Pericardial Disease in the Developing World

Ntsekhe, Mpiko

doi:10.1016/j.cjca.2023.05.005

Cited by 4 publications

(2 citation statements)

References 94 publications

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“… 16 In developing countries, PE is commonly associated with tuberculosis, while viral infections and complications following surgery or medical interventions are more frequently observed in high‐income countries. 1 , 7 , 26 In most cases, PE lacks a definitive cause and is termed idiopathic (up to 50% of all cases), with small‐sized effusions generally considered benign. 1 , 6 , 7 An evidence‐based approach on how to manage these cases is lacking.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Utility of Pericardial Effusion in the General Population: Findings From the STAAB Cohort Study

Sahiti,

Cejka,

Schmidbauer

et al. 2024

JAHA

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Background The incidental finding of a pericardial effusion (PE) poses a challenge in clinical care. PE is associated with malignant conditions or severe cardiac disease but may also be observed in healthy individuals. This study explored the prevalence, determinants, course, and prognostic relevance of PE in a population‐based cohort. Methods and Results The STAAB (Characteristics and Course of Heart Failure Stages A/B and Determinants of Progression) cohort study recruited a representative sample of the population of Würzburg, aged 30 to 79 years. Participants underwent quality‐controlled transthoracic echocardiography including the dedicated evaluation of the pericardial space. Of 4965 individuals included at baseline (mean age, 55±12 years; 52% women), 134 (2.7%) exhibited an incidentally diagnosed PE (median diameter, 2.7 mm; quartiles, 2.0–4.1 mm). In multivariable logistic regression, lower body mass index and higher NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels were associated with PE at baseline, whereas inflammation, malignancy, and rheumatoid disease were not. Among the 3901 participants attending the follow‐up examination after a median time of 34 (30–41) months, PE was found in 60 individuals (1.5%; n=18 new PE, n=42 persistent PE). Within the follow‐up period, 37 participants died and 93 participants reported a newly diagnosed malignancy. The presence of PE did not predict all‐cause death or the development of new malignancy. Conclusions Incidental PE was detected in about 3% of individuals, with the vast majority measuring <10 mm and completely resolving. PE was not associated with inflammation markers, death, incident heart failure, or malignancy. Our findings corroborate the view of current guidelines that a small PE in asymptomatic individuals can be considered an innocent phenomenon and does not require extensive short‐term monitoring.

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Section: Discussionmentioning

confidence: 99%

Prognostic Utility of Pericardial Effusion in the General Population: Findings From the STAAB Cohort Study

Sahiti,

Cejka,

Schmidbauer

et al. 2024

JAHA

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“…1 The etiology of constrictive pericarditis is various including idiopathic, viral, prior cardiac surgery, history of radiotherapy, malignancy and trauma, whereas the most common cause remains to be tuberculosis, especially in developing countries. [2][3][4] The prognosis for constrictive pericarditis is poor, and in most cases conservative treatment only provides temporary relief of symptoms. 5 Pericardiectomy is a definitive treatment option, but surgical resection of pericardium carries a high risk of postoperative mortality with reported rate up to 17.6%.…”

Section: Introductionmentioning

confidence: 99%

The Important Role of Preoperative D-Dimer in Constrictive Pericarditis

Fang,

Zhong,

et al. 2024

TCRM

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Background:The impact of coagulation indicators on postoperative outcomes of patients with constrictive pericarditis undergoing pericardiectomy has been poorly investigated. This study aimed to assess the prognostic role of preoperative coagulation indicators in these patients. Methods: We retrospectively included 158 patients with constrictive pericarditis undergoing pericardiectomy. The diagnostic values of coagulation indicators for postoperative complications were evaluated by ROC curves. Patients were divided into two groups according to the cutoff value calculated by ROC curve. Postoperative outcomes were compared between the two groups. Logistic regression analysis was performed to identify risk factors of postoperative complications. Results: ROC curve showed that among different coagulation indicators, preoperative D-dimer (DD) level could effectively identify patients with postoperative complications (AUC 0.771, 95% CI 0.696-0.847, P < 0.001). Patients were divided into the low DD group and the high DD group. The comparison of postoperative outcomes suggested that high preoperative DD level was significantly associated with longer durations of vasoactive agents using (P = 0.018), intubation (P = 0.020), ICU stay (P = 0.008), chest drainage (P=0.004) and hospital stay (P = 0.002). Multivariable analysis showed that high preoperative DD level was the independent risk factor of postoperative complications (OR 6.892, 95% CI 2.604-18.235, P < 0.001). Conclusion: High preoperative DD level was significantly linked to poor postoperative outcomes and could provide an effective prediction ability for postoperative complications in patients with constrictive pericarditis.

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