Doppler Flow Patterns of Constrictive Pericarditis

To recognize the hemodynamic change in the constrictive pericarditis, we have reviewed the Doppler echocardiography, cardiac catheterization, and pathology of 6 patients who were admitted to Pusan National University Hospital due to right-side heart failure, diagnosed as constrictive pericarditis and were undertaken pericardiectomy. Doppler echocardiographic findings showed that acceleration and deceleration of early diastolic rapid filling were increased, followed by shortening of duration but there was a tendency to decrease in velocity-time integral of early diastolic rapid filling compared to that of atrial contraction filling in the left ventricle. On the contrary, there was decrease in acceleration of rapid filling in right ventricle, but other indices were comparable to that of left ventricle. The integral of D wave increased relatively compared to that of S wave in superior vena canal flow. Also, there was decrease in peak flow velocity, acceleration and velocity-time integral of aortic and pulmonary arterial flow velocity. One patient who had increased fraction of integral of early diastolic rapid filling compared to that of atrial contraction filling in right ventricle showed that he had higher central venous pressure and D wave was dominant in superior vena caval flow. In conclusion, Doppler flow patterns showed characteristic diastolic filling inpairment and systolic dysfunction in constrictive pericarditis, so that Doppler echocardiography is believed to be a useful method of noninvasive diagnosis and follow-up of hemodynamic change in constrictive pericarditis.

Doppler Echocardiographic Measurement of Cardiac Output

A noninvasive method for assessing cardiac output was evaluated by comparing it with thermodilution determinations in 25 patients who admitted to Pusan national university hospital from March, 1985 to December, 1986. This method used M-mode & two dimensional echocardiography to measure the internal diameter of aortic valve anulus & pulmonary valve anulus and pulsed doppler echocardiography to obtain aortic & pulmonary blood velocity. Good correlations were observed between thermodilution and doppler echocardiographic measurements of cardiac output from aortic flow (r=0.98, p<0.05) & pulmonary flow (r=0.86, p<0.05). Linear regression analysis yielded y=0.91x0.14 for aortic flow and y=0.77x0.84 for pulmonary flow. These results indicate that accurate cardiac output can be measured by noninvasive & simple doppler echocardiography.