Differentiation of constrictive pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue Doppler echocardiography
Differentiation of constrictive pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue Doppler echocardiography
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DOI：
10.1016/j.amjcard.2004.04.026
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发表时间：
2004-08-01
影响因子：
2.8
通讯作者：
Oh, JK
中科院分区：
文献类型：
--
作者：
Ha, JW;Ommen, SR;Oh, JK
本研究评价了组织多普勒超声心动图舒张早期二尖瓣环运动速度（E '）在鉴别缩窄性心包炎与限制性心肌病（原发性限制性心肌病和心脏淀粉样变性）中的诊断作用。研究组包括75名患者（53名男性，22名女性;平均年龄62岁，范围27至87岁）。其中，23例患者经手术证实为缩窄性心包炎，38例患者经活检证实为系统性淀粉样变性和心脏受累的典型超声心动图特征，14例患者为原发性限制性心肌病。测量标准二尖瓣流入特性。组织多普勒超声心动图用于测量隔环处的E'。缩窄性心包炎患者的E'显著高于原发性限制性心肌病或心脏淀粉样变性患者（12.3 vs 5.1 cm/s，p < 0.001）。E'临界值大于或等于8 cm/s时，诊断缩窄性心包炎的敏感性为95%，特异性为96%。缩窄性心包炎患者和心脏淀粉样变性患者的E'无重叠。在限制性心肌病的亚组分析中，心脏淀粉样变性患者的E'显著低于原发性限制性心肌病患者（4.6 vs 6.3 cm/s，p < 0.001）。因此，在有舒张性心力衰竭临床和超声心动图证据的患者中，E'速度可以区分缩窄性心包炎和限制性心肌病，并具有特定的截止值。(C)2004年，Excerpta Medica，Inc.
This study evaluated the diagnostic role of early diastolic mitral annular velocity (E') by tissue Doppler echocardiography for differentiating constrictive pericarditis from restrictive cardiomyopathy (primary restrictive cardiomyopathy and cardiac amyloidosis). The study group consisted of 75 patients (53 men, 22 women; mean age 62 years, range 27 to 87). Of these, 23 patients had surgically confirmed constrictive pericarditis, 38 had biopsy-proved systemic amyloidosis and typical echocardiographic features of cardiac involvement, and 14 had primary restrictive cardiomyopathy. Standard mitral inflow characteristics were measured. Tissue Doppler echocardiography was used to measure E' at the septal annulus. E' was significantly higher in patients with constrictive pericarditis than in those with primary restrictive cardiomyopathy or cardiac amyloidosis (12.3 vs 5.1 cm/second, p < 0.001). An E' cut-off value greater than or equal to 8 cm/second resulted in 95% sensitivity and 96% specificity for the diagnosis of constrictive pericarditis. There was no overlap of E' between patients who had constrictive pericarditis and those who had cardiac amyloidosis. In a subgroup analysis of restrictive cardiomyopathy, E' of patients who had cardiac amyloidosis was significantly lower than that of patients who had primary restrictive cardiomyopathy (4.6 vs 6.3 cm/second, p < 0.001). Thus, E' velocity can distinguish between constrictive pericardifis and restrictive cardiomyopathy with a specific cut-off value in patients with clinical and echocardiographic evidence of diastolic heart failure. (C) 2004 by Excerpta Medica, Inc.