Objective: Aim of this paper is to evaluate the outcomes of 'idiopathic' chronic large pericardial effusions without initial evidence of pericarditis. Methods: All consecutive cases of idiopathic chronic large pericardial effusions evaluated from 2000 to 2015 in three Italian tertiary referral centres for pericardial diseases were enrolled in a prospective cohort study. The term 'idiopathic' was applied to cases that performed a complete diagnostic evaluation to exclude a specific aetiology. A clinical and echocardiographic follow-up was performed every 3-6 months. Results: 100 patients were included (mean age 61.3±14.6 years, 54 females, 44 patients were asymptomatic according to clinical evaluation) with a mean follow-up of 50 months. The baseline median size of the effusion (evaluated as the largest end-diastolic echo-free space) was 25 mm (IQR 8) and decreased to a mean value of 7 mm (IQR 19; p<0.0001) with complete regression in 39 patients at the end of follow-up. There were no new aetiological diagnoses. Adverse events were respectively: cardiac tamponade in 8 patients (8.0%), pericardiocentesis in 30 patients (30.0%), pericardial window in 12 cases (12.0%) and pericardiectomy in 3 patients (3.0%). Recurrence-free survival and complications-free survival was better in patients treated without interventions (log rank p=0.0038). Conclusions: The evolution of 'idiopathic' chronic large pericardial effusions is usually benign with reduction of the size of the effusion in the majority of cases, and regression in about 40% of cases. The risk of cardiac tamponade is 2.2%/year and recurrence/complications survival was better in patients treated conservatively without interventions.
Outcomes of idiopathic chronic large pericardial effusion / M. Imazio, G. Lazaros, A. Valenti, C.C. De Carlini, S. Maggiolini, E. Pivetta, C. Giustetto, D. Tousoulis, Y. Adler, M. Rinaldi, A. Brucato. - In: HEART. - ISSN 1355-6037. - 105:6(2019), pp. 477-481.
|Titolo:||Outcomes of idiopathic chronic large pericardial effusion|
|Parole Chiave:||echocardiography; pericardial effusion; Cardiology and Cardiovascular Medicine|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
|Data di pubblicazione:||2019|
|Data ahead of print / Data di stampa:||1-ott-2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1136/heartjnl-2018-313532|
|Appare nelle tipologie:||01 - Articolo su periodico|