Pulmonary hypertension complicated by pericardial effusion: a single center experience.
Pulmonary hypertension complicated by pericardial effusion: a single center experience.
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DOI：
10.1177/1753465812471416
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发表时间：
2013-06
影响因子：
4.3
通讯作者：
Safdar Z
中科院分区：
文献类型：
--
作者：
Honeycutt GR;Safdar Z
心包积液是肺动脉高压（PAH）患者死亡率的独立预测因子。然而，肺动脉高压和心包积液患者的管理和结果没有得到很好的描述。在贝勒医学院和卫理公会医院进行了一项回顾性观察性研究，对2005年6月1日至2010年6月1日期间入院的所有患者进行了肺动脉高压和心包积液ICD-9编码的筛查。确定了138例心包积液患者，排除了103例患有心脏瓣膜病、近期手术或终末期肾病的患者。本分析纳入了35例经右心导管插入术或超声心动图诊断为PH并有心包积液记录的患者。收集人口统计学、血流动力学、实验室和生存数据。平均年龄为49.5±36岁（平均值±标准差），35例患者中有31例为女性（93%），肺动脉收缩压为77±19 mm Hg。平均随访时间为20.5±12.9个月。15例患者患有与结缔组织病相关的PAH（50%）。大多数心包积液患者（87%）采用保守治疗。4例血流动力学不稳定的患者（13%）接受了心包开窗术。其中1例患者开始接受依前列醇治疗，2例患者上调了PAH特异性药物的剂量。4例心包窗患者中有3例存活至随访期结束。我们队列的总生存率为60%，3例患者失访。在我们的心包积液患者队列中，结缔组织病相关PAH和女性占主导地位。75%接受心包开窗治疗血流动力学不稳定心包积液的患者存活至研究期结束。心包开窗术可能是不稳定PH伴心包积液患者的一种治疗选择。需要进一步的研究来确定这些患者的最佳治疗策略。
Pericardial effusion is an independent predictor of mortality in patients with pulmonary arterial hypertension (PAH). However, the management and outcomes of patients with pulmonary hypertension and pericardial effusion are not well described. A retrospective observational study was conducted at Baylor College of Medicine and The Methodist Hospital by screening all patients admitted between June 1, 2005 and June 1, 2010 with the ICD-9 codes for pulmonary hypertension and pericardial effusion. 138 patients with pericardial effusion were identified, and 103 patients were excluded if they had valvular heart disease, recent surgery or end stage renal disease. Thirty-five patients with PH diagnosed by a historical right heart catheterization or echocardiography and with documented pericardial effusion were included in this analysis. Demographic, hemodynamic, laboratory and survival data was collected. The mean age was 49.5±36 years (mean ± SD), 31 of 35 patients were females (93%) and pulmonary artery systolic pressure was 77±19 mm Hg. Mean follow-up period was 20.5±12.9 months. Fifteen patients had PAH associated with connective tissue disease (50%). Majority of the patients (87%) with pericardial effusion were managed conservatively. Four patients (13%) who were hemodynamically unstable underwent pericardial window placement. One of them was started on epoprostenol and two patients had the doses of PAH-specific medications uptitrated. Three of four pericardial window patients survived to the conclusion of the follow-up period. The overall survival in our cohort was 60% with three patients lost to follow-up. Connective tissue disease-associated PAH and female gender were predominant in our cohort of patients with pericardial effusion. Seventy-five percent of patients who were treated with pericardial window for hemodynamically unstable pericardial effusion survived till the end of the study period. Pericardial window may be a therapeutic option in unstable PH patients with pericardial effusion. Further studies are needed to determine the optimal treatment strategy for such patients.
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DOI：
10.1016/j.jtcvs.2011.08.055
发表时间：
2012-04-01
影响因子：
6
作者：
de Perrot, Marc;Granton, John T.;Keshavjee, Shaf
通讯作者：
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影响因子：
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作者：
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影响因子：
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影响因子：
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作者：
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通讯作者：
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影响因子：
4.6
作者：
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