Oncotarget

Research Papers:

Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension

Shao-Liang Chen, Hang Zhang, Du-Jiang Xie, Juan Zhang, Ling Zhou, Meng-Xuan Chen and Gregg W. Stone _

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Oncotarget. 2017; 8:54106-54114. https://doi.org/10.18632/oncotarget.14031

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Abstract

Shao-Liang Chen1, Hang Zhang1, Du-Jiang Xie2, Juan Zhang1, Ling Zhou2, Meng-Xuan Chen3 and Gregg W. Stone4

1Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China

2Division of Cardiology, Nanjing Heart Center, Nanjing, China

3Emory College of Arts and Science, Atlanta, GA, USA

4Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA

Correspondence to:

Shao-Liang Chen, email: chmengx@126.com

Gregg W. Stone, email: gstone@crf.org

Keywords: pulmonary arterial hypertension, pericardial effusion, pulmonary artery denervation, clinical worse event, rehospitalization

Received: October 04, 2016     Accepted: November 23, 2016     Published: December 20, 2016

ABSTRACT

Objectives: Pericardial effusion (PE) is correlated with outcomes in patients with pulmonary arterial hypertension (PAH). Pulmonary artery denervation (PADN) was used for treatment of PAH. The present study aimed to analyze the prognostic value of PE for outcomes after PADN in patients with WHO Group I, Group II and Group IV PAH.

Results: PE, frequently seen in patients with connective tissue disease, was featured by fast heart rate, decreased exercise capacity, more syncope, worsening pulmonary arterial hemodynamic and right atrium size. PADN procedure resulted in dramatic reduction of PE. After a median of 376 days follow-up, the rate of PAH-related event, all-cause death and rehospitalization increased over the PE amount and occurred in 29.8%, 19.7% and 25.2% of patients with PE, different to 3.4%, 3.4% and 6.8% of patients without PE (p = 0.034, p = 0.041 and p = 0.039, respectively). The reduction of PE during follow-up was similar among three groups.

Materials and methods: Between March 2012 and July 2014, a total of 66 consecutive patients (52 ± 16 years) who underwent PADN were stratified by no PE (n = 20), PE < 10 mm (n = 29) and PE ≥ 10 mm (n = 17) according to baseline echocardiograph. Dynamic change of PE and its correlation with PAH-related event after PADN were measured.

Conclusions: PE is associated with increased PAH-related event after PADN. PADN results in significant similar reduction of PE among patients with Group I, Group II and Group IV PAH.


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