Effective echocardiographic parameters for predicting cardiac tamponade in patients with large amount of pericardial effusion

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Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiac tamponade is life-threatening medical condition that needs rapid diagnosis and pericardiocentesis. For diagnosing cardiac tamponade, comprehensive and complex doppler echocardiographic evaluation is necessary. The aim of this study was to evaluate the echocardiographic parameters for differentiating cardiac tamponade in patients with large amount of pericardial effusion. Methods From March 2003 to January 2020, 392 patients with large amount of PE with TTE evaluation were enrolled. We divided the patients into two groups; group A: patients performed subsequent drainage (n=197), group B: patients who are not performed drainage (n=195). Quantitative echocardiographic parameters were compared between two groups and analyzed which parameters were related with cardiac tamponade. Results The patients in group A showed low left ventricular end-diastolic diameter/body surface area (LVEDD/BSA) (25.44 ± 7.75 vs. 28.86 ± 6.10 mm/m2, p<0.001), left atrium volume index (LAVI) (24.08 ± 13.53 vs. 42.69 ± 28.69 ml/m2, p<0.001), early diastolic mitral inflow velocity (E velocity) (0.63 ± 0.18 vs. 0.88 ± 0.31 m/s, p<0.001), right ventricular systolic pressure (RVSP) (31.23 ± 9.47 vs. 39.16 ± 16.49 mmHg, p<0.001), early diastolic mitral inflow velocity/early diastolic mitral annular tissue velocity (E/e’) (11.62 ± 5.07 vs. 16.56 ± 7.75, p<0.001) compared with group B. In the multivariable analysis, E velocity was the most statistically significant parameter (Odds ratio=0.034, 95% CI=0.003–0.470, p = 0.012) and LAVI was the second one (Odds ratio=0.952, 95% CI=0.913–0.993, p = 0.022) related with cardiac tamponade. The ROC curve showed the cutoff value of E velocity was 0.678 m/s (sensitivity=0.675, specificity=0.673) and that of LAVI was 26.62 ml/m2 (sensitivity=0.681, specificity=0.679) for no need of pericardial drainage. Conclusion In patients with large amount of PE, E velocity and LAVI can be simple and useful echocardiographic parameters to differentiate the patients with cardiac tamponade who need pericardial drainage.

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