Author + information
Pericardial effusion in pulmonary arterial hypertension (PAH) is an indicator of right heart failure and a marker of poor prognosis; its significance on serial transthoracic echocardiograms (TTE) is not clear.
We examined our database for PAH patients followed at our center (10/99-11/07). Baseline and follow-up TTE (1.0±0.5y) and outcomes were studied (N=200). A p-value ≤ 0.05 indicated statistical significance.
Over a median follow-up of 4.6 ± 2.6 y, 149 patients died. Pericardial effusion was present in 20% at baseline and 29% during follow up. Patients with any pericardial effusion during follow-up had significantly higher creatinine, pulmonary vascular resistance, lower cardiac output, and were more likely to be treated with prostanoids. Patients were also significantly likely to have more right atrial dilation, right ventricular dilation and dysfunction, and higher tricuspid regurgitant velocity. During follow-up, there was significantly increased prostanoids (58% vs 28%) and combination therapy (8% vs 2%) use compared to baseline. Persistence of pericardial effusion on both baseline and follow-up TTE was associated with worse outcome (figure), and an independent predictor of survival after adjusting for age, creatinine, and functional class (p=0.002).
Persistence of pericardial effusion in PAH despite vasoactive therapy predicts worse outcomes; absence or resolution of pericardial effusion with therapy suggests better prognosis.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension: Pre-Clinical, Clinical, Biomarkers
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1294-151
- 2013 American College of Cardiology Foundation