Patel Yash, Agarwal Vikram, Argulian Edgar
Mount Sinai Heart, Mount Sinai St Luke's Hospital, Icahn School of Medicine, New York, New York.
Division of Cardiology, St. Luke's Hospital, Chesterfield, Missouri.
Am J Cardiol. 2018 Jun 1;121(11):1409-1412. doi: 10.1016/j.amjcard.2018.02.023. Epub 2018 Mar 5.
Subacute tamponade is a challenging diagnosis requiring careful consideration of both clinical and imaging data. We aimed at exploring the association of initial blood pressure with markers of pericardial effusion severity in patients with moderate and large pericardial effusion. We conducted a retrospective, single-center study in 102 well-phenotyped patients with moderate and large pericardial effusion. The presenting systolic and diastolic blood pressure recordings were divided into tertiles to examine the association between the blood pressure and the different established markers of pericardial effusion severity. On presentation, 42% of patients had systolic blood pressure exceeding 130 mm Hg, and only 5% of patients had systolic blood pressure <90 mm Hg. Patients in the lowest blood pressure tertiles did not differ significantly from patients in the upper tertiles in terms of clinical, etiologic, or echocardiographic characteristics. Although patients who underwent pericardial drainage had higher presenting heart rates, no significant differences were seen in the blood pressure recordings, either systolic or diastolic (mean 125 mm Hg vs 130 mm Hg, p = 0.36 and 76 vs 75 mm Hg, p = 0.82, respectively). In conclusion, systolic and diastolic blood pressure recordings upon initial presentation do not demonstrate a significant association with markers of effusion severity or the need for drainage in patients with moderate and large pericardial effusion.
亚急性心脏压塞是一种具有挑战性的诊断,需要仔细考虑临床和影像学数据。我们旨在探讨中度和大量心包积液患者初始血压与心包积液严重程度标志物之间的关联。我们对102例具有明确表型的中度和大量心包积液患者进行了一项回顾性单中心研究。将就诊时的收缩压和舒张压记录分为三分位数,以检查血压与不同的已确立的心包积液严重程度标志物之间的关联。就诊时,42%的患者收缩压超过130 mmHg,只有5%的患者收缩压<90 mmHg。血压最低三分位数的患者与最高三分位数的患者在临床、病因或超声心动图特征方面无显著差异。尽管接受心包引流的患者就诊时心率较高,但收缩压和舒张压记录均无显著差异(分别为平均125 mmHg对130 mmHg,p = 0.36;76对75 mmHg,p = 0.82)。总之,对于中度和大量心包积液患者,就诊时的收缩压和舒张压记录与积液严重程度标志物或引流需求无显著关联。