Assessment of the left ventricular diastolic function in constrictive pericarditis by digitised M-mode echocardiography

Abstract

Digitised M-mode echocardiography was used to study the diastolic left ventricular function in ten patients with constrictive pericarditis. Each patient was matched for heart rate and stroke volume with a control patient who had normal left ventricular end-diastolic pressure and coronary arteries. All 20 patients underwent right and left cardiac catheterisation. In patients with constrictive pericarditis compared with controls, the median (range) left ventricular peak diameter lengthening rate, normalised for end-diastolic dimension, was 4.5 (2.5-8.0) s-1 and 2.9 (1.6-4.1) (p less than 0.01), and the rapid filling period fraction of diastole was 0.28 (0.18-0.37) and 0.37 (0.21-0.58) (p less than 0.05), while the mitral valve E-F slope was 20.1 (10.5-39.2) cm/s and 11.8 (7.6-14.5) (p less than 0.05), respectively. Thus, the early rate of left ventricular diameter lengthening is increased in constrictive pericarditis independent of heart rate and stroke volume, while the actual duration of the rapid filling period is decreased. These results, obtained noninvasively, extend the findings of previous invasive studies. The method may help in the difficult clinical diagnosis of constrictive pericarditis, although there is some overlap with the normal control range.