Discrimination between constrictive pericarditis and restrictive cardiomyopathy using real-time three-dimensional echocardiography

作者：Pan Cuizhen^*; Pan Wenzhi; Shu Xianhong; Chen Haiyan; Kong Dehong

来源：Experimental and Clinical Cardiology, 2013, 19(1).

• Constrictive pericarditis
• Mechanical dyssynchrony
• Real-time three-dimensional echocardiography
• Restrictive cardiomyopathy

OBJECTIVE: To examine left ventricular global function and left ventricular mechanical dyssynchrony (LVMD) in patients with constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM) using real-time three-dimensional echocardiography (RT-3DE), and assess the value of RT-3DE in discriminating CP from RCM.
METHODS: Seventeen patients with RCM, 10 patients with CP and 52 healthy volunteers (control group) were examined. All patients underwent RT-3DE. The parameters of LVMD included time to minimum systolic volume (Tmsv) including the standard deviation (SD) of 16 segments (Tmsv 16-SD), 12 segments (Tmsv 12-SD) and six basal segments (Tmsv 6-SD), as well as adjusted by cardiac cycle and presented in terms of percentage (Tmsv 16-SD%, Tmsv 12-SD% and Tmsv 6-SD%.)
RESULTS: The average excursion, maximum excursion and left ventricular ejection fraction (63.26 +/- 5.05% versus 52.94 +/- 8.48%; P<0.05) were lower in RCM patients than in CP patients (all P<0.05), while all these variables were not different between CP patients and control group (all P>0.05). All of the parameters of LVMD, including Tmsv 16-SD, Tmsv 12-SD, Tmsv 6-SD, Tmsv 16-SD%, Tmsv 12-SD% and Tmsv 6-SD% were significantly higher in RCM patients than CP patients (all P<0.05), while there were no difference of these variables between CP patients and control group (all P>0.05). All of the LVMD parameters could differentiate RCM from CP, whereas Tmsv 16-SD (area under the curve 0.87 +/- 0.057; P<0.001; sensitivity 82%; specificity 79%) and Tmsv 16-SD% (area under the curve 0.91 +/- 0.043; P<0.001; sensitivity 82%; specificity 78%) provided greatest power for discriminating RCM from CP.
CONCLUSIONS: LVMD parameters measured by RT-3DE may serve as powerful noninvasive tool for discriminating between RCM and CP.

• 出版日期2013
• 单位复旦大学