Conventional signs of tamponade include right ventricular and atrial collapse and respiratory variation in mitral inflow velocities. Despite being reliable, they are qualitative in nature and are not well correlated with clinical signs of deterioration or improvement. Tamponade is invariably preceded and associated with diastolic dysfunction, and tissue Doppler imaging (TDI) can help in early detection of it, earlier than conventional signs. For this purpose, 36 patients presenting with pericardial effusion have been subjected to echocardiography, including effusion dimensions, presence or absence of routine signs of tamponade and TDI-derived LV and RV E/E′ ratios, as well as clinical signs of tamponade to test the diagnostic accuracy of echocardiographic parameters against them. Right atrial and ventricular collapse were the least accurate in the detection of tamponade, while effusion dimension > 14 mm was the most accurate among conventional parameters to point toward tamponade. RV and LV diastolic dysfunction as evidenced by E/E′ ratio showed 100% sensitivity in predicting tamponade, while LV E/E′ ratio showed the highest specificity (100%) in the same context. The higher diagnostic accuracy of LV E/E′ ratio might be also related to the presence of chronic kidney disease patients, with an already jeopardized LV function. TDI technology is now available in most of the portable echocardiography machines and can serve as part of point-of-care echocardiography in the early detection of cardiac tamponade and in decision making for pericardiocentesis. Larger studies can help in consolidating the impression driven from our small-scale cross-sectional study.

中文翻译：

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组织多普勒与传统参数诊断填塞心包积液：三级转诊中心的横断面研究

填塞的常规症状包括右心室和心房塌陷以及二尖瓣流入速度的呼吸变化。尽管可靠，但它们本质上是定性的，与恶化或改善的临床症状没有很好的相关性。填塞总是发生在舒张功能障碍之前，并且与舒张功能障碍相关，组织多普勒成像 (TDI) 可以帮助早期发现它，比传统体征更早。为此，对 36 名出现心包积液的患者进行了超声心动图检查，包括积液尺寸、是否存在常规填塞体征、TDI 衍生的 LV 和 RV E/E' 比值，以及待测试的填塞临床体征超声心动图参数对它们的诊断准确性。右心房和心室塌陷在检测心包填塞方面最不准确，而积液尺寸 > 14 mm 是指示心包填塞的常规参数中最准确的。通过 E/E' 比值证明的 RV 和 LV 舒张功能障碍在预测填塞方面显示出 100% 的敏感性，而 LV E/E' 比值在相同情况下显示出最高的特异性 (100%)。LV E/E' 比值的较高诊断准确性也可能与慢性肾病患者的存在有关，这些患者的左心室功能已经受到损害。TDI 技术现已应用于大多数便携式超声心动图机，并且可以作为现场超声心动图的一部分，用于心脏压塞的早期检测和心包穿刺术的决策。更大规模的研究有助于巩固我们小规模横断面研究得出的印象。