Septal Shift for the Diagnosis of COnstrictive Pericarditis: The Impact of Inspiratory Effort Quantification on Deep Breathing Manoeuvres

Browse trials for

• Pericarditis 58

Study population

Groups and cohorts

• Breathing effort type

  Current known criteria for constrictive pericarditis will be test under: 1- spontaneous breathing 2- Breathing with a negative pressure of -15 to - 30 cm of water 3- Breathing with a negative pressure of more than - 30 cm of water.

  Behavioral: Breathing

Interventions

• BehavioralBreathing

  Subjects will have to breath 1- Spontaneously 2- to produce a negative pressure of -15 to -30 cm of water and 3- to produce a negative pressure more than -30 cm of water.

Primary outcomes

1. Measurement of the interventricular septum position between inspiration and expiration as assessed by CMR.

   Analysis of respiratory-related septal excursion. The relative position of the septum can be obtained by dividing the distance between RV free wall and septum by the biventricular distance. If done during inspiration and expiration, at early ventricular filling, the respiratory-related septal excursion can be quantified.

   Time frame: Immediate

Secondary outcomes

1. Presence or absence (categorical variable) of a diastolic bounce as assessed by CMR.

   Diastolic bounce corresponds to a displacement of inter ventricular septum towards de left ventricle during the protodiastolic period.

   Time frame: Immediate

2. Measurement of the variation of flow through the mitral and tricuspid valve between inspiration and expiration as assessed by CMR.

   Real-Time Phase-Contrast acquisition using a custom-made sequence with through-plane velocity encoding to simultaneously measure MV and TV inflow velocities by prescribing a slice position across both atrioventricular valves from a horizontal long-axis view.

   Time frame: Immediate

3. Biventricular Index: measurement of the heart contour between inspiration and expiration as assessed by CMR.

   Short axis cross section through the mid ventricle. The epicardial tracings is performed in end expiration and end inspiration. The end inspiratory epicardial tracing is divided by the end expiratory epicardial tracing to obtain the biventricular index

   Time frame: Immediate

4. Presence or absence (categorical variable) of diastolic flow reversal in inferior vein cave as assessed by cardiovascular magnetic resonance (CMR).

   Real-time cine imaging of the inferior vein cave for 10 s

   Time frame: Immediate

5. Presence or Absence of lack of myocardial slippage in relation to the pericardium as assessed by CMR (tagging sequence)

   Four-chamber tagged cardiac magnetic resonance image showing lack of slippage between parietal and visceral pericardia. The tag lines break between parietal and visceral pericardia during the cardiac cycle in a normal heart. In constrictive pericarditis, the tag lines do not break.

   Time frame: Immediate

6. Measurement of the relative atrial volume ratio as assessed by CMR.

   The relative atrial volume ratio (RAR) is defined as the left auricular (LA) volume divided by right auricular (RA) volume. For the LA volume, the biplane area- length method will be used. For the RA volume, the monoplane area-length formula will be used.

   Time frame: Immediate.