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Pericardial effusion and heart failure
International Journal of Cardiology 192 (2015) 21
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Pericardial effusion and heart failure Uğur Aksu a,⁎, Kamuran Kalkan b a b
Atatürk University, Faculty of Medicine, Department of Cardiology, Erzurum, Turkey Malkara State Hospital, Department of Cardiology, Tekirdağ, Turkey
a r t i c l e
i n f o
Article history: Received 4 May 2015 Accepted 6 May 2015 Available online 8 May 2015 Keywords: Pericardial effusion Heart failure
Dear Editor, We read the article ‘Prognostic implications of pericardial effusion in acute heart failure: Does size matter?’ by Santas et al. with interest [1]. Their study showed that a non-hemodynamically relevant but significant PE, at least moderate in size, was strongly associated with 1-year mortality. Pericardial effusion can present to the clinics in a variety of ways within a spectrum ranging from an asymptomatic presentation to a cardiac tamponade. It can co-exist with other diseases as well as it can exist isolated. The treatment of this condition involves anti-inflammatory treatments and in emergency clinical situations pericardiocentesis can be a life saving intervention [2–4]. In this context, inclusion of patients with isolated heart failure alone in the study of Santas et al. can be a factor to increase the probability of faulty results. This is because of the fact that those patients with acute myocardial infarction, acute pericarditis–myocarditis and those with a systemic disease or active cancer are excluded in this study. Yet
⁎ Corresponding author at: Atatürk University, Faculty of Medicine, Department of Cardiology, Yakutiye Training and Research Hospital, Erzurum, Turkey. E-mail address: [email protected] (U. Aksu).
http://dx.doi.org/10.1016/j.ijcard.2015.05.022 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
according to the real life data these conditions represent the majority of patients with heart failure and considering that myocardial infarction is one of the most common causes of heart failure [1,4,5]. This limitation of the study can appear as a factor to interfere with the evaluation and interpretation of the current study. Again, heart failure can be seen together with systemic diseases and myocarditis [3]. This represents another limitation of this study. It can be useful if the authors could provide data and comment on these issues. In conclusion pericardial effusion can develop based on a variety of diseases within a large spectrum [5,6]. But the association between the extend and duration of the effusion and the mortality and also the treatment modalities are still controversial [2,5,6].
Conflict of interest There is no conflict of interests.
References [1] E. Santas, J. Sandino, F.J. Chorro, J. Mendez, G. Minana, E. Nunez, J. Sanchis, J. Nunez, Prognostic implications of pericardial effusion in acute heart failure: does size matter? Int. J. Cardiol. 184C (2015) 259–261. [2] M. Imazio, Y. Adler, Management of pericardial effusion, Eur. Heart J. 34 (16) (2013) 1186–1197. [3] M. Imazio, B.M. Mayosi, A. Brucato, Y. Adler, Pericardial effusion triage, Int. J. Cardiol. 145 (2) (2010) 403–404. [4] C. Lestuzzi, M. Berretta, W. Tomkowski, 2015 update on the diagnosis and management of neoplastic pericardial disease, Expert. Rev. Cardiovasc. Ther. 13 (4) (2015) 377–389. [5] J. Sagrista-Sauleda, A.S. Merce, J. Soler-Soler, Diagnosis and management of pericardial effusion, World J. Cardiol. 3 (5) (2011) 135–143. [6] M. Imazio, Y. Adler, Pharmacological therapy of pericardial diseases, Curr. Pharm. Des. 21 (4) (2015) 525–530.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Pericardial effusion and heart failure Uğur Aksu a,⁎, Kamuran Kalkan b a b
Atatürk University, Faculty of Medicine, Department of Cardiology, Erzurum, Turkey Malkara State Hospital, Department of Cardiology, Tekirdağ, Turkey
a r t i c l e
i n f o
Article history: Received 4 May 2015 Accepted 6 May 2015 Available online 8 May 2015 Keywords: Pericardial effusion Heart failure
Dear Editor, We read the article ‘Prognostic implications of pericardial effusion in acute heart failure: Does size matter?’ by Santas et al. with interest [1]. Their study showed that a non-hemodynamically relevant but significant PE, at least moderate in size, was strongly associated with 1-year mortality. Pericardial effusion can present to the clinics in a variety of ways within a spectrum ranging from an asymptomatic presentation to a cardiac tamponade. It can co-exist with other diseases as well as it can exist isolated. The treatment of this condition involves anti-inflammatory treatments and in emergency clinical situations pericardiocentesis can be a life saving intervention [2–4]. In this context, inclusion of patients with isolated heart failure alone in the study of Santas et al. can be a factor to increase the probability of faulty results. This is because of the fact that those patients with acute myocardial infarction, acute pericarditis–myocarditis and those with a systemic disease or active cancer are excluded in this study. Yet
⁎ Corresponding author at: Atatürk University, Faculty of Medicine, Department of Cardiology, Yakutiye Training and Research Hospital, Erzurum, Turkey. E-mail address: [email protected] (U. Aksu).
http://dx.doi.org/10.1016/j.ijcard.2015.05.022 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
according to the real life data these conditions represent the majority of patients with heart failure and considering that myocardial infarction is one of the most common causes of heart failure [1,4,5]. This limitation of the study can appear as a factor to interfere with the evaluation and interpretation of the current study. Again, heart failure can be seen together with systemic diseases and myocarditis [3]. This represents another limitation of this study. It can be useful if the authors could provide data and comment on these issues. In conclusion pericardial effusion can develop based on a variety of diseases within a large spectrum [5,6]. But the association between the extend and duration of the effusion and the mortality and also the treatment modalities are still controversial [2,5,6].
Conflict of interest There is no conflict of interests.
References [1] E. Santas, J. Sandino, F.J. Chorro, J. Mendez, G. Minana, E. Nunez, J. Sanchis, J. Nunez, Prognostic implications of pericardial effusion in acute heart failure: does size matter? Int. J. Cardiol. 184C (2015) 259–261. [2] M. Imazio, Y. Adler, Management of pericardial effusion, Eur. Heart J. 34 (16) (2013) 1186–1197. [3] M. Imazio, B.M. Mayosi, A. Brucato, Y. Adler, Pericardial effusion triage, Int. J. Cardiol. 145 (2) (2010) 403–404. [4] C. Lestuzzi, M. Berretta, W. Tomkowski, 2015 update on the diagnosis and management of neoplastic pericardial disease, Expert. Rev. Cardiovasc. Ther. 13 (4) (2015) 377–389. [5] J. Sagrista-Sauleda, A.S. Merce, J. Soler-Soler, Diagnosis and management of pericardial effusion, World J. Cardiol. 3 (5) (2011) 135–143. [6] M. Imazio, Y. Adler, Pharmacological therapy of pericardial diseases, Curr. Pharm. Des. 21 (4) (2015) 525–530.