Constrictive Pericarditis in the Modern EraNovel Criteria for Diagnosis in the Cardiac Catheterization Laboratory
Deepak R. Talreja, MD, FACC,
Rick A. Nishimura, MD, FACC*,
Jae K. Oh, MD, FACC and
David R. Holmes, MD, FACC
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
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Figure 1 LV and RV High-Fidelity Manometer Pressure Traces From 2 Patients During Expiration and Inspiration
Note that both patients have early rapid filling and elevation and end-equalization of the left ventricular (LV) and right ventricular (RV) pressures at end expiration. (A) A patient with surgically documented constrictive pericarditis. During inspiration there is an increase in the area of the RV pressure curve (orange shaded area) compared with expiration. The area of the LV pressure curve (yellow shaded area) decreases during inspiration as compared with expiration. (B) A patient with restrictive myocardial disease documented by endomyocardial biopsy. During inspiration there is a decrease in the area of the RV pressure curve (orange shaded area) as compared with expiration. The area of the LV pressure curve (yellow shaded area) is unchanged during inspiration as compared with expiration.
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Figure 2 Scatterplots of the Hemodynamic Variables in Patients With Surgically Proven CP Versus Those With RMD
(Upper left) Difference of the left ventricular end-diastolic pressure (LVEDP) minus the right ventricular end-diastolic pressure (RVEDP). (Upper right) Height of the rapid filling wave (RFW). (Lower left) Ratio of the RVEDP to the right ventricular systolic pressure (RVSP). (Lower right) Peak pulmonary artery systolic pressure (PASP). CP = constrictive pericarditis; RMD = restrictive myocardial disease.
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Figure 3 Scatterplot of the Ratio of RV to LV Area Comparing Expiration Versus Inspiration
This ratio is a measurement of the degree of ventricular interaction. Abbreviations as in Figures 1 and 2.
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