Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Lung Cancer | Research

Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China

Authors: Shucai Wang, Jiazheng Zhao, Chanchan Wang, Ning Zhang

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients' clinical manifestations, imaging often performs an essential role in diagnosis and prognosis.

Methods

Patients diagnosed with MPE between 2013 and 2018 at one tumor hospital were included and followed up. The data covered the basic clinical features, imaging findings, treatments and prognosis of patients with MPE, and the factors that may have affected the prognosis were explored.

Results

A total of 216 patients with MPE were included with the median age of 60 years. The most common primary cancer type was lung cancer (73.6%), the most common symptom was dyspnea (62.9%) and the most common abnormal electrocardiogram finding was sinus tachycardia (42.1%). The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR = 2.37, P = 0.010), electrocardiographic evidence of sinus tachycardia (HR = 1.76, P = 0.006) and echocardiographic evidence of cardiac tamponade (HR = 3.33, P < 0.001).

Conclusions

MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.
Literature
1.
go back to reference Ceriani E, Cogliati C. Update on bedside ultrasound diagnosis of pericardial effusion. Intern Emerg Med. 2016;11(3):477–80.CrossRef Ceriani E, Cogliati C. Update on bedside ultrasound diagnosis of pericardial effusion. Intern Emerg Med. 2016;11(3):477–80.CrossRef
2.
go back to reference Chahine J, Shekhar S, Mahalwar G, Imazio M, Collier P, Klein A. Pericardial involvement in cancer. Am J Cardiol. 2021;145:151–9.CrossRef Chahine J, Shekhar S, Mahalwar G, Imazio M, Collier P, Klein A. Pericardial involvement in cancer. Am J Cardiol. 2021;145:151–9.CrossRef
3.
go back to reference Carasso S, Grosman-Rimon L, Nassar A, Kusniec F, Ghanim D, Elbaz-Greener G, et al. Serum BNP levels are associated with malignant pericardial effusion. Int J Cardiol Heart Vasc. 2019;23:100359. Carasso S, Grosman-Rimon L, Nassar A, Kusniec F, Ghanim D, Elbaz-Greener G, et al. Serum BNP levels are associated with malignant pericardial effusion. Int J Cardiol Heart Vasc. 2019;23:100359.
4.
go back to reference Han P, Yao R, Zhai D, Cheng C, Yang F, Sun S, et al. A case report of lung adenocarcinoma with polyserous effusions as the onset symptom. Medicine (Baltimore). 2017; 96(36):e7867. Han P, Yao R, Zhai D, Cheng C, Yang F, Sun S, et al. A case report of lung adenocarcinoma with polyserous effusions as the onset symptom. Medicine (Baltimore). 2017; 96(36):e7867.
5.
go back to reference Hancock EW. Neoplastic pericardial disease. Cardiol Clin. 1990;8(4):673–82.CrossRef Hancock EW. Neoplastic pericardial disease. Cardiol Clin. 1990;8(4):673–82.CrossRef
6.
go back to reference Burazor I, Imazio M, Markel G, Adler Y. Malignant pericardial effusion. Cardiology. 2013;124(4):224–32.CrossRef Burazor I, Imazio M, Markel G, Adler Y. Malignant pericardial effusion. Cardiology. 2013;124(4):224–32.CrossRef
7.
go back to reference Higdon ML, Atkinson CJ, Lawrence KV. Oncologic emergencies: recognition and initial management. Am Fam Phys. 2018;97(11):741–8. Higdon ML, Atkinson CJ, Lawrence KV. Oncologic emergencies: recognition and initial management. Am Fam Phys. 2018;97(11):741–8.
8.
go back to reference Taguchi S. Comprehensive review of the epidemiology and treatments for malignant adult cardiac tumors. Gen Thorac Cardiovasc Surg. 2018;66(5):257–62.CrossRef Taguchi S. Comprehensive review of the epidemiology and treatments for malignant adult cardiac tumors. Gen Thorac Cardiovasc Surg. 2018;66(5):257–62.CrossRef
9.
go back to reference McCurdy MT, Shanholtz CB. Oncologic emergencies. Crit Care Med. 2012;40(7):2212–22.CrossRef McCurdy MT, Shanholtz CB. Oncologic emergencies. Crit Care Med. 2012;40(7):2212–22.CrossRef
10.
go back to reference Refaat MM, Katz WE. Neoplastic pericardial effusion. Clin Cardiol. 2011;34(10):593–8.CrossRef Refaat MM, Katz WE. Neoplastic pericardial effusion. Clin Cardiol. 2011;34(10):593–8.CrossRef
11.
go back to reference Verlaan D, Veltman JD, Grady B. Total electrical alternans in a patient with malignant pericardial tamponade. BMJ Case Rep. 2018;2018. Verlaan D, Veltman JD, Grady B. Total electrical alternans in a patient with malignant pericardial tamponade. BMJ Case Rep. 2018;2018.
12.
go back to reference Goyal M, Woods KM, Atwood JE. Electrical alternans: a sign, not a diagnosis. South Med J. 2013;106(8):485–9.CrossRef Goyal M, Woods KM, Atwood JE. Electrical alternans: a sign, not a diagnosis. South Med J. 2013;106(8):485–9.CrossRef
13.
go back to reference Argula RG, Negi SI, Banchs J, Yusuf SW. Role of a 12-lead electrocardiogram in the diagnosis of cardiac tamponade as diagnosed by transthoracic echocardiography in patients with malignant pericardial effusion. Clin Cardiol. 2015;38(3):139–44.CrossRef Argula RG, Negi SI, Banchs J, Yusuf SW. Role of a 12-lead electrocardiogram in the diagnosis of cardiac tamponade as diagnosed by transthoracic echocardiography in patients with malignant pericardial effusion. Clin Cardiol. 2015;38(3):139–44.CrossRef
14.
go back to reference Khalid N, Chhabra L, Spodick DH. Response to role of a 12-lead electrocardiogram in the diagnosis of cardiac tamponade as diagnosed by transthoracic echocardiography in patients with malignant pericardial effusion. Clin Cardiol. 2015;38(7):445–6.CrossRef Khalid N, Chhabra L, Spodick DH. Response to role of a 12-lead electrocardiogram in the diagnosis of cardiac tamponade as diagnosed by transthoracic echocardiography in patients with malignant pericardial effusion. Clin Cardiol. 2015;38(7):445–6.CrossRef
15.
go back to reference Chalikias G, Samaras A, Ziakas A, Kikas P, Thomaidis A, Drosos I, et al. Novel echocardiographic prognostic markers for cardiac tamponade in patients with large malignant pericardial effusions: a paradigm shift from flow to tissue imaging. Echocardiography. 2017;34(9):1315–23.CrossRef Chalikias G, Samaras A, Ziakas A, Kikas P, Thomaidis A, Drosos I, et al. Novel echocardiographic prognostic markers for cardiac tamponade in patients with large malignant pericardial effusions: a paradigm shift from flow to tissue imaging. Echocardiography. 2017;34(9):1315–23.CrossRef
16.
go back to reference Kim YK, Kim JS, Lee KW, Yi CA, Goo JM, Jung SH. Multidetector CT findings and differential diagnoses of malignant pleural mesothelioma and metastatic pleural diseases in Korea. Korean J Radiol. 2016;17(4):545–53.CrossRef Kim YK, Kim JS, Lee KW, Yi CA, Goo JM, Jung SH. Multidetector CT findings and differential diagnoses of malignant pleural mesothelioma and metastatic pleural diseases in Korea. Korean J Radiol. 2016;17(4):545–53.CrossRef
17.
go back to reference Kligerman S. Imaging of pericardial disease. Radiol Clin North Am. 2019;57(1):179–99.CrossRef Kligerman S. Imaging of pericardial disease. Radiol Clin North Am. 2019;57(1):179–99.CrossRef
18.
go back to reference Lestuzzi C, Berretta M, Tomkowski W. 2015 update on the diagnosis and management of neoplastic pericardial disease. Exp Rev Cardiovasc Ther. 2015;13(4):377–89.CrossRef Lestuzzi C, Berretta M, Tomkowski W. 2015 update on the diagnosis and management of neoplastic pericardial disease. Exp Rev Cardiovasc Ther. 2015;13(4):377–89.CrossRef
19.
go back to reference Cai Z, Yao Y. Reduction of pericardial effusion in advanced non-small cell lung cancer patients with KRAS, TP53, and MET mutation treated with nivolumab. J Int Med Res. 2020;48(8):300060520937490.CrossRef Cai Z, Yao Y. Reduction of pericardial effusion in advanced non-small cell lung cancer patients with KRAS, TP53, and MET mutation treated with nivolumab. J Int Med Res. 2020;48(8):300060520937490.CrossRef
Metadata
Title
Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China
Authors
Shucai Wang
Jiazheng Zhao
Chanchan Wang
Ning Zhang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02331-9

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue