[Vena caval flow patterns in patients with constrictive pericarditis: analysis by catheter-tip Doppler flowmetry].
Changes in superior and inferior vena caval flow patterns were analyzed in 5 patients with constrictive pericarditis and were compared with those of 10 normal control subjects. Caval flows were measured using catheter-tip Doppler flowmeters. The normal controls showed biphasic M-shaped flow patterns; the peaks of the first forward flow (S wave) and of the second forward flow (D wave) appeared coincident with mid-systole and mid-diastole, respectively. Reverse flows fell during the atrial contraction period (A wave) and late systole (V wave). In the normal controls, the ratios of the S wave to the D wave (S/D ratio) and the A wave to the S wave (A/S ratio) were 2.15 +/- 0.41 and 0.18 +/- 0.10, respectively, and there was a disproportionate respiratory variation in the S and D waves in the normal controls. In constrictive pericarditis, superior and inferior vena caval flow velocities were lower than those in the normal controls. The S/D and A/S ratios were 1.46 +/- 0.27 (p < 0.05 vs control) and 0.66 +/- 0.15 (p < 0.01 vs control), respectively, with the A wave increasing in proportion to the severity of constrictive pericarditis. In addition, there was only a minimal respiratory variation in constrictive pericarditis. In conclusion, recognition of the patterns of the superior and inferior vena caval flow velocities may be useful for diagnosing constrictive pericarditis.
Fukuda
K
K
Department of Medicine, Keio University School of Medicine, Tokyo.
Handa
S
S
Abe
S
S
Kyotani
S
S
Inoue
S
S
Negishi
K
K
Satoh
T
T
Hori
S
S
Nakamura
Y
Y
D000328:Adult; D001783:Blood Flow Velocity; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010494:Pericarditis, Constrictive / Q000175:diagnosis* / Q000503:physiopathology; D014684:Venae Cavae / Q000503:physiopathology*