagnosing constrictive pericarditis. Motion ve locities of the ventricular septum (VS) and left ventricular (LV) post erior wall along the short axis, and those of the anterior right ventr icular (RV) wall, VS, and LV posterior wall along the long axis were r ecorded using pulsed tissue Doppler imaging in 12 patients with constr ictive pericarditis, who were diagnosed by cardiac catheterization, an d also in 20 normal subjects. Peak early diastolic and atrial systolic velocities (Ew and Aw, respectively) were calculated, and the time be tween the aortic component of the second heart sound and the peak of t he early diastolic velocity (IIA-Ew) was determined. The peak Ew and I I A-Ew along the short and long axes were significantly higher and sho rter, respectively, in the patient group than in the normal group. In the patient group, the motion velocity of the VS along the short axis showed a ''backward'' motion with a sharp and marked peak velocity imm ediately before Ew, or a biphasic early diastolic wave; a clear ''down ward'' motion immediately after Ew was observed in the motion velociti es of the anterior RV wall, VS, and LV posterior wall along the long a xis. These distinctive backward and downward motions were not observed in any of the ventricular walls of the normal subjects. In conclusion , the early diastolic RV and LV wall motion velocity patterns along th e short and long axes as measured by pulsed tissue Doppler imaging pro vide important information for the diagnosis of constrictive pericardi tis. (C) 1998 by Excerpta Medica, Inc.