الفهرس 
Introduction and aim of WorkOnly 14 pages are availabe for public view
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Abstract
Aim of work: The aim of this study is to evaluate how the newer Doppler modalitiy (i.e. TDI) compared with Doppler flow indices can differentiate between restrictive cardiomyopathy and constrictive pericarditis. Methods: The study included 50 patients with RCS as a test group. They were 31 males and 19 females with their age ranging from 13-65 years (mean age 30.6 17.7). They were classified into: group I: with RCM and comprised 25 patients, 12 males and 13 females with their age ranging from 13 to 54 years (mean age 30.07 15.8). The major cause of RCM was cardiac amyloidosis. group II: with CP, and comprised 25 patients, 19 males and 6 females with age ranging from 14 to 54 years (mean age 29.6 3.4). The main etiology of CP was TB in 14 cases, other etiologies include radiation in 4 and idiopathic in 7 cases. A control group of 50 healthy subjects were submitted to the study. They were age and sex matched. All patients underwent a thorough clinical evaluation; Laboratory tests including: CBC, ESR, serum creatinine, liver function tests and blood glucose (fasting and post prandial); ECG, plain x ray chest and heart and CT scanning of the heart; and Echocardiography: including M-mode, 2-dimensional, conventional pulsed Doppler and tissue Doppler echocardiography. Results: ” Standard trans-mitral and tricuspid flow recordings: A pattern of increased early (E-wave), decreased DT-E and late A wave (mitral and tricuspid flow velocities) and increased E/A ratio was noted in RCS when compared to normal control group. No significant differences in the previous mitral and tricuspid flow velocities were noted among patients in RCM when compared to those in CP (P > 0.05). ” Tissue Doppler imaging: Ea was significantly lower at all sites in patients with RCM than those with CP. Using a peak Ea of 8.0 cm/s, we have clearly separated patients CP from those with RCM with no overlap. Conclusion: The determination of myocardial velocities in the longitudinal axis by TDI represents a powerful non invasive tool for assessment of diastolic dysfunction in RCS and for differentiating RCM from CP. A peak Ea of 8.0 cm/s and Ea/E index of 0.11 differentiate patients with constriction from those with restriction with no overlap with high predictive value (P < 0.001) and with comparable accuracy to the traditional methods of flow measurements.