Abstract
Background: Bone marrow transplant (BMT) is necessary in varying diseases. However, it has known cardiac risks and complications, including pericardial effusions (PE). PE can be life threatening if not identified early, and its treatment can be invasive, ie pericardiocentesis. Our objective is to identify echocardiographic (echo) findings that could help identify high risk subsets for developing a PE post BMT. Methods: We retrospectively identified BMT patients from January 2011 - December 2019 in our institution that developed moderate to large PE requiring treatment. Our controls consisted of BMT patients that did not develop PE. Baseline demographics, BMT data, PE treatments, and echo data was obtained. Echo variables included markers of systolic function, diastolic function, and LV size prior to BMT in both sets of patients. We performed a t-test for comparison and Pearson correlation. Results: We performed over 180 BMTs in our institution during this time. Of these, 50 were noted to have any degree of pericardial effusion, but 15 patients developed symptomatic pericardial effusions requiring further interventions. Our study included 13 subjects and 12 controls. Our subjects ranged from 8 months to 17 years old, 3F/10M. Even though the left ventricle end diastolic diameter (LVIDd) z-scores were within normal, they were statistically larger (p 0.02) in the PE group. Both groups had the same average hemoglobin (9.2). There was no difference in the pre-BMT systolic function or diastolic function parameters between the two groups. The duration of the PE (after the BMT)correlated with LVIDd z-score (Figure 1; r 0.6, p 0.02) and MV septal E’ (r -0.6, p 0.03) and E/E’ (r 0.6, p 0.05) from the pre-BMT echo. Conclusions: Assessing LV size and LV diastolic markers pre-BMT could be simple yet important measurements to pay closer attention to, which can then help direct improved screening in pediatric post-BMT patients. These findings should be explored further in larger studies.
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