Chirag Rajyaguru1, Amita Kalra2, Arang Samim3,4, Belayneh Abejie5, Ralph Wessel3, Jose Joseph Vempilly6. 1. Division of Cardiology, UCSF Fresno, Fresno, USA. 2. Department of Medicine, Stanford Health Center, Stanford, USA. 3. UCSF Fresno, Fresno, USA. 4. VA Medical Center, Fresno, USA. 5. Department of Medicine, UCSF Fresno, Fresno, USA. 6. VA Medical Center, UCSF Fresno, 2615 E. Clinton Ave, Fresno, CA, 9370-2223, USA. JJosephVempilly@fresno.ucsf.edu.
Abstract
PURPOSE: Pleural effusion is a common finding in patients with congestive heart failure (CHF). The pathogenesis of pleural effusion in heart failure is multifactorial. However, the role of right and left ventricular function assessed by ECHO cardiogram has not been studied. Therefore, we explored the association between right and left ventricular parameters on echocardiogram in patients with heart failure with and without pleural effusion diagnosed using CT scan of chest. METHODS: A case-control study was utilized to explore the objectives. Using strict exclusion criteria, patients admitted with a single diagnosis of acute CHF were stratified into those with and without pleural effusion using CT scan of chest done at admission. Multiple logistic regression analysis was used to identify significant factors associated with pleural effusion. RESULTS: Among the 70 patients, 36 (51%) had pleural effusions. The mean E/A ratio in patients with effusion (2.53 ± 1.1) was significantly higher than in patients without effusion (1.15 ± 0.9), p < 0.01. Multiple logistic regression analysis showed that elevated E/A ratio was significantly associated with pleural effusion, OR 3.26 (95% CI 1.57-6.77, p < 0.009). Left ventricular ejection fraction (LVEF), septal E', lateral E', and medial E/E' ratio were not significantly different in patients with and without pleural effusion. CONCLUSION: Elevated E/A ratio is a risk factor for the formation of pleural effusion in patients with heart failure.
PURPOSE:Pleural effusion is a common finding in patients with congestive heart failure (CHF). The pathogenesis of pleural effusion in heart failure is multifactorial. However, the role of right and left ventricular function assessed by ECHO cardiogram has not been studied. Therefore, we explored the association between right and left ventricular parameters on echocardiogram in patients with heart failure with and without pleural effusion diagnosed using CT scan of chest. METHODS: A case-control study was utilized to explore the objectives. Using strict exclusion criteria, patients admitted with a single diagnosis of acute CHF were stratified into those with and without pleural effusion using CT scan of chest done at admission. Multiple logistic regression analysis was used to identify significant factors associated with pleural effusion. RESULTS: Among the 70 patients, 36 (51%) had pleural effusions. The mean E/A ratio in patients with effusion (2.53 ± 1.1) was significantly higher than in patients without effusion (1.15 ± 0.9), p < 0.01. Multiple logistic regression analysis showed that elevated E/A ratio was significantly associated with pleural effusion, OR 3.26 (95% CI 1.57-6.77, p < 0.009). Left ventricular ejection fraction (LVEF), septal E', lateral E', and medial E/E' ratio were not significantly different in patients with and without pleural effusion. CONCLUSION: Elevated E/A ratio is a risk factor for the formation of pleural effusion in patients with heart failure.
Authors: Sherif F Nagueh; Otto A Smiseth; Christopher P Appleton; Benjamin F Byrd; Hisham Dokainish; Thor Edvardsen; Frank A Flachskampf; Thierry C Gillebert; Allan L Klein; Patrizio Lancellotti; Paolo Marino; Jae K Oh; Bogdan Alexandru Popescu; Alan D Waggoner Journal: J Am Soc Echocardiogr Date: 2016-04 Impact factor: 5.251
Authors: Liza Thomas; Thomas H Marwick; Bogdan A Popescu; Erwan Donal; Luigi P Badano Journal: J Am Coll Cardiol Date: 2019-04-23 Impact factor: 24.094