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Idiopathic pericardial effusion in patients with hypertrophic cardiomyopathy

Sarinya Puwanant1,2, Veraprapas Kittipibul3,4, Nattakorn Songsirisuk3,4

  • 1Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. spuwanant@gmail.com.

The International Journal of Cardiovascular Imaging
|October 12, 2021
PubMed

Insights

Idiopathic pericardial effusion (i-PEF) is uncommon in hypertrophic cardiomyopathy (HCM) patients. Moderate-to-large i-PEF is associated with younger age, right ventricular hypertrophy, and pulmonary hypertension in HCM.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Research

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition.
  • Pericardial effusion can occur in various cardiac diseases.
  • The prevalence and characteristics of idiopathic pericardial effusion (i-PEF) in HCM are not well-defined.

Purpose of the Study:

  • To determine the prevalence of moderate-to-large i-PEF in adult patients with HCM.
  • To identify clinical and echocardiographic hemodynamic profiles associated with i-PEF in HCM.
  • To investigate the etiology of i-PEF in this patient population.

Main Methods:

  • Retrospective analysis of 292 adult patients with HCM.
  • Exclusion of patients with known causes of pericardial effusion.
  • Echocardiographic assessment of pericardial effusion size and cardiac structure/function.
  • Analysis of clinical data and, in a subset, pericardial fluid and tissue.

Main Results:

  • 11 out of 277 eligible HCM patients (4%) had moderate-to-large i-PEF.
  • Patients with i-PEF were younger and showed increased right ventricular (RV) hypertrophy and reverse septal curvature.
  • Elevated mean and systolic pulmonary pressures and right atrial pressure were observed in patients with i-PEF.
  • Pericardial fluid and tissue analysis indicated a transudative and nonspecific etiology.

Conclusions:

  • Moderate-to-large idiopathic pericardial effusion is uncommon in hypertrophic cardiomyopathy.
  • i-PEF in HCM is associated with a specific hemodynamic profile including pulmonary hypertension and RV pressure overload.
  • The underlying pathophysiology of i-PEF in HCM remains undetermined, necessitating further investigation.

Keywords:
Hypertrophic cardiomyopathyPathologyPericardial effusion

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