Avi Shimony1, Benjamin D Fox, David Langleben, Lawrence G Rudski. 1. Center for Pulmonary Vascular Disease and Division of Cardiology, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Québec, Canada.
Abstract
BACKGROUND: The incidence of pericardial effusion (PEF) during long-term follow-up among patients with pulmonary arterial hypertension (PAH) is unknown. We aimed to determine the incidence and prognostic significance of developing a new PEF among PAH patients. METHODS: Records of consecutive patients diagnosed with PAH between January 1990 and May 2010 were reviewed. Patients had systematically undergone right heart catheterization, transthoracic echocardiography, and coronary angiography during their initial assessment as well as routine echocardiograms during follow-up. Effusions were graded as small (echo-free space in diastole <10 mm), moderate (10-20 mm), or large (≥ 20 mm). RESULTS: The entire cohort consisted of 154 patients. The prevalence of identified PEF during initial assessment was 28.6%. The incidence of PEF among patients with no effusions who had additional echocardiographic studies during follow-up (n = 102) was 44.1%. Patients who developed PEF during follow-up had no differences with respect to baseline characteristics, associated aetiologies, hemodynamic parameters, and extent of coronary disease. Among these 102 patients, survival estimates were 94.9%, 75.0%, and 62.4% at 1, 3, and 5 years, respectively. Development of a PEF that was at least moderate-sized at its first appearance was a predictor of mortality in univariate (hazard ratio, 6.85; 95% confidence interval, 2.60-18.10) as well as multivariate analysis (hazard ratio, 3.95; 95% confidence interval, 1.26-12.40). CONCLUSIONS: PEF develops frequently in PAH patients. In patients with no PEF at baseline, the appearance of a new moderate-size or larger PEF is associated with increased mortality, whereas no significantly increased mortality was observed when a small PEF develops.
BACKGROUND: The incidence of pericardial effusion (PEF) during long-term follow-up among patients with pulmonary arterial hypertension (PAH) is unknown. We aimed to determine the incidence and prognostic significance of developing a new PEF among PAH patients. METHODS: Records of consecutive patients diagnosed with PAH between January 1990 and May 2010 were reviewed. Patients had systematically undergone right heart catheterization, transthoracic echocardiography, and coronary angiography during their initial assessment as well as routine echocardiograms during follow-up. Effusions were graded as small (echo-free space in diastole <10 mm), moderate (10-20 mm), or large (≥ 20 mm). RESULTS: The entire cohort consisted of 154 patients. The prevalence of identified PEF during initial assessment was 28.6%. The incidence of PEF among patients with no effusions who had additional echocardiographic studies during follow-up (n = 102) was 44.1%. Patients who developed PEF during follow-up had no differences with respect to baseline characteristics, associated aetiologies, hemodynamic parameters, and extent of coronary disease. Among these 102 patients, survival estimates were 94.9%, 75.0%, and 62.4% at 1, 3, and 5 years, respectively. Development of a PEF that was at least moderate-sized at its first appearance was a predictor of mortality in univariate (hazard ratio, 6.85; 95% confidence interval, 2.60-18.10) as well as multivariate analysis (hazard ratio, 3.95; 95% confidence interval, 1.26-12.40). CONCLUSIONS: PEF develops frequently in PAH patients. In patients with no PEF at baseline, the appearance of a new moderate-size or larger PEF is associated with increased mortality, whereas no significantly increased mortality was observed when a small PEF develops.
Authors: Martin Koestenberger; Mark K Friedberg; Eirik Nestaas; Ina Michel-Behnke; Georg Hansmann Journal: Pulm Circ Date: 2016-03 Impact factor: 3.017
Authors: D Thiwanka Wijeratne; Katherine Lajkosz; Susan B Brogly; M Diane Lougheed; Li Jiang; Ahmad Housin; David Barber; Ana Johnson; Katharine M Doliszny; Stephen L Archer Journal: Circ Cardiovasc Qual Outcomes Date: 2018-02
Authors: V J M Baggen; M M P Driessen; M C Post; A P van Dijk; J W Roos-Hesselink; A E van den Bosch; J J M Takkenberg; G T Sieswerda Journal: Neth Heart J Date: 2016-06 Impact factor: 2.380
Authors: Haris M Vaid; Ximena Camacho; John T Granton; Muhammad M Mamdani; Zhan Yao; Samantha Singh; David N Juurlink; Tara Gomes Journal: Can Respir J Date: 2016-04-11 Impact factor: 2.409