Study on right and left atrial dynamics in chronic constrictive pericarditis by esophageal echocardiography

: In 9 normal subjects (N) and 4 patients with chronic constrictive pericarditis (CP) with normal sinus rhythm, esophageal echocardiography was performed to obtain simultaneous echograms of the right atrial free wall and the interatrial septum, and both atrial dynamics were evaluated. In spite of increased mean right atrial and mean pulmonary arterial wedge pressures in CP, there were no significant differences in left, right and total atrial end-diastolic dimensions between N and CP. This indicates that there is a decrease in compliance of atrio-pericardial system in CP. Atrial shortening of both atria during active atria contraction was decreased in CP, while there was no significant difference in atrial dimension measured at the beginning of the active atrial shortening between N and CP. This impaired pump function might be due to increased ventricular late-diastolic pressure or organic change in the atrial muscle. The passive enlargement of both atria was impaired during atrial filling phase in CP. Thus, it was concluded that in CP the active shortening and passive enlargement of the right and left atria are decreased, and the atria tend to be a conduit.