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Pleural effusions in acute decompensated heart failure: Prevalence and prognostic implications
José Luis Morales-Rull1, Silvia Bielsa2, Alicia Conde-Martel3
1Heart Failure Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLLEIDA, Lleida, Spain.
European Journal of Internal Medicine
|February 12, 2018
Summary
Pleural effusions (PEs) are common in acute decompensated heart failure (ADHF), affecting nearly half of patients. While associated with specific clinical factors, PEs do not independently predict mortality.
Area of Science:
- Cardiology
- Pulmonology
- Internal Medicine
Background:
- Pleural effusions (PEs) are common in acute decompensated heart failure (ADHF).
- The prevalence, characteristics, and prognostic impact of PEs in ADHF are not well-established.
- This study investigates these aspects in a large ADHF cohort.
Purpose of the Study:
- To determine the prevalence of PEs in patients with ADHF.
- To identify clinical characteristics associated with PEs in ADHF.
- To assess the prognostic implications of PEs in ADHF patients.
Main Methods:
- Retrospective review of 3245 consecutive ADHF patients from the Spanish RICA Registry.
- Comparison of clinical characteristics between patients with and without PEs on chest radiographs.
- Development of a predictive model for PE development.
Main Results:
- PEs were present in 46% of ADHF patients, predominantly bilateral (58%) or right-sided (27%).
- Factors associated with PEs included male gender, elevated NT-pro-BNP (>3500 pg/ml), high sPAP (>55 mmHg), and low prealbumin (<15 mg/l).
- Elevated NT-pro-BNP (>8000 pg/ml) and low systolic arterial pressure (<110 mmHg) independently predicted 1-year mortality, but PEs did not.
Conclusions:
- Nearly half of ADHF patients exhibit PEs on chest radiographs.
- PEs are associated with male gender, elevated sPAP, and high NT-pro-BNP levels.
- PEs are not independent predictors of 1-year mortality in ADHF.
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