New observations from MR velocity-encoded flow measurements concerning diastolic function in constrictive pericarditis.

Abstract

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.