Respiratory effects on systolic time intervals during pericardial effusion

Area of Science:

• Cardiology
• Diagnostic Imaging
• Physiology

Background:

• Pericardial effusion without cardiac tamponade involves excess pericardial fluid but lacks typical signs like pulsus paradoxus.
• Distinguishing effusion from dry pericarditis is crucial for patient management.

Purpose of the Study:

• To investigate the physiological impact of pericardial effusion without cardiac tamponade.
• To determine if echocardiographic findings can indicate effusion in the absence of pulsus paradoxus.

Main Methods:

• Echocardiography was used to assess 19 patients with pericardial findings but no tamponade.
• Systolic time intervals, including left ventricular ejection time (LVET) and preejection period (PEP), were measured.
• Patients were categorized into those with effusion and those with dry pericarditis.

Main Results:

• Patients with pericardial effusion showed significant changes in delta LVET (17.9 ms) and delta PEP (12.1 ms) compared to controls.
• These changes were present even in patients without respiratory variation in systolic pressure.
• Dry pericarditis patients had minimal changes in delta LVET (8.0 ms) and delta PEP (7.0 ms).

Conclusions:

• Excess pericardial fluid is physiologically active, even without causing cardiac tamponade.
• Exaggerated respiratory fluctuations in systolic time intervals can suggest pericardial effusion when echocardiograms are inconclusive.