Assessment of pseudohypertrophy as a measure of left-ventricular compression in patients with cardiac tamponade

Background: Left-ventricular pseudohypertrophy reflecting left-ventricular compression was reported in a selected group of patients with cardiac tampo nade. Hypothesis: Criteria for the presence of pseudohypertrophy can be est ablished to gu ide its use as a sign of left-ventricular compression in pat ients with cardiac tamponade. Methods: Left-ventricular wall thickness, dia meters, relative diastolic wall thickness (%) = (posterior wall thickness/e nd diastolic radius) x 100 and estimated left-ventricular mass were measure d in patients with small, moderate and large pericardial effusion, in patie nts with cardiac tamponade before and after pericardiocentesis (16 patients in each group) and in 30 control subjects with normal echocardiograms. Res ults: Left-ventricular posterior wall thickness was increased (12 +/- 2 vs. 9 +/- 1 mm, p < 0.001), left-ventricular end-diastolic diameter was reduce d (3.9 +/- 0.5 vs. 4.6 +/- 0.3 cm, p < 0.001) and relative left-ventricular diastolic wall thickness was increased (61 <plus/minus> 13 vs. 41 +/- 4.5% , p < 0.001) only in patients with cardiac tamponade compared to controls, but not in patients with small, moderate and large effusions, respectively (relative wall thickness: 42 <plus/minus> 5, 41 +/- 7 and 44 +/- 7%, p = NS ). Mean values of the estimated left-ventricular mass were similar in all g roups. Following pericardiocentesis all parameters were normal. Conclusions : Despite normal left-ventricular mass, relative left-ventricular diastolic wall thickness is elevated in patients with cardiac tamponade. In contrast it is normal in patients with various degrees of pericardial effusion supp orting its use as a quantitative measure of left-ventricular compression in patients with suspected cardiac tamponade. Copyright (C) 2001 S. Karger AG . Basel.