Department of Clinical Radiology, University Hospitals-Campus Grosshadern, Ludwig-Maximilian University, Munich, Germany.
Eur Radiol. 2010 Aug;20(8):1831-40. doi: 10.1007/s00330-010-1741-7. Epub 2010 Mar 4.
To assess diastolic function in patients with constrictive pericarditis (CP) by using velocity-encoded flow measurements at the atrioventricular valves and to evaluate whether conclusions regarding increased ventricular pressure can be drawn.
Twenty-two patients with CP and 20 healthy subjects were examined on a 1.5-T MR system. In addition to evaluation of pericardial thickness, ventricular volumes and septal movement, velocity-encoded flow measurements were performed at the level of the atrioventricular valves for assessment of diastolic function. Amplitudes of the e- and a-waves were measured and e- to a-wave ratios were calculated. The correlation of transtricuspid e- to a-wave ratios and right ventricular end-diastolic pressures (RVEDP) was calculated.
Right ventricular volumes were significantly smaller in patients with CP (p < 0.001). Abnormal septal movement was detected in all patients except one with CP and in none of the healthy subjects. In patients with CP mean transtricuspid e- to a-wave ratios were significantly smaller compared with healthy subjects. Individual transtricuspid e- to a-wave ratios were highly correlated with RVEDP (r = 0.6, p = 0.01).
An elaborate MR examination can identify patients with CP. Velocity-encoded flow measurements with calculation of transtricuspid e- to a-wave ratios are a valuable tool for detection of diastolic dysfunction in patients with CP. The value of e- to a-wave ratios may indicate elevated RVEDP.
通过房室瓣速度编码流测量评估缩窄性心包炎（CP）患者的舒张功能，并评估是否可以得出心室压力增加的结论。
在 1.5T MR 系统上检查 22 例 CP 患者和 20 例健康受试者。除了评估心包厚度、心室容积和室间隔运动外，还在房室瓣水平进行速度编码流测量以评估舒张功能。测量 e 波和 a 波的幅度，并计算 e 波与 a 波的比值。计算三尖瓣 e 波与 a 波比值与右心室舒张末期压（RVEDP）的相关性。
CP 患者的右心室容积明显较小（p < 0.001）。除了一名 CP 患者外，所有患者均存在异常室间隔运动，而在健康受试者中均未发现。CP 患者的平均三尖瓣 e 波与 a 波比值明显小于健康受试者。个体三尖瓣 e 波与 a 波比值与 RVEDP 高度相关（r = 0.6，p = 0.01）。
详细的 MR 检查可以识别 CP 患者。计算三尖瓣 e 波与 a 波比值的速度编码流测量是检测 CP 患者舒张功能障碍的有价值工具。e 波与 a 波比值的价值可能表明 RVEDP 升高。
