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. 1989 Jan;61(1):29–37. doi: 10.1136/hrt.61.1.29

Restrictive cardiomyopathy and constrictive pericarditis: non-invasive distinction by digitised M mode echocardiography.

J M Morgan 1, L Raposo 1, J C Clague 1, W H Chow 1, P J Oldershaw 1
PMCID: PMC1216617  PMID: 2917096

Abstract

It is difficult to distinguish between restrictive cardiomyopathy and constrictive pericarditis on the basis of clinical findings and simple investigation. Cardiac catheterisation has been the reference standard for diagnosis but even this does not always permit an accurate distinction. A Summagraphics digitiser and Prime 750 computer system were used to digitise the echocardiograms of 15 patients with restrictive cardiomyopathy, 10 with constrictive pericarditis and a group of 20 age and sex matched normal subjects of similar age and sex distribution. Compared with controls, patients with restrictive cardiomyopathy showed a significant reduction in the following variables (a) decreased fractional shortening, (b) decreased peak left ventricular filling and emptying rates, (c) decreased percentage posterior wall thickening, and (d) decreased peak left ventricular posterior wall thickening and thinning rates. Whereas patients with constrictive pericarditis only had significantly reduced peak left ventricular filling and posterior wall thinning rates and significantly increased posterior wall thinning rate. When patients with restrictive cardiomyopathy were compared with those with constrictive pericarditis the significant differences were: (a) decreased peak left ventricular emptying rate, (b) decreased percentage posterior wall thickening, and (c) decreased peak left ventricular posterior wall thickening and thinning rates. Digitisation of M mode echocardiograms, with particular attention to posterior wall function, may be a useful adjunct to cardiac catheterisation in distinguishing restrictive cardiomyopathy from constrictive pericarditis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson P. A. Diagnostic problem: constrictive pericarditis or restrictive cardiomyopathy? Cathet Cardiovasc Diagn. 1983;9(1):1–7. doi: 10.1002/ccd.1810090102. [DOI] [PubMed] [Google Scholar]
  2. BERGH N. P., KRAUSE F., LINDER E. SOME ASPECTS OF DIAGNOSIS AND TREATMENT IN CHRONIC PERICARDITIS. Acta Chir Scand. 1964 Dec;128:683–697. [PubMed] [Google Scholar]
  3. Benotti J. R., Grossman W., Cohn P. F. Clinical profile of restrictive cardiomyopathy. Circulation. 1980 Jun;61(6):1206–1212. doi: 10.1161/01.cir.61.6.1206. [DOI] [PubMed] [Google Scholar]
  4. Borer J. S., Henry W. L., Epstein S. E. Echocardiographic observations in patients with systemic infiltrative disease involving the heart. Am J Cardiol. 1977 Feb;39(2):184–188. doi: 10.1016/s0002-9149(77)80189-6. [DOI] [PubMed] [Google Scholar]
  5. Chew C., Ziady G. M., Raphael M. J., Oakley C. M. The functional defect in amyloid heart disease. The "stiff heart" syndrome. Am J Cardiol. 1975 Oct 6;36(4):438–444. doi: 10.1016/0002-9149(75)90891-7. [DOI] [PubMed] [Google Scholar]
  6. Chun P. K., Rocchini A. P. Occult constrictive pericarditis in infancy. Documentation by rapid volume expansion. Chest. 1980 Oct;78(4):648–650. doi: 10.1378/chest.78.4.648. [DOI] [PubMed] [Google Scholar]
  7. Culliford A. T., Lipton M., Spencer F. C. Operation for chronic constrictive pericarditis: Do the surgical approach and degree of pericardial resection influence the outcome significantly? Ann Thorac Surg. 1980 Feb;29(2):146–152. doi: 10.1016/s0003-4975(10)61653-0. [DOI] [PubMed] [Google Scholar]
  8. Engel P. J., Fowler N. O., Tei C. W., Shah P. M., Driedger H. J., Shabetai R., Harbin A. D., Franch R. H. M-mode echocardiography in constrictive pericarditis. J Am Coll Cardiol. 1985 Aug;6(2):471–474. doi: 10.1016/s0735-1097(85)80188-1. [DOI] [PubMed] [Google Scholar]
  9. Falk R. H., Plehn J. F., Deering T., Schick E. C., Jr, Boinay P., Rubinow A., Skinner M., Cohen A. S. Sensitivity and specificity of the echocardiographic features of cardiac amyloidosis. Am J Cardiol. 1987 Feb 15;59(5):418–422. doi: 10.1016/0002-9149(87)90948-9. [DOI] [PubMed] [Google Scholar]
  10. Graham I. M. Surgical versus medical treatment in disease of the left main coronary artery. Am Heart J. 1978 Jul;96(1):1–3. doi: 10.1016/0002-8703(78)90118-7. [DOI] [PubMed] [Google Scholar]
  11. Hancock E. W. On the elastic and rigid forms of constrictive pericarditis. Am Heart J. 1980 Dec;100(6 Pt 1):917–923. doi: 10.1016/0002-8703(80)90074-5. [DOI] [PubMed] [Google Scholar]
  12. Hirota Y., Kohriyama T., Hayashi T., Kaku K., Nishimura H., Saito T., Nakayama Y., Suwa M., Kino M., Kawamura K. Idiopathic restrictive cardiomyopathy: differences of left ventricular relaxation and diastolic wave forms from constrictive pericarditis. Am J Cardiol. 1983 Aug;52(3):421–423. doi: 10.1016/0002-9149(83)90156-x. [DOI] [PubMed] [Google Scholar]
  13. Hosenpud J. D., Niles N. R. Clinical, hemodynamic and endomyocardial biopsy findings in idiopathic restrictive cardiomyopathy. West J Med. 1986 Mar;144(3):303–306. [PMC free article] [PubMed] [Google Scholar]
  14. Janos G. G., Arjunan K., Meyer R. A., Engel P., Kaplan S. Differentiation of constrictive pericarditis and restrictive cardiomyopathy using digitized echocardiography. J Am Coll Cardiol. 1983 Feb;1(2 Pt 1):541–549. doi: 10.1016/s0735-1097(83)80086-2. [DOI] [PubMed] [Google Scholar]
  15. Kawai C., Matsumori A., Kawamura K. Myocardial biopsy. Annu Rev Med. 1980;31:139–157. doi: 10.1146/annurev.me.31.020180.001035. [DOI] [PubMed] [Google Scholar]
  16. MacKay E. H., Littler W. A., Sleight P. Critical assessment of diagnostic value of endomyocardial biopsy. Assessment of cardiac biopsy. Br Heart J. 1978 Jan;40(1):69–78. doi: 10.1136/hrt.40.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Meaney E., Shabetai R., Bhargava V., Shearer M., Weidner C., Mangiardi L. M., Smalling R., Peterson K. Cardiac amyloidosis, contrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol. 1976 Nov 4;38(5):547–556. doi: 10.1016/s0002-9149(76)80001-x. [DOI] [PubMed] [Google Scholar]
  18. Nishimura R. A., Connolly D. C., Parkin T. W., Stanson A. W. Constrictive pericarditis: assessment of current diagnostic procedures. Mayo Clin Proc. 1985 Jun;60(6):397–401. doi: 10.1016/s0025-6196(12)60850-7. [DOI] [PubMed] [Google Scholar]
  19. Oakley C. M. Clinical recognition of the cardiomyopathies. Circ Res. 1974 Aug;35(2):suppl II–II:167. [PubMed] [Google Scholar]
  20. Popp R. L. Echocardiographic assessment of cardiac disease. Circulation. 1976 Oct;54(4):538–552. doi: 10.1161/01.cir.54.4.538. [DOI] [PubMed] [Google Scholar]
  21. Robbins M. A., Pizzarello R. A., Stechel R. P., Chiaramida S. A., Gulotta S. J. Resting and exercise hemodynamics in constrictive pericarditis and a case of cardiac amyloidosis mimicking constriction. Cathet Cardiovasc Diagn. 1983;9(5):463–471. doi: 10.1002/ccd.1810090505. [DOI] [PubMed] [Google Scholar]
  22. Schnittger I., Bowden R. E., Abrams J., Popp R. L. Echocardiography: pericardial thickening and constrictive pericarditis. Am J Cardiol. 1978 Sep;42(3):388–395. doi: 10.1016/0002-9149(78)90933-5. [DOI] [PubMed] [Google Scholar]
  23. St John Sutton M. G., Reichek N., Kastor J. A., Giuliani E. R. Computerized M-mode echocardiographic analysis of left ventricular dysfunction in cardiac amyloid. Circulation. 1982 Oct;66(4):790–799. doi: 10.1161/01.cir.66.4.790. [DOI] [PubMed] [Google Scholar]

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