TY - JOUR
T1 - Using mitral 'annulus reversus' to diagnose constrictive pericarditis
AU - Reuss, Christina S.
AU - Wilansky, Susan M.
AU - Lester, Steven J.
AU - Lusk, Joan L.
AU - Grill, Diane E.
AU - Oh, Jae K.
AU - Tajik, A. Jamil
PY - 2009/5/1
Y1 - 2009/5/1
N2 - AimsTo characterize mitral medial and lateral annular velocities in constrictive pericarditis or restrictive cardiomyopathy compared with normal subjects.Methods and resultsTissue Doppler imaging peak systolic velocity (S′), peak early diastolic annular velocity (e′), and timing difference between mitral early flow and early annular movement were measured in 14 patients with constrictive pericarditis, 10 with restrictive cardiomyopathy, and 17 normal subjects using the apical four-chamber view lateral and medial mitral annulus. In controls, mitral lateral e′ velocity was 25 higher than medial e′ velocity (13.0 ± 3.1 vs. 10.7 ± 2.8 cm/s; P = 0.02), whereas with constrictive pericarditis, averaged lateral e′ velocity was 2 lower than medial e′ velocity (10.7 ± 2.5 vs. 11.2 ± 3.1 cm/s; P > 0.05). This relationship represented a reversal of lateral and medial e′ velocities compared with normal subjects (P = 0.004). Differences in S′, E/e′, and timing intervals between normal subjects and patients with constrictive pericarditis were not statistically significant; however, restrictive cardiomyopathy could be distinguished from constrictive pericarditis and controls with all other parameters (S′, E/e′, medial and lateral e′ velocities, and timing interval differences; all P < 0.05).ConclusionPractical applications of tissue Doppler imaging for evaluation of possible constrictive pericarditis include reversal of the relationship between lateral and medial e′ velocities (i.e. 'annulus reversus').
AB - AimsTo characterize mitral medial and lateral annular velocities in constrictive pericarditis or restrictive cardiomyopathy compared with normal subjects.Methods and resultsTissue Doppler imaging peak systolic velocity (S′), peak early diastolic annular velocity (e′), and timing difference between mitral early flow and early annular movement were measured in 14 patients with constrictive pericarditis, 10 with restrictive cardiomyopathy, and 17 normal subjects using the apical four-chamber view lateral and medial mitral annulus. In controls, mitral lateral e′ velocity was 25 higher than medial e′ velocity (13.0 ± 3.1 vs. 10.7 ± 2.8 cm/s; P = 0.02), whereas with constrictive pericarditis, averaged lateral e′ velocity was 2 lower than medial e′ velocity (10.7 ± 2.5 vs. 11.2 ± 3.1 cm/s; P > 0.05). This relationship represented a reversal of lateral and medial e′ velocities compared with normal subjects (P = 0.004). Differences in S′, E/e′, and timing intervals between normal subjects and patients with constrictive pericarditis were not statistically significant; however, restrictive cardiomyopathy could be distinguished from constrictive pericarditis and controls with all other parameters (S′, E/e′, medial and lateral e′ velocities, and timing interval differences; all P < 0.05).ConclusionPractical applications of tissue Doppler imaging for evaluation of possible constrictive pericarditis include reversal of the relationship between lateral and medial e′ velocities (i.e. 'annulus reversus').
KW - Cardiomyopathy
KW - Doppler ultrasound
KW - Echocardiography, adult
KW - Pericardial heart disease
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U2 - 10.1093/ejechocard/jen258
DO - 10.1093/ejechocard/jen258
M3 - Article
C2 - 18952625
AN - SCOPUS:64749109049
VL - 10
SP - 372
EP - 375
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 3
ER -