Cardiac tamponade as an independent condition affecting the relationship between the plasma B-type natriuretic peptide levels and cardiac function

Minai, Kosuke; Komukai, Kimiaki; Arase, Satoshi; Nagoshi, Tomohisa; Matsuo, Seiichiro; Ogawa, Kazuo; Kayama, Yosuke; Inada, Keiichi; Tanigawa, Shin‐ichi; Takemoto, Tomoyuki; Sekiyama, Hiroshi; Date, Taro; Ogawa, Takayuki; Taniguchi, Ikuo; Yoshimura, Michihiro

doi:10.1007/s00380-012-0278-x

Cited by 12 publications

(10 citation statements)

References 15 publications

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“…CMR, which has emerged as a primary tool for noninvasive assessment of myocardial inflammation in patients with myocarditis [10], did not show myocardial injury in the present case of EGPA even at the time of cardiac tamponade. Thus, cardiac tamponade in this patient does not seem to be the result of myocarditis and heart failure [11]. Agard et al reported a case of EPGA with cardiac tamponade, which was not accompanied by other visceral involvement, though detailed analysis about myocardial involvement was not performed [5].…”

Section: Discussionmentioning

confidence: 95%

Cardiac tamponade leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg−Strauss syndrome): a case report and review of the literature

et al. 2014

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Eosinophilic granulomatosis with polyangiitis (EGPA), which was previously called Churg-Strauss syndrome, is a necrotizing systemic vasculitis of unknown cause accompanied by prominent eosinophilia. Cardiovascular complications, including eosinophilic myocarditis, are a major cause of mortality in this disorder. Acute pericarditis with slight pericardial effusion is a typical manifestation in EGPA, though hemodynamically significant pericardial effusion has been reported in a few cases. We report a case that initially presented with isolated cardiac tamponade, which was followed by systemic manifestations of EGPA over 3 weeks. Including the present case, previous EGPA cases with cardiac tamponade are reviewed to delineate its clinical characteristics.

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Section: Discussionmentioning

confidence: 95%

Cardiac tamponade leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg−Strauss syndrome): a case report and review of the literature

et al. 2014

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“…Natriuretic peptides, on the other hand, are a well-defined marker of heart failure, which increases when the volume or pressure load of the heart increases 16 . While the BNP levels were not high in large pericardial effusion and cardiac tamponade due to decreased stretching of the ventricles, they were shown to increase after the drainage of pericardial effusion 15 . The NT-proBNP values evaluated in our study are the values obtained from the samples taken at the hospital admission of the patients, which suggests that a high NT-proBNP level may be a marker for inpatient mortality, independent of the tamponadeinduced heart failure clinic.…”

Section: Discussionmentioning

confidence: 85%

“…Cardiac tamponade is a condition in which the filling functions of the heart are impaired due to pericardial effusion, and clinical findings such as dyspnea, tachycardia, and hypotension can mimic heart failure 15 . Natriuretic peptides, on the other hand, are a well-defined marker of heart failure, which increases when the volume or pressure load of the heart increases 16 .…”

Section: Discussionmentioning

confidence: 99%

Cancer prevalence, inpatient mortality and its predictors after pericardiocentesis

Çerik

Dindaş

Koyun

et al. 2020

Cumhuriyet Medical Journal

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Pericardiocentesis is a percutaneous drainage procedure performed in cardiac tamponade or a moderate-large pericardial effusion that does not respond to medical treatment. The prognosis varies according to the etiology of pericardial effusion, and the parameters that can determine the prognosis are unknown. In this study, we aimed to find predictors that can determine inpatient mortality in patients who underwent pericardiocentesis and to determine cancer etiology. Method: Ninety-one patients who underwent pericardiocentesis due to moderate-large pericardial effusion or pericardial tamponade were evaluated retrospectively. Baseline characteristics of the patients, their cancer diagnosis before and after pericardiocentesis, pericardial effusion cytology, echocardiographic parameters and laboratory parameters in the baseline evaluation were evaluated. The group with inpatient death (n = 14) and the surviving group (n = 77) were compared with each other. Results: There was no significant difference between baseline demographic characteristics and echocardiographic parameters when the patients with inpatient mortality and survivors were compared; only patients diagnosed with cancer (p <0.001) and patients with malignant cytology (p = 0.041) were statistically significantly higher in the group with inpatient mortality. When patients with inpatient mortality and survivors were compared in terms of laboratory parameters, aspartate aminotransferase (AST) [55 (27-455), 26 (19-45); p = 0.007, respectively], lactate dehydrogenase (LDH) [527 (438-944), 282 (225-381); p <0.001, respectively], C-reactive protein (CRP) [120.5 (19.8-140.7), 36.5 (8.26-86.15); p = 0.016, respectively], NTproBNP [8964 (7780-9432), 1310 (351-4556); p = 0.049] values were significantly higher in the inpatient mortality group than in the surviving group. The presence of cancer (p = 0.001), AST (p = 0.008), alanine aminotransferase (ALT) (p = 0.013), LDH (p = 0.015), CRP (p = 0.046) parameters were detected to be predictors that can be used to predict inpatient mortality in the univariate logistic regression analysis conducted to determine the predictors that could indicate inpatient mortality. Conclusions: Inpatient mortality is high in patients that were detected to have underlying malignancy and pericardial involvement after pericardiocentesis. In the initial evaluation of these patients, simple laboratory tests such as AST, ALT, NTproBNP, LDH, CRP can give an idea about the short-term prognosis of the disease.

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“…Previous studies reported conflicting findings regarding serum BNP levels in patients with pericardial effusion, with some studies reporting an increase [8,9], whereas others reported a decrease [10,11]. The differences in BNP levels were probably due to different pericardial effusion etiologies.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that BNP levels in pericardial fluid accumulation were elevated [8,9]. In contrast, other studies have documented that in large pericardial effusion [10] or cardiac tamponade [11], plasma BNP levels were relatively suppressed, while after pericardiocentesis, plasma BNP levels increased markedly. These observations were suggested to reflect the physically compressed and decompressed cardiac chambers respectively.…”

Section: Introductionmentioning

confidence: 99%

Serum BNP levels are associated with malignant pericardial effusion

Carasso

Grosman‐Rimon

Nassar

et al. 2019

IJC Heart & Vasculature

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Introduction The development of malignant pericardial effusion indicates a poor prognosis and is the leading cause of cardiac tamponade. The objectives of the study were to examine the levels of BNP in traumatic, malignant and non-malignant pericardial effusion etiologies, and to assess the value of serum and pericardial fluid BNP levels in the prognosis of malignant pericardial effusion. Methods A of 56 patients with clinical and echocardiographic diagnosis of pre-tamponade or tamponade who required pericardiocentesis were included in the study. BNP levels were assessed in the serum and within the pericardial fluid. The diagnostic value of BNP levels in discriminating between malignant and non- malignant etiology of pericardial effusion was examined using a receiver-operating characteristic (ROC). Results Pericardial fluid BNP levels were similar across all etiology groups. In patients with malignant etiology, the amount of pericardial fluid was high and their serum BNP levels were relatively low. BNP levels were strong predictors of malignant pericardial effusion, and the cut-off point of BNP ≤ 250 pg/ml demonstrated the highest sensitivity (90.0%) for malignant etiology. Conclusions Low serum BNP levels were significantly associated with malignancy in patients undergoing pericardiocentesis for pericardial effusions. Serum BNP levels <250 pg/ml may trigger more extensive diagnostic testing for malignant pericardial effusion in patients with small pericardial effusion who are not considered for pericardiocentesis due to small effusion, in whom the etiology is unclear.

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Cardiac tamponade as an independent condition affecting the relationship between the plasma B-type natriuretic peptide levels and cardiac function

Cited by 12 publications

References 15 publications

Cardiac tamponade leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg−Strauss syndrome): a case report and review of the literature

Cardiac tamponade leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg−Strauss syndrome): a case report and review of the literature

Cancer prevalence, inpatient mortality and its predictors after pericardiocentesis

Serum BNP levels are associated with malignant pericardial effusion

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