Abstract 16085: Relationship Between Echocardiographically Estimated and Invasively Measured Filling Pressures in Constrictive Pericarditis; Annulus Paradoxus or Not?
Introduction_ The ratio between pulsed Doppler velocities of transmitral inflow (E) and mitral annulus (e’) recorded in early diastole (E/e’) increases with increased left ventricular filling pressures (LVFP). However, a small study reported an inverse, paradoxical relationship between LV filling pressures and E/e’ in the presence of constrictive pericarditis (CP).
Hypothesis- To test the paradoxical relationship between LVFP and E/e’ if it can be reproduced in a larger sample size.
Methods_ We assessed preoperative data of patients with surgically confirmed CP who were in sinus rhythm, with no mitral valve disease, and an echo performed within 14 days prior to left and right heart catheterization. E velocity and tissue Doppler of septal and lateral mitral annular e’ velocities and mean pulmonary capillary wedge pressure (PCWP) were measured.
Results_ A total of 45 patients (35 men; mean age, 65±11 years) were identified. The interval between echo and catheterization was 8±6 days. Mean EF of 55±6. The mean E velocity was 90±28 cm/s, mean septal and lateral annulus e’ velocities were 13±4 cm/s and 13±3 cm/s, respectively, and mean PCWP was 21±6 mm Hg. By linear regression, there was no correlation between septal, lateral E/e’ or average with PCWP (r= -0.12, 95%CI -0.39 to 0.17; P= 0.432, r= -0.10, 95%CI -0.38 to 0.199; P=0.513, r = -0.12, 95%CI -0.40 to 0.17; P = 0.408, respectively).
Conclusions: Patients with CP do not show either positive or inverse (paradoxical) relationship between E/e’ and PCWP. Thus, the simple parameter of E/e’ cannot be used to routinely predict filling pressures in CP patients. This suggests the heterogeneity of the hemodynamics in patients with CP
- © 2011 by American Heart Association, Inc.