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Journal of Cardiovascular Magnetic Resonance

, 13:15

First Online: 25 February 2011Received: 02 September 2010Accepted: 25 February 2011

Abstract

BackgroundThe differentiation of constrictive pericarditis CP from restrictive cariomyopathy RCM is often difficult. This study sought to determine the clinical utility of cardiovascular magnetic resonance imaging CMR for differentiating both these disorders.

MethodsTwenty-three patients with surgically documented CP, 22 patients with RCM and 25 normal subjects were included in the study. CMR yielded information about cardiac morphology, function and tissue characteristics. The left LA and right atrial RA volume was calculated using the area-length method. The relative atrial volume ratio RAR was defined as the LA volume divided by RA volume. Receiver operating characteristic curve analysis was used to test the ability of different variables in differentiating CP from RCM.

ResultsThe maximal pericardial thickness in CP patients was significantly larger than in normal subjects and RCM patients. The RA volume index in RCM patients 90.5 ± 35.3 mL-m was significantly larger than in CP patients 71.4 ± 15.7 mL-m, p = 0.006 and normal subjects 38.1 ± 9.0 mL-m, p < 0.001. The LA volume index in RCM 96.0 ± 37.0 mL-m and CP patients 105.6 ± 25.1 mL-m was significantly larger than in normal subjects 39.5 ± 9.5 mL-m, p < 0.001 for all. The RAR in CP patients 1.50 ± 0.29 was significantly larger than in RCM patients 1.12 ± 0.33, p < 0.001 and normal subjects 1.06 ± 0.20, p < 0.001. There were no differences between RCM patients and normal subjects in the RAR p = 0.452. At a cut-off value of 1.32 for the RAR, the sensitivity was 82.6%, and the specificity was 86.4% in the detection of CP. Septal bounce was identified in 95.7% CP patients, in none of RCM patients and normal subjects. Late gadolinium enhancement LGE was present in 31.8% RCM patients and absence in all CP patients and normal subjects.

ConclusionsCMR with LGE and RAR can facilitate differentiation of CP from RCM.

List of abbreviations usedCPConstrictive pericarditis

RCMRestrictive cardiomyopathy

CMRCardiovascular magnetic resonance

LGELate gadolinium enhancement

RARRelative atrial volume ratio

LVLeft ventricular

RVRight ventricular

LALeft atrial

LAILeft artial volume index

RARight atrial

RAIRight atrial index

SDStandard deviation

ROCReceiver operating characteristics

AUCArea under receiver operating characteristics curve

CIConfidence interval.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-13-15 contains supplementary material, which is available to authorized users.

Huaibing Cheng, Shiliang Jiang, Minjie Lu, Chaowu Yan, Jian Ling, Yan Zhang, Qiong Liu, Ning Ma, Gang Yin, Renate Jerecic and Zuoxiang He contributed equally to this work.

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Author: Huaibing Cheng - Shihua Zhao - Shiliang Jiang - Minjie Lu - Chaowu Yan - Jian Ling - Yan Zhang - Qiong Liu - Ning Ma - Ga

Source: https://link.springer.com/article/10.1186/1532-429X-13-15







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