Difference in the respiratory variation between pulmonary venous and mitral inflow doppler velocities in patients with constrictive pericarditis with and without atrial fibrillation
Tomotsugu Tabata, MD, PhDa,
Samer S. Kabbani, MDa,
R. Daniel Murray, PhDa,
James D. Thomas, MD, FACCa,
Ibrahim Abdalla, MDa and
Allan L. Klein, MD, FACCa
a Cardiovascular Imaging Center, Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

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Figure 1 Respiratory variation in pulsed Doppler MV and PV velocities in patients with constrictive pericarditis and sinus rhythm. The MV-E velocity decreased from Exp to Insp. The MV-A velocity slightly decreased from Exp to Insp. Both of the PV-S and D velocities dramatically decreased from Exp to Insp. A = mitral inflow late filling wave; D = pulmonary venous diastolic wave; E = mitral inflow early filling wave; Exp = expiration; Insp = inspiration; MV = mitral inflow; PV = pulmonary venous flow; S = pulmonary venous systolic wave.
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Figure 2 The beat-to-beat change in pulsed Doppler MV and PV velocities in patients with atrial fibrillation without constrictive pericarditis. In the subjects with atrial fibrillation without constrictive pericarditis, early diastolic MV and PV velocities become greater with long filling intervals as shown by white arrows regardless of the phase of respiration. D = pulmonary venous diastolic wave; E = mitral inflow early filling wave; Exp = expiration; Insp = inspiration; MV = mitral inflow; PV = pulmonary venous; S = pulmonary venous systolic wave.
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Figure 3 Respiratory variation in pulsed Doppler MV and PV velocities in patients with constrictive pericarditis and atrial fibrillation. A decrease in the MV-E and PV-D velocities during a long filling interval immediately after the onset of inspiration was observed as shown by the thinner arrows. In contrast, there was an increase in those velocities during short filling interval at the onset of expiration as shown by a thick arrow. D = pulmonary venous diastolic wave; E = mitral inflow early filling wave; Exp = expiration; Insp = inspiration; MV = mitral inflow; PV = pulmonary venous; S = pulmonary venous systolic wave.
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