Parameter | Favors constrictive pericarditis | Favors restrictive cardiomyopathy |
Biomarkers |
BNP | <100 pg/mL | >400 pg/mL |
Echocardiographic parameters |
Ventricular septal shift (bounce)* | Present | Absent |
Inspiratory change in IVRT | Increased | No change |
Pericardial thickness | Increased | Normal |
Respirophasic changes in ventricular filling velocity¶Δ | Increased (as much as 30 to 40% variation) | Minimal (usually <10%) |
Hepatic venous flow | Reversal of forward flow during expiration | Reversal of forward flow during inspiration |
Color M-mode flow propagation | >100 cm/second | <45 cm/second |
Early diastolic Doppler tissue velocity E’ at mitral annulus | Normal or increased (>12 cm/second) | Normal or decreased (<8 cm/second) |
"Annulus reversus"◊ | Yes | No |
Strain analysis (absolute global longitudinal strain) | >16% | ≤10% |
CMR parameters |
Relative atrial volume ratio (LA/RA volume) | ≥1.5 | ≤1.1 |
Late gadolinium enhancement | Pericardial enhancement common in constrictive pericarditis | Myocardial enhancement frequently noted in amyloidosis |
Global longitudinal strain | Normal | Reduced |
Ventricular interdependence (cine CMR maximal septal respiratory excursion) | >11% | <8% |
Cardiac catheterization parameters |
Respiratory change in LV and RV pressures | Discordant | Concordant |
RAP/PCWP ratio | >0.77 | ≤0.77 |