Abstract
ObjectivesPericardial effusion (PE) is correlated with outcomes in patients with pulmonary arterial hypertension (PAH). Pulmonary artery denervation (PADN) was used for treatment of PAH. The present study aimed to analyze the prognostic value of PE for outcomes after PADN in patients with WHO Group I, Group II and Group IV PAH.ResultsPE, frequently seen in patients with connective tissue disease, was featured by fast heart rate, decreased exercise capacity, more syncope, worsening pulmonary arterial hemodynamic and right atrium size. PADN procedure resulted in dramatic reduction of PE. After a median of 376 days follow-up, the rate of PAH-related event, all-cause death and rehospitalization increased over the PE amount and occurred in 29.8%, 19.7% and 25.2% of patients with PE, different to 3.4%, 3.4% and 6.8% of patients without PE (p = 0.034, p = 0.041 and p = 0.039, respectively). The reduction of PE during follow-up was similar among three groups.Materials and methodsBetween March 2012 and July 2014, a total of 66 consecutive patients (52 ± 16 years) who underwent PADN were stratified by no PE (n = 20), PE < 10 mm (n = 29) and PE ≥ 10 mm (n = 17) according to baseline echocardiograph. Dynamic change of PE and its correlation with PAH-related event after PADN were measured.ConclusionsPE is associated with increased PAH-related event after PADN. PADN results in significant similar reduction of PE among patients with Group I, Group II and Group IV PAH.
Highlights
Pulmonary artery hypertension (PAH) is a debilitating condition, resulting in dyspnea and fatigue, impaired exercise capacity, and reduced survival [1]
After a median of 376 days follow-up, the rate of PAHrelated event, all-cause death and rehospitalization increased over the pericardial effusion (PE) amount and occurred in 29.8%, 19.7% and 25.2% of patients with PE, different to 3.4%, 3.4% and 6.8% of patients without PE (p = 0.034, p = 0.041 and p = 0.039, respectively)
PE is associated with increased PAH-related event after pulmonary artery denervation (PADN)
Summary
Pulmonary artery hypertension (PAH) is a debilitating condition, resulting in dyspnea and fatigue, impaired exercise capacity, and reduced survival [1]. Pericardial fluid accumulation masks the echocardiographic findings of cardiac tamponade [6] and impairs the ventricular diastolic filling, which carries an additional risk to patients with PAH, [4, 6] in PAH due to CTD [7]. Our group recently, reported the actual experimental [8] and short-term clinical results of pulmonary artery denervation (PADN) via significant reductions in pulmonary arterial pressure (PAP) and PE size, and improvement of 6MWD at 3-month follow-up in patients with idiopathic PAH who were unresponsive to medication [9]. The present study aimed to analyze the dynamic change of PE and its predictive value for clinical outcomes in consecutive patients with idiopathic or secondary PAH or secondary PH from left ventricular dysfunction [LVD] who underwent PADN procedure
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