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open access

Vol 25, No 6 (2018)
Original articles — Clinical cardiology
Submitted: 2017-10-04
Accepted: 2017-12-29
Published online: 2018-01-10
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Pericardial effusion unrelated to surgery is a predictor of mortality in heart transplant patients

Simon F. Stämpfli1, Tardu Özkartal1, Niels Hagenbuch2, Stephan Bernhart1, Andreas J. Flammer1, Alessandra Vecchiati1, Georg M. Fröhlich1, Frank Ruschitzka1, Leonhard Held2, Felix C. Tanner1
DOI: 10.5603/CJ.a2018.0001
·
Pubmed: 29341061
·
Cardiol J 2018;25(6):714-721.
Affiliations
  1. Arrhythmia and Electrophysiology, Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland
  2. Division of Biostatistics, Institute for Social and Preventive Medicine, University of Zurich, 8091 Zurich, Switzerland

open access

Vol 25, No 6 (2018)
Original articles — Clinical cardiology
Submitted: 2017-10-04
Accepted: 2017-12-29
Published online: 2018-01-10

Abstract

Background: Hemodynamically irrelevant pericardial effusion (PeEf) is a predictor of adverse outcome in heart failure patients. The clinical relevance of a PeEf unrelated to surgery in heart transplant patients remains unknown. This study assesses the prognostic value of PeEf occurring later than 1 year after transplantation.

Methods: All patients undergoing heart transplantation in Zurich between 1989 and 2012 were screened. Cox proportional hazard models were used to analyze mortality (primary) and hospitalization (secondary endpoint). PeEf time points were compared to baseline for rejection, immunosuppressants, tumors, inflam­mation, heart failure, kidney function, hemodynamic, and echocardiographic parameters.

Results: Of 152 patients (mean age 48.3 ± 11.9), 25 developed PeEf. Median follow-up period was 11.9 (IQR 5.8–17) years. The number of deaths was 6 in the PeEf group and 46 in the non-PeEf group. The occurrence of PeEf was associated with a 2.5-fold increased risk of death (HR 2.49, 95% CI 1.02–6.13, p = 0.046) and hospitalization (HR 2.53, 95% CI 1.57–4.1, p = 0.0002).

Conclusions: This study reveals that the finding of hemodynamically irrelevant PeEf in heart trans­plant patients is a predictor of adverse outcome, suggesting that a careful clinical assessment is war­ranted in heart transplant patients exhibiting small PeEf.

Abstract

Background: Hemodynamically irrelevant pericardial effusion (PeEf) is a predictor of adverse outcome in heart failure patients. The clinical relevance of a PeEf unrelated to surgery in heart transplant patients remains unknown. This study assesses the prognostic value of PeEf occurring later than 1 year after transplantation.

Methods: All patients undergoing heart transplantation in Zurich between 1989 and 2012 were screened. Cox proportional hazard models were used to analyze mortality (primary) and hospitalization (secondary endpoint). PeEf time points were compared to baseline for rejection, immunosuppressants, tumors, inflam­mation, heart failure, kidney function, hemodynamic, and echocardiographic parameters.

Results: Of 152 patients (mean age 48.3 ± 11.9), 25 developed PeEf. Median follow-up period was 11.9 (IQR 5.8–17) years. The number of deaths was 6 in the PeEf group and 46 in the non-PeEf group. The occurrence of PeEf was associated with a 2.5-fold increased risk of death (HR 2.49, 95% CI 1.02–6.13, p = 0.046) and hospitalization (HR 2.53, 95% CI 1.57–4.1, p = 0.0002).

Conclusions: This study reveals that the finding of hemodynamically irrelevant PeEf in heart trans­plant patients is a predictor of adverse outcome, suggesting that a careful clinical assessment is war­ranted in heart transplant patients exhibiting small PeEf.

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Keywords

survival, hospitalization, cancer, prognosis, echocardiography

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About this article
Title

Pericardial effusion unrelated to surgery is a predictor of mortality in heart transplant patients

Journal

Cardiology Journal

Issue

Vol 25, No 6 (2018)

Pages

714-721

Published online

2018-01-10

Page views

2840

Article views/downloads

921

DOI

10.5603/CJ.a2018.0001

Pubmed

29341061

Bibliographic record

Cardiol J 2018;25(6):714-721.

Keywords

survival
hospitalization
cancer
prognosis
echocardiography

Authors

Simon F. Stämpfli
Tardu Özkartal
Niels Hagenbuch
Stephan Bernhart
Andreas J. Flammer
Alessandra Vecchiati
Georg M. Fröhlich
Frank Ruschitzka
Leonhard Held
Felix C. Tanner

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