Abstract 9613: Two-dimensional Strain (2d-strain) Analysis for the Differentiation Between Constrictive Pericarditis and Restrictive Cardiomyopathy
Introduction: Two-dimensional strain (2DS) is a novel method to measure strain from standard two-dimensional echocardiographic images. The aim of our study was to characterize global and regional function abnormalities using this technique in patients (pts) with constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM).
Methods: We studied 90 individuals, 58 consecutive pts with heart failure of either proven pericardial (CP) or myocardial origin (RCM; biopsy proven cardiac amyloidosis), and 32 individuals as contol group. Global longitudinal strain (GLS) and regional peak systolic strain (PSS), as well as global transversal strain (GTS) was assessed by 2DS in the apical four-chamber-view using a dedicated software package (Vivid 7, GE Healthcare). Global radial strain (GRS) and global circumferential strain (GCS) was assessed in the parasternal short axis view. All pts underwent a complete echocardiographic and hemodynamic assessment.
Results: Out of the 90 individuals (mean age: 57±12 years) 27 had CP, 31RCM, and 32 were controls. The thickness of the interventricular septum (IVSD) was significantly increased in pts with RCM (16±4 mm vs. 8±2 mm, resp. 9±2, p<0.001). Mean GLS was -13.2±4.0% in the CP-group, -9.4±3.4% in the RCM-group (p<0.001), and -20.0±3.7% in the control group. The pts with RCM showed a significant base-to-apex gradient of the longitudinal PSS in the septal and lateral segments (see table). GRS was significantly decreased in RCM in comparison to CP (13.5±8.6 % RCM, 32.2±17.4% CP, 35.4±22.1% control, p<0.001). There was no significant difference of GTS and GCS between the RCM and CP groups
Conclusion: 2DS-analysis of GLS, PPS and GRS proved to be useful as additional echocardiographic tool for the differentiation between pts with RCM and CP. The RCM pts showed a significant base-to-apex-gradient of the PSS in the septal and lateral segments.
- © 2012 by American Heart Association, Inc.