Annulus paradoxus : Transmitral flow velocity to mitral annular velocity ratio is inversely proportional to pulmonary capillary wedge pressure in patients with constrictive pericarditis

The early diastolic velocity of the mitral annulus (E') is reduced in patients with diastolic dysfunction and increased filling pressures. Because transmitral inflow early velocity (E) increases progressively with higher filling pressures, E/E' has been shown to have a strong positive rela...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2001-08, Vol.104 (9), p.976-978
Main Authors: HA, Jong-Won, OH, Jae K, LING, Lieng H, NISHIMURA, Rick A, SEWARD, James B, TAJIK, A. Jamil
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood Flow Velocity
Cardiology. Vascular system
Diseases of the pericardium
Echocardiography, Doppler
Female
Heart
Heart Ventricles - physiopathology
Hemodynamics
Humans
Male
Medical sciences
Middle Aged
Mitral Valve - physiopathology
Pericarditis, Constrictive - pathology
Pericarditis, Constrictive - physiopathology
Pulmonary Wedge Pressure
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Summary:The early diastolic velocity of the mitral annulus (E') is reduced in patients with diastolic dysfunction and increased filling pressures. Because transmitral inflow early velocity (E) increases progressively with higher filling pressures, E/E' has been shown to have a strong positive relationship with pulmonary capillary wedge pressure (PCWP) and left ventricular end-diastolic pressure. However, previous studies have primarily involved patients without a pericardial abnormality. In constrictive pericarditis (CP), E' is not reduced, despite increased filling pressures. This study evaluated the relationship between E/E' and PCWP in patients with CP. We studied 10 patients (8 men; mean age, 64+/-7 years) with surgically confirmed CP. Doppler echocardiography was performed to measure early and late diastolic transmitral flow velocities. Tissue Doppler echocardiography was performed to measure E'. PCWP was measured with right heart catheterization. All patients were in sinus rhythm. Mean E and E' were 91+/-15 cm/s and 11+/-4 cm/s, respectively. Mean PCWP was 25+/-6 mm Hg. E' was positively correlated with PCWP (r=0.69, P=0.027). There was a significant inverse correlation between E/E' and PCWP (r=-0.74, P=0.014). Despite high left ventricular filling pressures, E/E' (mean, 9+/-4) was
ISSN:0009-7322
1524-4539
DOI:10.1161/hc3401.095705