Predicting pericardial effusions in end-stage renal disease: Does pulmonary hypertension play a role?

De Cicco Ignacio A, McBride Cameron, Llanos-Chea Fiorella, Gacad Vincent E, Yu Patrick L, Benjamin-Garner Ruby A, Aisenberg Gabriel M
2017 Cardiovascular Disorders and Medicine  
Pericardial effusion occurs, in variable extent, in 35% of patients on hemodialysis. Pulmonary hypertension is considered responsible for the generation and maintenance of pericardial effusion, but such association has not been proven in hemodialysis patients. Methods: We retrospectively collected data on patients with end-stage renal disease (ESRD) on hemodialysis who had two or more transthoracic echocardiograms. We investigated demographic and echocardiographic data focused on trying to find
more » ... an association between right ventricular systolic pressure (RVSP) above 40 mmHg and the presence of pericardial effusion. Results: 129 patients had 395 echocardiograms. Sixty-six percent of studies showed RVSP above 40 mm Hg, while 43% showed variable degrees of pericardial effusion. We found a weak positive correlation between these variables (R coefficient= 0.16). RVSP above 40 mmHg predicted the presence (but not severity) of pericardial effusion even in patients without severe systolic heart failure. In follow-up TTE, the incidence of a new effusion was higher among patients whose RVSP was or rose above 40 mm Hg compared to those with normal RVSP (20% vs. 7%, P=0.03). Hemodialysis schedule did not modify the results. Conclusions: A single RVSP above 40 mmHg predicts the presence but not severity of pericardial effusion in ESRD patients, while consistently elevated RVSP appears to also predict the emergence of new, mostly mild pericardial effusion among those patients.
doi:10.15761/cdm.1000160 fatcat:6ph36mr6izgnvd5ke2ougddube