Comparison of Usefulness of Tissue Doppler Imaging Versus Brain Natriuretic Peptide for Differentiation of Constrictive Pericardial Disease from Restrictive Cardiomyopathy

Partho P. Sengupta, Vijay K. Krishnamoorthy, Walter P. Abhayaratna, Josef Korinek, Marek Belohlavek, Thoralf M. Sundt, Krishnaswamy Chandrasekaran, James B. Seward, A. Jamil Tajik, Bijoy K. Khandheria

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26 Scopus citations

Abstract

Brain (B-type) natriuretic peptide (BNP) and tissue Doppler imaging may distinguish restrictive cardiomyopathy (RCMP) from idiopathic constrictive pericardial disease (CP). However, their comparative efficacy is unknown for patients with CP from secondary causes (e.g., surgery or radiotherapy). We compared the efficacy of tissue Doppler imaging and BNP for differentiation of RCMP (n = 15) and CP (n = 16) were compared. BNP was higher in patients with RCMP than CP (p = 0.008), but the groups overlapped, particularly for BNP <400 pg/ml. BNP was lower with idiopathic CP than secondary CP (139 ± 50 vs 293 ± 69 pg/ml; p <0.001) or RCMP (139 ± 50 vs 595 ± 499 pg/ml; p <0.001), but not significantly different between those with secondary CP and RCMP (293 ± 69 vs 595 ± 499 pg/ml; p = 0.1). Patients with CP and RCMP had less overlap in early diastolic and isovolumic contraction tissue Doppler imaging velocities compared with BNP, with clear separation of groups evident with mean early diastolic annular velocities (averaged from 4 walls). Early diastolic tissue Doppler imaging velocity was superior to BNP for differentiation of CP and RCMP (area under the curve 0.97 vs 0.76, respectively; p = 0.01). In conclusion, mean early diastolic mitral annular velocity correctly distinguished CP from RCMP even when there was a large overlap of BNP between the 2 groups.

Original languageEnglish (US)
Pages (from-to)357-362
Number of pages6
JournalAmerican Journal of Cardiology
Volume102
Issue number3
DOIs
StatePublished - Aug 1 2008

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Sengupta, P. P., Krishnamoorthy, V. K., Abhayaratna, W. P., Korinek, J., Belohlavek, M., Sundt, T. M., Chandrasekaran, K., Seward, J. B., Tajik, A. J., & Khandheria, B. K. (2008). Comparison of Usefulness of Tissue Doppler Imaging Versus Brain Natriuretic Peptide for Differentiation of Constrictive Pericardial Disease from Restrictive Cardiomyopathy. American Journal of Cardiology, 102(3), 357-362. https://doi.org/10.1016/j.amjcard.2008.03.068