Oylumlu Muhammed, Davutoglu Vedat, Sucu Murat, Ercan Suleyman, Ozer Orhan, Yuce Murat
Department of Cardiology, Dumlupinar University School of Medicine, 43020, Kutahya, Turkey,
Int J Cardiovasc Imaging. 2014 Jun;30(5):907-10. doi: 10.1007/s10554-014-0421-0. Epub 2014 Apr 8.
We aimed to determine long-term prognostic role of echocardiographic and hematologic parameters in heart failure patients complicated with incidental pleural effusion (PE) diagnosed during echocardiographic evaluation. The study was performed by evaluating patient records in which PE was incidentally detected during echocardiographic examination in a tertiary teaching hospital between Jan 2002 and Dec 2012. Total 151 patients with heart failure complicated with PE were analyzed. All patients' mortality data were collected from registry center of Social Insurance Institution which is officially responsible for recording all mortality data in Turkey. Detailed echocardiographic and hematologic parameters including creatinine, uric acid, albumin, sodium, potassium, hemoglobin at the time of hospital admission were analyzed. Data from 151 eligible patients were analyzed. We compared patients who died (n = 51) during follow-up with the survivors (n = 100) in terms of patients' echocardiographic and hematological features. Mean duration of follow-up was 71.5 ± 45.6 months. Fifty-one patients (33.8 %) died during this follow-up period. From all echocardiographic parameters only dilated left atrium (LA) diameter was found to be associated with a poor prognosis (p = 0.034). Low albumin, sodium and hemoglobin levels were associated with poor prognosis (p < 0.001, p = 0.002 and p = 0.007, respectively). We showed that dilated LA, as well as low albumin, low sodium and low hemoglobin levels had a worse prognostic significance than patients with normal LA size, within normal limits of albumin, sodium and hemoglobin levels in patients with heart failure complicated with PE determined incidentally by echocardiography.
我们旨在确定超声心动图和血液学参数在超声心动图评估期间诊断为合并偶发性胸腔积液（PE）的心力衰竭患者中的长期预后作用。该研究通过评估2002年1月至2012年12月在一家三级教学医院超声心动图检查期间偶然发现PE的患者记录来进行。共分析了151例合并PE的心力衰竭患者。所有患者的死亡率数据均从土耳其负责记录所有死亡率数据的社会保险机构登记中心收集。分析了入院时包括肌酐、尿酸、白蛋白、钠、钾、血红蛋白在内的详细超声心动图和血液学参数。对151例符合条件的患者的数据进行了分析。我们比较了随访期间死亡的患者（n = 51）和存活患者（n = 100）的超声心动图和血液学特征。平均随访时间为71.5±45.6个月。在此随访期间，51例患者（33.8%）死亡。在所有超声心动图参数中，仅发现左心房（LA）直径扩大与预后不良相关（p = 0.034）。低白蛋白、低钠和低血红蛋白水平与预后不良相关（分别为p < 0.001、p = 0.002和p = 0.007）。我们发现，在超声心动图偶然确定合并PE的心力衰竭患者中，LA扩大以及低白蛋白、低钠和低血红蛋白水平比LA大小正常、白蛋白、钠和血红蛋白水平在正常范围内的患者具有更差的预后意义。
