Prognostic implications of pericardial and pleural effusion in patients with cardiac amyloidosis
| Autor: | Christina Binder, C Capelle, Christian Hengstenberg, Hong Qin, Hermine Agis, Fabian Dusik, Luciana Camuz Ligios, René Rettl, Renate Kain, Theresa Marie Dachs, Thomas Binder, Diana Bonderman, Franz Duca, Roza Badr Eslam, Benjamin Seirer |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Pleural effusion Biopsy Heart Ventricles Cardiac amyloidosis 030204 cardiovascular system & hematology Pericardial effusion Pericardial Effusion Strain 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Clinical endpoint Humans 030212 general & internal medicine Effusion Outcome Aged Aged 80 and over Original Paper biology business.industry Myocardium Amyloidosis General Medicine Middle Aged Prognosis medicine.disease Pleural Effusion Transthyretin Echocardiography Heart failure biology.protein Cardiology Right ventricle Female Speckle tracking imaging Cardiomyopathies Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Clinical Research in Cardiology |
| ISSN: | 1861-0692 1861-0684 |
| Popis: | Background Pericardial and pleural effusion are common findings in patients with cardiac amyloidosis (CA). It is not known, whether effusions correlate with right ventricular (RV) function in these patients. Furthermore, data on the prognostic significance of pleural and pericardial effusion in CA is scarce. Methods Patients with transthyretin (ATTR) and light chain (AL) CA were included in a clinical registry. All patients underwent transthoracic echocardiography at baseline. The presence of pericardial and pleural effusion was determined in every patient. The clinical endpoint was defined as cardiac death or heart failure hospitalization. Results In total, 143 patients were analysed. Of these, 85 patients were diagnosed with ATTR and 58 patients with AL. Twenty-four patients presented with isolated pericardial effusion and 35 with isolated pleural effusion. In 19 patients, both pericardial and pleural effusion were found and in 65 patients no effusion was present at baseline. The presence of pleural effusion correlated well with poor RV function, measured by global RV free-wall strain (p = 0.007) in patients with AL, but not in ATTR. No such correlation could be found for pericardial effusion in either amyloidosis subtype. Patients with AL presenting with pleural effusion had worse outcomes compared to patients with pericardial effusion alone or no effusion at baseline. In the ATTR group, there was no difference in outcomes according to presence and type of effusion. Conclusion More than 50% of patients with CA presented with pleural and/or pericardial effusions. While pleural effusion was clearly associated with poor RV function in AL, we were not able to detect this association with pericardial effusion. |
| Databáze: | OpenAIRE |
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