Pleural effusion in severe aortic stenosis: marker of an adverse haemodynamic constellation and poor prognosis.

Aortic stenosis Chest radiography Haemodynamics Pleural effusion Pulmonary artery wedge pressure

Journal

ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191

Informations de publication

Date de publication:
10 Jan 2024
Historique:
revised: 25 11 2023
received: 05 10 2023
accepted: 18 12 2023
medline: 11 1 2024
pubmed: 11 1 2024
entrez: 11 1 2024
Statut: aheadofprint

Résumé

Pleural effusion (PE) is a common chest radiography (CXR) finding in patients with advanced cardiac disease. The pathophysiology and clinical value of PE in this setting are incompletely defined. We aimed to assess the haemodynamic correlates and prognostic impact of PE in patients with severe aortic stenosis (AS). We studied 471 patients (mean age 74 ± 10 years) with severe AS (indexed aortic valve area 0.42 ± 0.12 cm In severe AS patients, the presence of PE, particularly bilateral PE, is a marker of a poor haemodynamic constellation. Bilateral PE is associated with a substantially increased post-AVR mortality.

Identifiants

pubmed: 38200702
doi: 10.1002/ehf2.14666
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Références

Cardinale L, Priola AM, Moretti F, Volpicelli G. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure. World J Radiol 2014;6:230-237. doi:10.4329/wjr.v6.i6.230
Yaku H, Seko Y, Kato T, Morimoto T, Kimura T. Prognostic implications of residual pleural effusions at discharge in patients with acute decompensated heart failure. Eur J Intern Med 2021;85:133-135. doi:10.1016/j.ejim.2020.11.023
Llorens P, Javaloyes P, Masip J, Gil V, Herrero-Puente P, Martin-Sanchez FJ, et al. Prognostic value of chest radiographs in patients with acute heart failure: the radiology in acute heart failure (RAD-ICA) study. Emergencias 2019;31:318-326.
Wiener-Kronish JP, Matthay MA, Callen PW, Filly RA, Gamsu G, Staub NC. Relationship of pleural effusions to pulmonary hemodynamics in patients with congestive heart failure. Am Rev Respir Dis 1985;132:1253-1256. doi:10.1164/arrd.1985.132.6.1253
Chopra A, Highland KB, Kilb E, Huggins JT. The relationship of pleural and pericardial effusion with pulmonary hemodynamics in patients with pulmonary hypertension. Am J Med Sci 2021;361:731-735. doi:10.1016/j.amjms.2021.01.003
Shochat M, Shotan A, Trachtengerts V, Blondheim DS, Kazatsker M, Gurovich V, et al. A novel radiological score to assess lung fluid content during evolving acute heart failure in the course of acute myocardial infarction. Acute Card Care 2011;13:81-86. doi:10.3109/17482941.2011.567279
Wright SP, Moayedi Y, Foroutan F, Agarwal S, Paradero G, Alba AC, et al. Diastolic pressure difference to classify pulmonary hypertension in the assessment of heart transplant candidates. Circ Heart Fail 2017;10:e004077. doi:10.1161/CIRCHEARTFAILURE.117.004077
Houston BA, Tedford RJ. What we talk about when we talk about the wedge pressure. Circ Heart Fail 2017;10:e004450. doi:10.1161/CIRCHEARTFAILURE.117.004450
Reddy YNV, El-Sabbagh A, Nishimura RA. Comparing pulmonary arterial wedge pressure and left ventricular end diastolic pressure for assessment of left-sided filling pressures. JAMA Cardiol 2018;3:453-454. doi:10.1001/jamacardio.2018.0318
Maeder MT, Weber L, Rickli H. Pulmonary hypertension in aortic valve stenosis. Trends Cardiovasc Med 2020; doi:10.1161/CIRCHEARTFAILURE.117.004450
Genereux P, Pibarot P, Redfors B, Mack MJ, Makkar RR, Jaber WA, et al. Staging classification of aortic stenosis based on the extent of cardiac damage. Eur Heart J 2017;38:3351-3358. doi:10.1093/eurheartj/ehx381
Maeder MT, Weber L, Weilenmann D, Haager PK, Joerg L, Taramasso M, et al. Invasive hemodynamic staging classification of cardiac damage in patients with aortic stenosis undergoing valve replacement. Can J Cardiol 2020;36:1667-1674. doi:10.1016/j.cjca.2020.02.004
Elgwairi E, Abdalla A, Elkheshen A, Elharabi Z, Nugent K. Pleural effusions in patients with congestive heart failure: Frequency, pathogenesis, diagnosis, and implications. Cardiol Rev 2022, Publish Ahead of Print; doi:10.1097/CRD.0000000000000469
Hoeper MM, Rosenkranz S. Was Paul wood wrong about pre-capillary pulmonary hypertension protecting against pulmonary congestion in left heart disease? Eur Heart J 2022;43:3432-3434. doi:10.1093/eurheartj/ehac176
Reddy YNV, Obokata M, Wiley B, Koepp KE, Jorgenson CC, Egbe A, et al. The haemodynamic basis of lung congestion during exercise in heart failure with preserved ejection fraction. Eur Heart J 2019;40:3721-3730. doi:10.1093/eurheartj/ehz713
Omote K, Sorimachi H, Obokata M, Reddy YNV, Verbrugge FH, Omar M, et al. Pulmonary vascular disease in pulmonary hypertension due to left heart disease: Pathophysiologic implications. Eur Heart J 2022;43:3417-3431. doi:10.1093/eurheartj/ehac184
Chertow BS, Kadzielawa R, Burger AJ. Benign pleural effusions in long-standing diabetes mellitus. Chest 1991;99:1108-1111. doi:10.1378/chest.99.5.1108
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599-3726. doi:10.1093/eurheartj/ehab368
Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg 2021;60:727-800. doi:10.1093/ejcts/ezab389
Gertz ZM, McCauley BD, Raina A, O'Donnell W, Shellenberger C, Willhide J, et al. Estimation of oxygen consumption in elderly patients with aortic stenosis. Catheter Cardiovasc Interv 2014;83:E128-E133. doi:10.1002/ccd.25018

Auteurs

Alexander Breuss (A)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Maximilian Porsch (M)

Department of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

André Aschmann (A)

Department of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Lukas Weber (L)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Sharon Appert (S)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Philipp K Haager (PK)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Daniel Weilenmann (D)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Simon Wildermuth (S)

Department of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Hans Rickli (H)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Micha T Maeder (MT)

Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
University of Basel, Basel, Switzerland.

Classifications MeSH