Prevalence and prognosis of pericardial effusion in patients affected by pectus excavatum: A case-control study.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 Dec 2021
Historique:
received: 24 08 2021
revised: 23 09 2021
accepted: 04 10 2021
pubmed: 10 10 2021
medline: 9 11 2021
entrez: 9 10 2021
Statut: ppublish

Résumé

The presence of pectus excavatum(PEX) has been occasionally associated with pericardial effusion. Aim of the present study was to compare incidence and prognosis of pericardial effusion in a group of unselected patients with PEX vs a control group. From a prospective registry of consecutive patients who underwent chest CT for cardiovascular disease, subjects with a radiological diagnosis of PEX were retrospectively identified (cases); from the same registry patients (controls) without rib cage abnormalities were randomly selected, until a 1:2 ratio was reached. The presence of pericardial effusion at CT was quantified. Follow-up was obtained for a composite end-point: cardiac tamponade, need for pericardiocentesis, need for cardiac surgery for relapsing pericardial effusion. A total of 43 patients with PEX (20 females) and a control group of 86 cases (31 females) without rib cage abnormalities were identified. Pericardial effusion evaluated at CT was significatively more prevalent in patients with PEX vs control group, 37.2% vs 13.9% (p < 0.001), respectively; four patients with PEX (9.3%) had at least moderate pericardial effusion vs no subjects among the controls (p = 0.004). PEX diagnosis was significantly associated to pericardial effusion at multi-variate analysis (OR95%CI 10.91[3.47-34.29], p < 0.001). At a mean follow-up of 6.5 ± 3.4 years no pericardial events were recorded. Our findings support the higher prevalence of pericardial effusion in patients with PEX when compared to a control group. The absence of adverse pericardial events at follow-up suggest the good prognosis of these effusions, that in the appropriate clinical setting might not be considered "idiopathic".

Sections du résumé

BACKGROUND BACKGROUND
The presence of pectus excavatum(PEX) has been occasionally associated with pericardial effusion. Aim of the present study was to compare incidence and prognosis of pericardial effusion in a group of unselected patients with PEX vs a control group.
METHODS METHODS
From a prospective registry of consecutive patients who underwent chest CT for cardiovascular disease, subjects with a radiological diagnosis of PEX were retrospectively identified (cases); from the same registry patients (controls) without rib cage abnormalities were randomly selected, until a 1:2 ratio was reached. The presence of pericardial effusion at CT was quantified. Follow-up was obtained for a composite end-point: cardiac tamponade, need for pericardiocentesis, need for cardiac surgery for relapsing pericardial effusion.
RESULTS RESULTS
A total of 43 patients with PEX (20 females) and a control group of 86 cases (31 females) without rib cage abnormalities were identified. Pericardial effusion evaluated at CT was significatively more prevalent in patients with PEX vs control group, 37.2% vs 13.9% (p < 0.001), respectively; four patients with PEX (9.3%) had at least moderate pericardial effusion vs no subjects among the controls (p = 0.004). PEX diagnosis was significantly associated to pericardial effusion at multi-variate analysis (OR95%CI 10.91[3.47-34.29], p < 0.001). At a mean follow-up of 6.5 ± 3.4 years no pericardial events were recorded.
CONCLUSION CONCLUSIONS
Our findings support the higher prevalence of pericardial effusion in patients with PEX when compared to a control group. The absence of adverse pericardial events at follow-up suggest the good prognosis of these effusions, that in the appropriate clinical setting might not be considered "idiopathic".

Identifiants

pubmed: 34626741
pii: S0167-5273(21)01559-X
doi: 10.1016/j.ijcard.2021.10.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

179-183

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Edoardo Conte (E)

Centro Cardiologico Monzino, IRCCS, Milan, Italy; Università di Milano, Deptartment of Biomedical Sciences for Health, University of Milan, Milan, Italy. Electronic address: edoardo.conte@ccfm.it.

Cecilia Agalbato (C)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Gianfranco Lauri (G)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Saima Mushtaq (S)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Chiara Carollo (C)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Alice Bonomi (A)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Lorenza Zanotto (L)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Eleonora Melotti (E)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Alessia Dalla Cia (A)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Marco Guglielmo (M)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Andrea Baggiano (A)

Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health - Cardiovascular Section, University of Milan, Milan, Italy'.

Andrea Annoni (A)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Alberto Formenti (A)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Elisabetta Mancini (E)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Antonio Maria D'Angelo (AM)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Alessandra Rota (A)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Emilio Assanelli (E)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Chiarella Sforza (C)

Università di Milano, Deptartment of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Gianluca Pontone (G)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Mauro Pepi (M)

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Daniele Andreini (D)

Centro Cardiologico Monzino, IRCCS, Milan, Italy; Università di Milano, Department of Biomedical and Clinical Sciences "Luigi Sacco", Fatebefratelli Hospital, Milan, Italy.

Antonio Brucato (A)

Università di Milano, Department of Biomedical and Clinical Sciences "Luigi Sacco", Fatebefratelli Hospital, Milan, Italy.

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Classifications MeSH