Chest
Original ResearchPulmonary Vascular DiseasePericardial Effusions in Pulmonary Arterial Hypertension: Characteristics, Prognosis, and Role of Drainage
Section snippets
Materials and Methods
The study was approved by the Mayo Clinic Institutional Review Board (protocol 09-3439). All patients provided informed consent for use of medical data for research purposes. We studied all consecutive adult patients aged ≥ 18 years with PAH seen at the Mayo Clinic in Rochester, Minnesota, between January 1, 1995, and December 31, 2005. Patients were included from the date of the first visit confirming the diagnosis of PAH at a dedicated PH clinic. The study was limited to only those given a
Patient Characteristics and Pericardial Effusion Incidence
Characteristics of the 577 patients who met the inclusion criteria are outlined in Table 1. At the time of PAH diagnosis, a pericardial effusion was identified in 150 patients (26%) on index echocardiogram (Fig 1). The majority of effusions were small (n = 128) compared with moderate and greater effusions (n = 22). Of 427 patients with no effusion on index echocardiogram, pericardial effusion developed in 146 on follow-up echocardiograms. Those patients underwent 8 ± 7 echocardiograms over
Discussion
Pericardial effusions in the setting of PAH are common and typically small in size, rarely causing hemodynamic compromise. The findings confirm that even a small quantity of excess pericardial fluid in a patient with PAH portends a poor prognosis. Pericardial effusions in PAH appear to be a marker of comorbidity with either concomitant connective tissue disease or high venous pressure; these two factors are recognized to confer an adverse risk.2 Independent of these findings, the presence of a
Acknowledgments
Author contributions: Dr Kane had full access to all the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Fenstad: contributed to the study design; data acquisition, analysis, and interpretation; and drafting of the manuscript.
Dr Le: contributed to the data acquisition and analysis and drafting of the manuscript.
Dr Sinak: contributed to the study design, data interpretation, and drafting of the manuscript.
Dr Maradit-Kremers:
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Funding/Support: This project was supported by the Mayo Clinic and in part by an unrestricted research grant from Pfizer Inc.
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