[Correlation between the inferior vena cava collapsibility and asymptomatic pericardial effusion in hemodialysis patients].

INTRODUCTION

The inferior vena cava collapsibility index is a sign of hypervolemia in hemodialysis patients. Asymptomatic pericardial effusion in these patients can be either a sign of hypervolemia or bad systolic function of the left ventricle, or both. The aim of this study was to assess the incidence of asymptomatic pericardial effusion and its correlation to collapsibility index in haemodialysis patients during 2-year follow-up.

RESULTS

Of 115 consecutive hemodialysis patients, at the beginning of the study and on every 6 months we performed: clinical, ECG, echocardiography, laboratory assessment. There was 29 patients with asymptomatic pericardial effusion (25.21%) vs. 86 (74.79%) without asymptomatic pericardial effusion. There was no significant difference considering gender, age, vintage of HD between the groups. Colapsibillity index was statistically significantly lower among the patients with asymptomatic pericardial effusion: 0.39+/-0.09 vs. 0.69+/-0.21 in those without it; p<0.001. Asymptomatic pericardial effusion correlated inversely with colapsibillity index (r=-0.577; p<0.0001) and ejection fraction of left ventricle (r=-0.282; p<0.030) and positively with the dimension of left ventricle in diastole. The colapsibillity index had inverse correlation with asymptomatic pericardial effusion (r=-0.668; p<0.0001), end-diastolic dimension of the left ventricle (r=-0.464; p<0.0001), and only one positive correlation with Kt/V (r=0.294, p<0.002). During the follow-up, 16 pts (13.91%) died: 7 of them had a symptomatic pericardial effusion (43.75%). Factors with greatest relative risk for death were: persistent asymptomatic pericardial effusion (3.48); systolic dysfunction at the second examination (2.95): heart failure (2.88) at the third.

CONCLUSION

Colapsibillity index and asymptomatic pericardial effusion are the closely correlated in inverse manner and both are the sign of hypervolemia. Asymptomatic pericardial effusion is also a sign of a bad systolic function and a very bad prognosis.