CMR characterization of atrioventricular inflow in constrictive pericarditis - findings of blood impact physiology

Methods We compared SSFP four chamber view images (20 phases per cycle protocol) between 11 surgically-confirmed CP patients and 11 controls. We deconvoluted the mechanics of the septal bounce and correlated it with periods of the cardiac cycle. To demonstrate that the septal bounce is caused by the interaction between the tricuspid inflow and septum we constructed a parameter called the septal flow ratio equal with the ratio between the tricuspid inflow directed towards the interventricular septum and the total tricuspid inflow at peak rapid ventricular filling, as seen in the Figure. Assuming that the tricuspid inflow is perpendicular on the tricuspid valve annulus plane, the dark rectangles represent the inflow impacting the septum while the white rectangles represent the inflow impacting the right ventricular free wall, with their sum representing the total inflow. Left panels are 3 examples of CP while on the right are 3 normal patients.