Tissue Doppler echocardiography in constrictive pericarditis and restrictive cardiomyopathy

Shown are examples of echocardiograms from a normal subject, a patient with a restrictive cardiomyopathy, and a patient with constrictive pericarditis. Panel A shows the posterior left ventricular wall on an M-mode echocardiogram, panel B is the mitral inflow velocity obtained from Doppler echocardiogram, and panel C is from tissue Doppler echocardiogram. The Doppler echocardiogram from the mitral valve inflow records a deep narrow E wave and diminutive A wave in both constrictive pericarditis and restrictive cardiomyopathy. Tissue Doppler records a diminutive myocardial velocity (E') in restrictive cardiomyopathy (arrow), but E' is similar to E in constrictive pericarditis. Tissue Doppler is thus a powerful means to distinguish between these two disease entities.