1007-19 Transesophageal Echocardiography is a Useful Technique in Localizing Pericardial Thickening in Patients with Diastolic Dysfunction Compared to Magnetic Resonance Imaging

Transesophageal echocardiography(TEE) has been used to differentiate constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) by Doppler echocardiography; however its utility to anatomically localize pericardial thickening (PT) has not been described. We prospectively studied 62 patients with clinically suspected diastolic dysfunction with both TEE and magnetic resonance imaging (MRI), and detected 35 patients (29 M; mean age 59±14 yrs.) with pericardial disease (surgically confirmed, n=13) and compared the location PT independently. Fourteen pts. had CP, 6 had effusive-CP and 15 had mixed CP/RCM. PT location was graded independently as predominantly involving the right heart (RT), left heart (LT), generalized (GE) or no thickening (NO).(pts)TEEMRIRTLTGENORT0000LT0021GE00300NO2000TEE and MRI were in agreement in 30 (86%) of 35 patients (concordance>70%; P=0.05). TEE was able to visualize PT adjacent to the right ventricular apex and left ventricular apex but TEE was limited in visualizing the lateral LV wall.ConclusionsTEE and MRI are concordant in localizing pericardial thickening in pts with diastolic dysfunction. These findings suggest that TEE, when combined with Doppler flows, provides an excellent technique in the diagnosis of constrictive pericarditis