Index of biventricular interdependence calculated using cardiac MRI: A proof of concept study in patients with and without constrictive pericarditis

Nandan S. Anavekar, Benjamin F. Wong, Thomas A. Foley, Kalkidan Bishu, Arunark Kolipaka, Chi Wan Koo, Masud H. Khandaker, Jae K. Oh, Phillip M. Young

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


We sought to propose a magnetic resonance (MR) imaging-derived index of biventricular interdependence as a diagnostic parameter to distinguish patients with surgically-confirmed pericardial constriction from those without. Free-breathing real time MR pulse sequences of seventeen subjects with surgically proven constrictive pericarditis and thirty-five patients referred for clinically-indicated cardiac MR examinations but without documented constriction were analyzed using a novel index of biventricular interdependence. Cross-sectional biventricular areas at end diastole using the epicardial surface were traced at the mid left ventricular level at end-inspiration and end-expiration and an index of biventricular interdependence, defined as the ratio of (biventricular end-diastolic area at end-inspiration)/(biventricular end-diastolic area at end-expiration) was calculated for each subject. The mean index for both groups was calculated and results were statistically compared. The index of biventricular interdependence approximated unity (mean index 1.03 ± 0.03 SD) in patients with surgically confirmed pericardial constriction, indicating similar biventricular area at end-inspiration and end-expiration, and was significantly lower than in individuals without constrictive pericarditis (mean index 1.28 ± 0.10 SD; p < 0.0001). The MR-derived index of biventricular interdependence was significantly different between subjects with surgically-confirmed pericardial constriction and subjects where pericardial constraint was not suspected and may serve as a useful metric in the hemodynamic assessment of patients with a potential diagnosis of constrictive pericarditis.

Original languageEnglish (US)
Pages (from-to)363-369
Number of pages7
JournalInternational Journal of Cardiovascular Imaging
Issue number2
StatePublished - Feb 2013


  • Constrictive pericarditis
  • Index
  • Ventricular interdependence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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