208 490

Cited 4 times in

Differential Impact of Constrictive Physiology after Pericardiocentesis in Malignancy Patients with Pericardial Effusion

Authors
 In-Jeong Cho  ;  Hyuk-Jae Chang  ;  Hyemoon Chung  ;  Sang-Eun Lee  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Namsik Chung 
Citation
 PLOS ONE, Vol.10(12) : e0145461, 2015 
Journal Title
PLOS ONE
Issue Date
2015
MeSH
Aged ; Echocardiography* ; Female ; Heart/physiopathology* ; Humans ; Male ; Middle Aged ; Neoplasms/complications* ; Neoplasms/mortality ; Neoplasms/pathology ; Pericardial Effusion/diagnosis ; Pericardial Effusion/etiology ; Pericardial Effusion/mortality ; Pericardial Effusion/surgery* ; Pericardiocentesis/adverse effects* ; Pericardiocentesis/methods ; Retrospective Studies
Abstract
BACKGROUND: Echocardiographic signs of constrictive physiology (CP) after pericardiocentesis are frequently observed in malignancy patients. The purpose of the current study was to explore whether features of CP after pericardiocentesis have prognostic impact in malignancy patients with pericardial effusion (PE).

METHODS: We retrospectively reviewed 467 consecutive patients who underwent pericardiocentesis at our institution from January 2006 to May 2014. Among them, 205 patients with advanced malignancy who underwent comprehensive echocardiography after the procedure comprised the study population. Co-primary end points were all-cause mortality (ACM) and repeated drainage (RD) for PE. Patients were divided into four subgroups according to cytologic result for malignant cells and CP (positive cytology with negative CP, both positive, both negative, and negative cytology with positive CP).

RESULTS: CP after pericardiocentesis was present in 106 patients (50%) at median 4 days after the procedure. During median follow-up of 208 days, ACM and RD occurred in 162 patients (79%) and 29 patients (14%), respectively. Cox regression analysis revealed that independent predictors for ACM were male gender and positive cytology (all, p < 0.05). For RD, predictors were positive cytology, the absence of cardiac tamponade, and negative CP after pericardiocentesis (all, p < 0.05). When the patients were divided into four subgroups, patients with negative cytology and positive CP demonstrated the most favorable survival (hazard ratio [HR]: 0.39, p = 0.005) and the lowest RD rates (HR: 0.07, p = 0.012).

CONCLUSION: CP after pericardiocentesis is common, but does not always imply poor survival or the need for RD in patients with advanced malignancies. On the contrary, the presence of CP in patients with negative cytology conferred the most favorable survival and the lowest rate of RD. Comprehensive echocardiographic evaluation for CP after pericardiocentesis would be helpful for predicting prognosis in patients with advanced malignancies.
Files in This Item:
T201505220.pdf Download
DOI
10.1371/journal.pone.0145461
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Sang-Eun(이상은) ORCID logo https://orcid.org/0000-0001-6645-4038
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Chung, Hye Moon(정혜문)
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157062
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links