Abdelghani Mohamed Salah, Altermanini Mohammad, Rahhal Alaa, Alkhalailah Osama, Shunnar Khalid, Shehadeh Mohanad, Alqalalwah Adalah, AlQudah Baraa, Shebani Ahmed, Obeidat Ibrahim, AlAni Haneen, Ibrahim Mohamed Izham Mohamed, Elhassan Mawahib, Kaddoura Rasha, Al Suwaidi Jassim, Arabi Abdulrahman
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Heart Views. 2024 Oct-Dec;25(4):212-218. doi: 10.4103/heartviews.heartviews_120_24. Epub 2025 May 10.
Pericardial effusion can lead to severe complications such as cardiac tamponade, necessitating immediate intervention. Various causes and prevalence vary according to the region. To the best of our knowledge, there is limited data from the Middle East region about pericardial effusion and outcomes of pericardiocentesis.
This retrospective observational study was conducted at Heart Hospital, the only tertiary cardiology center in Qatar, to assess the clinical and echocardiographic characteristics of pericardial effusion and the impact of pericardiocentesis. Patients admitted to the cardiac intensive care unit between January 2017 and February 2021 with significant pericardial effusion confirmed either by large amount using transthoracic echocardiography (TTE), clinical signs, or echocardiographic signs suggestive of tamponade were included. The study evaluated clinical outcomes, including complications of pericardiocentesis and laboratory parameters before and after the procedure.
A total of 114 patients were included in our retrospective analysis. The most common etiology of pericardial effusion in the study was idiopathic (31.6%), followed by malignancy (25.4%), viral infection (13.2%), and tuberculosis (12.3%). Most patients (95%) had moderate to large effusions by TTE. Pericardiocentesis was successfully performed in 82.5% of patients. After pericardiocentesis, heart rate significantly decreased from 105 to 95 bpm ( < 0.001), and laboratory results showed significant improvement in renal and liver function, including serum creatinine, alanine transaminase, aspartate aminotransferase, and bilirubin levels. There were no pericardiocentesis-related deaths, but 6.38% of patients died within 28 days due to advanced primary diseases.
Idiopathic causes were the most common, followed by malignancy. Pericardiocentesis, performed in an ICU setting with TTE guidance, was safe, with a 100% survival rate and low complication risk. Patients with impaired kidney and liver functions experienced significant improvement postprocedure. These findings offer valuable insights into pericardial effusion in Qatar and allow for comparisons with neighboring Middle Eastern countries.
心包积液可导致严重并发症，如心脏压塞，需要立即进行干预。其病因和患病率因地区而异。据我们所知，中东地区关于心包积液和心包穿刺术结果的数据有限。
这项回顾性观察研究在卡塔尔唯一的三级心脏病中心心脏医院进行，以评估心包积液的临床和超声心动图特征以及心包穿刺术的影响。纳入2017年1月至2021年2月期间入住心脏重症监护病房、经经胸超声心动图（TTE）大量积液、临床体征或提示心脏压塞的超声心动图征象确诊为大量心包积液的患者。该研究评估了临床结局，包括心包穿刺术的并发症以及术前和术后的实验室参数。
我们的回顾性分析共纳入114例患者。该研究中心包积液最常见的病因是特发性（31.6%），其次是恶性肿瘤（25.4%）、病毒感染（13.2%）和结核病（12.3%）。大多数患者（95%）经TTE检查有中至大量积液。82.5%的患者成功进行了心包穿刺术。心包穿刺术后，心率从105次/分钟显著降至95次/分钟（<0.001），实验室结果显示肾功能和肝功能显著改善，包括血清肌酐、丙氨酸转氨酶、天冬氨酸转氨酶和胆红素水平。没有与心包穿刺术相关的死亡，但6.38%的患者因晚期原发性疾病在28天内死亡。
特发性病因最为常见，其次是恶性肿瘤。在重症监护病房（ICU）环境下在TTE引导下进行的心包穿刺术是安全的，生存率为100%，并发症风险低。肾功能和肝功能受损的患者术后有显著改善。这些发现为卡塔尔的心包积液提供了有价值的见解，并有助于与中东邻国进行比较。
