Prognostic impact of small pericardial effusion in acute heart failure.

BACKGROUND

The relationship between small pericardial effusion (SPE) and outcomes has not been well studied in patients with heart failure. Therefore, we aimed to investigate the prevalence and importance of SPE in acute heart failure (AHF).

METHODS

A total of 398 hospitalized patients with AHF were retrospectively reviewed. Patients' baseline demographic, clinical, echocardiographic, and laboratory characteristics were noted. SPE was defined as the presence of a pericardial effusion <10 mm. The primary outcome was one-year mortality.

RESULTS

SPE was noted in 54 (13.6%) of the patients. Mortality at one year was greater for patients with a small effusion compared with those without SPE (44.4 vs. 11.4%, respectively; p < 0.001), and the one-year mortality rate for the whole group was 15.8%. Age (HR = 1.12, 95% CI 1.054-1.854, p = 0.024), N-terminal pro-B-type natriuretic peptide >4800 pg/ml (HR = 1.628, 95% CI 01.102-4.805, p = 0.001), left ventricular ejection fraction <30% (HR = 1.878, 95% CI 1.154-4.524, p = 0.001), and presence of SPE (HR = 1.567, 95% CI 1.122-2.991, p = 0.005) were independent predictors of one-year mortality on multivariate analysis.

CONCLUSIONS

The presence of SPE on admission was an independent predictor of one-year mortality in AHF.