Importance Enhanced ventricular interdependence is a highly sensitive and specific criterion for the diagnosis of constrictive pericarditis (CP), but simultaneous ventricular measurements can be challenging at cardiac catheterization. Ejection times (ETs) correlate with stroke volumes and can be easily measured from arterial pressure tracings.

Objective To assess respirophasic changes in pulmonary artery (PA) ETs and aorta (Ao) ETs as a marker for enhanced ventricular interdependence.

Design, Setting, and Participants Retrospective analysis of simultaneous left-side and right-side heart catheterizations between January 2006 and January 2017 was performed. The data were analyzed in June 2020. All catheterizations were performed at the Mayo Clinic, Rochester, Minnesota. This study evaluated patients undergoing left-side and right-side heart catheterization for assessment of CP after noninvasive evaluation was inconclusive.

Main Outcomes and Measures Measurements of the PA and Ao ETs were made during inspiration and expiration. Ventricular interaction was mainly assessed by evaluating the difference of ETs from expiration to inspiration as well as the difference in Ao minus the difference in PA.

Results A total of 10 patients with surgically proven CP and 10 patients without CP (restrictive cardiomyopathy or severe tricuspid regurgitation) were identified. Of these 20 included patients, 10 (50%) were female, and the median (interquartile range) age was 59.5 (47.0-67.5) years. There were no significant differences in demographic characteristics or baseline hemodynamic measurements. In patients with CP compared with those without CP, there was a significantly greater decrease in PA ET (mean [SD], −31.8 [28.6] vs 5.1 [9.5]; P < .001) and a nonsignificantly greater increase in Ao ET (mean [SD], 19.0 [15.7] vs 10.5 [9.1]; P = 0.20) during expiration vs inspiration. Thus, the difference in Ao ET minus the difference in PA ET during expiration vs inspiration was significantly greater in those with CP compared with those without CP (mean [SD], 50.8 [22.5] milliseconds vs 5.4 [15.2] milliseconds; P < .001).

Conclusions and Relevance In this study, PA and Ao measurements of ETs throughout the respiratory cycle were a simple, easily obtainable, and accurate parameter for the diagnosis of CP.

重要性 增强心室相互依赖性是诊断缩窄性心包炎 (CP) 的高度敏感和特异性标准，但同时心室测量在心导管插入术中可能具有挑战性。射血时间 (ET) 与每搏量相关，并且可以从动脉压追踪中轻松测量。

目的 评估肺动脉 (PA) ETs 和主动脉 (Ao) ETs 的呼吸相变化作为增强心室相互依赖性的标志物。

设计、设置和参与者 对 2006 年 1 月至 2017 年 1 月期间同时进行的左侧和右侧心脏导管插入术进行了回顾性分析。数据于 2020 年 6 月进行分析。所有导管插入术均在明尼苏达州罗切斯特市的梅奥诊所进行。本研究评估了接受左侧和右侧心导管术以评估 CP 的患者，但无创评估结果尚无定论。

主要结果和措施 PA 和 Ao ET 的测量是在吸气和呼气期间进行的。心室相互作用主要通过评估 ET 从呼气到吸气的差异以及 Ao 的差异减去 PA 的差异来评估。

结果 共确定了 10 例经手术证实为 CP 的患者和 10 例无 CP（限制性心肌病或严重三尖瓣关闭不全）的患者。在这 20 名患者中，10 名（50%）为女性，中位（四分位距）年龄为 59.5（47.0-67.5）岁。人口统计学特征或基线血流动力学测量值没有显着差异。与没有 CP 的患者相比，患有 CP 的患者的 PA ET 下降幅度更大（平均 [SD]，-31.8 [28.6] vs 5.1 [9.5]；P  < .001），Ao ET 增加幅度不显着。平均值 [SD]，19.0 [15.7] 与 10.5 [9.1]；P = 0.20）在呼气与吸气期间。因此，与没有 CP 的患者相比，CP 患者的 Ao ET 减去呼气与吸气期间 PA ET 的差异显着更大（平均 [SD]，50.8 [22.5] 毫秒 vs 5.4 [15.2] 毫秒；P  < . 001)。

结论和相关性 在本研究中，整个呼吸周期内 ET 的 PA 和 Ao 测量值是诊断 CP 的简单、容易获得且准确的参数。