TY - JOUR
T1 - Comparison of Usefulness of Tissue Doppler Imaging Versus Brain Natriuretic Peptide for Differentiation of Constrictive Pericardial Disease from Restrictive Cardiomyopathy
AU - Sengupta, Partho P.
AU - Krishnamoorthy, Vijay K.
AU - Abhayaratna, Walter P.
AU - Korinek, Josef
AU - Belohlavek, Marek
AU - Sundt, Thoralf M.
AU - Chandrasekaran, Krishnaswamy
AU - Seward, James B.
AU - Tajik, A. Jamil
AU - Khandheria, Bijoy K.
N1 - Funding Information:
This work was supported by a Grant-in-Aid from the American Society of Echocardiography, Raleigh, North Carolina.
PY - 2008/8/1
Y1 - 2008/8/1
N2 - Brain (B-type) natriuretic peptide (BNP) and tissue Doppler imaging may distinguish restrictive cardiomyopathy (RCMP) from idiopathic constrictive pericardial disease (CP). However, their comparative efficacy is unknown for patients with CP from secondary causes (e.g., surgery or radiotherapy). We compared the efficacy of tissue Doppler imaging and BNP for differentiation of RCMP (n = 15) and CP (n = 16) were compared. BNP was higher in patients with RCMP than CP (p = 0.008), but the groups overlapped, particularly for BNP <400 pg/ml. BNP was lower with idiopathic CP than secondary CP (139 ± 50 vs 293 ± 69 pg/ml; p <0.001) or RCMP (139 ± 50 vs 595 ± 499 pg/ml; p <0.001), but not significantly different between those with secondary CP and RCMP (293 ± 69 vs 595 ± 499 pg/ml; p = 0.1). Patients with CP and RCMP had less overlap in early diastolic and isovolumic contraction tissue Doppler imaging velocities compared with BNP, with clear separation of groups evident with mean early diastolic annular velocities (averaged from 4 walls). Early diastolic tissue Doppler imaging velocity was superior to BNP for differentiation of CP and RCMP (area under the curve 0.97 vs 0.76, respectively; p = 0.01). In conclusion, mean early diastolic mitral annular velocity correctly distinguished CP from RCMP even when there was a large overlap of BNP between the 2 groups.
AB - Brain (B-type) natriuretic peptide (BNP) and tissue Doppler imaging may distinguish restrictive cardiomyopathy (RCMP) from idiopathic constrictive pericardial disease (CP). However, their comparative efficacy is unknown for patients with CP from secondary causes (e.g., surgery or radiotherapy). We compared the efficacy of tissue Doppler imaging and BNP for differentiation of RCMP (n = 15) and CP (n = 16) were compared. BNP was higher in patients with RCMP than CP (p = 0.008), but the groups overlapped, particularly for BNP <400 pg/ml. BNP was lower with idiopathic CP than secondary CP (139 ± 50 vs 293 ± 69 pg/ml; p <0.001) or RCMP (139 ± 50 vs 595 ± 499 pg/ml; p <0.001), but not significantly different between those with secondary CP and RCMP (293 ± 69 vs 595 ± 499 pg/ml; p = 0.1). Patients with CP and RCMP had less overlap in early diastolic and isovolumic contraction tissue Doppler imaging velocities compared with BNP, with clear separation of groups evident with mean early diastolic annular velocities (averaged from 4 walls). Early diastolic tissue Doppler imaging velocity was superior to BNP for differentiation of CP and RCMP (area under the curve 0.97 vs 0.76, respectively; p = 0.01). In conclusion, mean early diastolic mitral annular velocity correctly distinguished CP from RCMP even when there was a large overlap of BNP between the 2 groups.
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U2 - 10.1016/j.amjcard.2008.03.068
DO - 10.1016/j.amjcard.2008.03.068
M3 - Article
C2 - 18638602
AN - SCOPUS:51749124235
SN - 0002-9149
VL - 102
SP - 357
EP - 362
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 3
ER -