Department of Interventional Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Calle 163A # 13B-60, 110131, Bogotá, Colombia.
School of Medicine, Universidad el Bosque, Bogotá, Colombia.
Sci Rep. 2022 Sep 26;12(1):16010. doi: 10.1038/s41598-022-19339-6.
Pericardial effusions requiring pericardiocentesis have multiple causes that vary among geographical regions and health contexts. This procedure can be performed for diagnostic or therapeutic indications. The purpose of this study was to identify the principal causes of pericardial effusions and indications for pericardiocentesis, exploring differences among groups. This was a retrospective case series of patients who underwent pericardiocentesis for pericardial effusion in a single center in Latin America. Demographic, clinical, echocardiographic, and procedural variables were recorded and analyzed. The primary outcome was to determine the causes of pericardial effusions in these patients and the indication (diagnostic, therapeutic, or both). The results are presented in two groups (inflammatory and noninflammatory) according to the cause of the pericardial effusion. One hundred sixteen patients with pericardial effusion underwent pericardiocentesis. The median age was 58 years (IQR 46.2-70.7), and 50% were male. In the noninflammatory pericardial effusion group, there were 61 cases (53%), among which neoplastic pericardial effusion was the most frequent cause (n = 25, 40.9%). In the inflammatory group, there were 55 cases (47%), and the main cause was postpericardiectomy syndrome after cardiac surgery (n = 31, 56.4%). In conclusion, the principal indication for pericardiocentesis was therapeutic (n = 66, 56.8%). Large pericardial effusion without hemodynamic effect of cardiac tamponade was significantly more frequent in the inflammatory group (p = 0.03). The principal cause of pericardial effusion in patients who underwent pericardiocentesis was postpericardiectomy syndrome after cardiac surgery, followed by neoplastic pericardial effusion. Pericardiocentesis is mainly a therapeutic procedure.
需要进行心包穿刺的心包积液有多种病因,这些病因在不同地区和卫生环境下有所差异。心包穿刺术可用于诊断或治疗目的。本研究旨在确定心包积液的主要病因和心包穿刺的适应证,并探讨不同分组之间的差异。这是一项在拉丁美洲某单一中心进行的回顾性病例系列研究,纳入了因心包积液而行心包穿刺术的患者。记录并分析了人口统计学、临床、超声心动图和程序变量。主要结局是确定这些患者心包积液的病因和适应证(诊断性、治疗性或两者兼有)。结果根据心包积液的病因分为两组(炎症性和非炎症性)。116 例心包积液患者接受了心包穿刺术。患者的中位年龄为 58 岁(IQR 46.2-70.7),50%为男性。在非炎症性心包积液组中,有 61 例(53%),其中肿瘤性心包积液是最常见的病因(n=25,40.9%)。在炎症性心包积液组中,有 55 例(47%),主要病因是心脏手术后心包切开术后综合征(n=31,56.4%)。结论,心包穿刺的主要适应证是治疗性(n=66,56.8%)。无心脏压塞血流动力学效应的大量心包积液在炎症组中更为常见(p=0.03)。心包穿刺患者心包积液的主要病因是心脏手术后心包切开术后综合征,其次是肿瘤性心包积液。心包穿刺术主要是一种治疗性操作。