Incidence of Pleural Effusions in Idiopathic and Familial Pulmonary Arterial Hypertension Patients
Incidence of Pleural Effusions in Idiopathic and Familial Pulmonary Arterial Hypertension Patients
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DOI：
10.1378/chest.08-0659
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发表时间：
2009-09-01
期刊：
影响因子：
9.6
通讯作者：
Light, Richard W.
中科院分区：
文献类型：
--
作者：
Tang, Ke-jing;Robbins, Ivan M.;Light, Richard W.
背景：胸腔积液常发生于左心衰患者。目前还没有大规模的临床研究调查单纯右心衰竭（RHF）患者胸腔积液的发生率。目的：目的探讨特发性肺动脉高压（IPAH）和家族性肺动脉高压（FPAH）患者胸腔积液的发生率。结果：147例IPAH患者中有31例（21.1%）有胸腔积液。(128例）或FPAH（19例）有胸腔积液。10例患者有RHF以外的胸腔积液解释。两名患者没有明显的解释。其余19例患者有RHF。与无胸腔积液的患者相比，RHF所致胸腔积液患者的平均右心房压明显更高（分别为16.0 ± 6.8和8.8 ± 5.5 mm Hg; p < 0.001）。两组患者的其他血流动力学参数无显著差异。大多数由RHF引起的积液为微量至少量（63.2%）和右侧（57.9%）或双侧（26.3%）。在19例因RHF发生胸腔积液的患者中，8例患者有腹水，1例患者有中度心包积液。四的五名患者接受胸腔穿刺术有transsudates.Conclusions：我们的研究表明，在IPAH和FPAH患者胸腔积液经常发生在孤立的RHF患者。（CHEST 2009; 136：688-693）
Background: Pleural effusion occurs often in patients with left heart failure. There are no large-scale clinical studies investigating the incidence of pleural effusion in patients with right heart failure (RHF) alone. Objectives: To determine the incidence of pleural effusions in patients with idiopathic pulmonary arterial hypertension (IPAH) and familial pulmonary arterial hypertension (FPAH).Methods: Consecutive IPAH and FPAH patients who were treated at Vanderbilt University Medical Center were retrospectively studied. Pleural effusions were detected by chest radiograph, chest CT scan, ultrasound, or autopsy.Results: Thirty-one of 147 patients (21.1%) with IPAH. (128 patients) or FPAH (19 patients) had pleural effusions. Ten patients had explanations for the pleural effusions other than RHF. Two patients had no obvious explanations. The remaining 19 patients had RHF. When compared with the patients without pleural effusions, the patients with pleural effusions due to RHF had significantly higher mean right atrial pressure (16.0 +/- 6.8 vs 8.8 +/- 5.5 mm Hg, respectively; p < 0.001). There was no significant difference in other hemodynamic parameters between the two patient groups. The majority of effusions due to RHF are trace to small (63.2%) and right sided (57.9%) or bilateral (26.3%). Of the 19 patients with pleural effusions due to RHF, 8 patients had ascites, and I patient bad moderate pericardial effusion. Four of the five patients who underwent thoracentesis had transudates.Conclusions: Our study in IPAH and FPAH patients demonstrates that pleural effusions frequently occur in patients with isolated RHF. (CHEST 2009; 136:688-693)