Novel echocardiographic prognostic markers for cardiac tamponade in patients with large malignant pericardial effusions: A paradigm shift from flow to tissue imaging

Chalikias, Georgios K.; Samaras, Antonis; Ziakas, Antonios; Kikas, Petros; Thomaidis, Adina; Drosos, Ioannis; Giannakoulas, George; Karvounis, Haralambos; Konstantinides, Stavros; Tziakas, Dimitrios

doi:10.1111/echo.13620

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…Echocardiography is the sensitive imaging technique for detecting pericardial effusion, and it perfectly shows a large number of pericardial effusion features [ 15 ]. And chest CT also has an irreplaceable advantage in the diagnosis of pericardial cavity occupation [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China

Wang

Zhao

Wang

et al. 2021

BMC Cardiovasc Disord

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Background The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients' clinical manifestations, imaging often performs an essential role in diagnosis and prognosis. Methods Patients diagnosed with MPE between 2013 and 2018 at one tumor hospital were included and followed up. The data covered the basic clinical features, imaging findings, treatments and prognosis of patients with MPE, and the factors that may have affected the prognosis were explored. Results A total of 216 patients with MPE were included with the median age of 60 years. The most common primary cancer type was lung cancer (73.6%), the most common symptom was dyspnea (62.9%) and the most common abnormal electrocardiogram finding was sinus tachycardia (42.1%). The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR = 2.37, P = 0.010), electrocardiographic evidence of sinus tachycardia (HR = 1.76, P = 0.006) and echocardiographic evidence of cardiac tamponade (HR = 3.33, P < 0.001). Conclusions MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.

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Section: Discussionmentioning

confidence: 99%

Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China

Wang

Zhao

Wang

et al. 2021

BMC Cardiovasc Disord

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“…11 Besides its utility in diagnosing PE, TAPSE has also been applied as a marker of pulmonary hypertension and, more recently, as a predictor for the development of cardiac tamponade in patients with malignant effusions. 12,13 A prior study showed that investigators trained in echocardiography could visually estimate TAPSE as normal or abnormal with good agreement. 9 However, to our knowledge, there is no prior literature examining whether emergency clinicians with a diverse level of training can accurately visually estimate TAPSE.…”

Section: Introductionmentioning

confidence: 99%

Visual Estimation of Tricuspid Annular Plane Systolic Excursion by Emergency Medicine Clinicians

Duanmu

Goldsmith

Henwood

et al. 2020

WestJEM

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Introduction: Tricuspid annular plane systolic excursion (TAPSE) is an established echocardiographic marker of right ventricular (RV) systolic function. The objective of this study was to evaluate whether emergency clinicians can visually estimate RV function using TAPSE in a set of video clips compared to a reference standard M-mode measurement. Methods: Emergency clinicians were shown a five-minute educational video on TAPSE. Participants then viewed 20 apical four-chamber point-of-care ultrasound (POCUS) echocardiography clips and recorded their estimate of TAPSE distance in centimeters (cm), as well as whether TAPSE was normal (>1.9 cm), borderline (1.5-1.9 cm), or abnormal (<1.5 cm). We calculated sensitivity, specificity, and overall accuracy of visual TAPSE categorization using M-mode measurement as the criterion standard. Participants also reported their comfort with assessing TAPSE on a five-point Likert scale before and after participation in the study. Results: Among 70 emergency clinicians, including 20 postgraduate year 1-4 residents, 22 attending physicians, and 28 physician assistants (PA), the pooled sensitivity and specificity for visual assessment of TAPSE was 88.6% (95% confidence interval, 85.4-91.7%) and 81.6% (95% CI, 78.2-84.4%), respectively. The sensitivity and specificity for the clips in which the measured TAPSE was <1.5 cm or >1.9 cm was 91.4% (95% CI, 88.4-94.3%) and 90.8% (95% CI, 87.7-93.9%), respectively. There was no significant difference in sensitivity (p = 0.27) or specificity (p = 0.55) between resident and attending physicians or between physicians and PAs (p = 0.17 and p = 0.81). Median self-reported comfort with TAPSE assessment increased from 1 (interquartile range [IQR] 1-2) to 3 (IQR 3-4) points after participation in the study. Conclusion: A wide range of emergency clinicians demonstrated fair accuracy for visual estimation of TAPSE on previously recorded POCUS echocardiography video clips. These findings should be considered hypothesis generating and warrant validation in larger, prospective studies. [

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The Management of Esophageal Cancer with Pericardial Involvement and the Vascular Reconstruction of Jejunal Interposition Grafts After Cervical Esophagectomy

Onar,

Ciloglu,

Filizcan

2024

Risk Factors and Therapy of Esophagus Cancer

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Novel echocardiographic prognostic markers for cardiac tamponade in patients with large malignant pericardial effusions: A paradigm shift from flow to tissue imaging

Cited by 5 publications

References 22 publications

Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China

Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China

Visual Estimation of Tricuspid Annular Plane Systolic Excursion by Emergency Medicine Clinicians

The Management of Esophageal Cancer with Pericardial Involvement and the Vascular Reconstruction of Jejunal Interposition Grafts After Cervical Esophagectomy

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