학술대회 발표 연제 초록

Background: In patients with constrictive pericarditis (CP), early diastolic septal mitral annular velocity (E�셲) is usually normal or exaggerated due to the limitation of lateral expansion by the constricting pericardium. However, there have been few studies about influences on early diastolic velocity of lateral annular velocity (E�셪) and tricuspid annular velocity (E�셱) in those patients. We sought to analyze and compare E�셲, E�셪 and E�셱 in the patients with CP. Methods: We evaluated 35 patients with CP and 35 normal controls using comprehensive echocardiography including tissue Doppler of mitral and tricuspid annulus. Etiologies of CP were as follows; tuberculous pericarditis (n=9), previous cardiac surgery (n=21), and unknown (n=5). We compared the ratio of E�셪 and E�셱 to E�셲 (E�셪/E�셲 and E�셱/E�셲 respectively) in the 2 groups. Results: The mean age of the CP group was 58.8 짹 14.5 and 86% was men, which were similar to the normal group (mean age of 55.7짹6.1 and 86% of men). Left ventricular end diastolic volume (LVEDD), left atrial volume index, right atrial size and deceleration time (DT) were significantly different between the groups. However, E�셪, E�셱 and E�셲 were not significantly different between the groups. Interestingly, E�셪/E�셲 was 1.08짹0.24 and E�셱/E�셲 was 0.97짹0.34 in the CP group, which were significantly lower than in the normal group (E�셪/E�셲 1.38짹0.35, p<0.001 and E�셱/E�셲 1.29짹0.35, p<0.001, respectively). Receiver operational characteristic curve demonstrated that E�셪/E�셲 could differentiate CP from normal with cutoff value of 1.12 (sensitivity 60%, specificity 89%, area under curve=0.75, 95%CI=0.677-0.894). In multivariable analysis, reduced E�셪/E�셲 (OR=11.3, p=0.016, 95%CI=1.56-82.2), reduced E�셱/E�셲 (OR=6.91, p<0.037, 95%CI=1.13-42.4), reduced LVEDD (OR=0.678, p<0.017, 95%CI=0.497-0.925) and reduced DT (OR=0.753, p<0.015, 95%CI=0.599-0.946) could independently predict CP. Conclusion: The ratio of E�셪/E�셲, and E�셱/E�셲 might be useful to differentiate CP from normal. Further evaluation of these indexes as a marker for the successful treatment of CP is warranted.