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Structural Heart Disease Echocardiographic Diagnosis of Constrictive Pericarditis Mayo Clinic Criteria Terrence D. Welch, MD; Lieng H. Ling, MBBS, MD; Raul E. Espinosa, MD; Nandan S. Anavekar, MBBCh; Heather J. Wiste, BA; Brian D. Lahr, MS; Hartzell V. Schaff, MD; Jae K. Oh, MD Background—Constrictive pericarditis is a potentially reversible cause of heart failure that may be difficult to differentiate from restrictive myocardial disease and severe tricuspid regurgitation. Echocardiography provides an important opportunity to evaluate for constrictive pericarditis, and definite diagnostic criteria are needed. Methods and Results—Patients with surgically confirmed constrictive pericarditis (n=130) at Mayo Clinic (2008–2010) were compared with patients (n=36) diagnosed with restrictive myocardial disease or severe tricuspid regurgitation after constrictive pericarditis was considered but ruled out. Comprehensive echocardiograms were reviewed in blinded fashion. Five principal echocardiographic variables were selected based on prior studies and potential for clinical use: (1) respiration-related ventricular septal shift, (2) variation in mitral inflow E velocity, (3) medial mitral annular e' velocity, (4) ratio of medial mitral annular e' to lateral e', and (5) hepatic vein expiratory diastolic reversal ratio. All 5 principal variables differed significantly between the groups. In patients with atrial fibrillation or flutter (n=29), all but mitral inflow velocity
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: May 1, 2014
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