1Universitätsklinikum Würzburg Medizinische Klinik I, Kardiologie Würzburg, Deutschland; 2Universitätsklinikum Würzburg Deutsches Zentrum für Herzinsuffizienz Würzburg, Deutschland; 3Universitätsklinikum Würzburg Medizinische Klinik und Poliklinik I Würzburg, Deutschland; 4Universitätsklinikum Würzburg Institut für Klinische Epidemiologie und Biometrie Würzburg, Deutschland
Background and aim. The incidental finding of pericardial effusion (PE) present a challenge, given its potential association with conditions like malignancy or inflammation as well as its occurrence as an innocent and transient phenomenon in healthy individuals. Data about prevalence and determinants of PE in the general population are scarce and recommendations regarding further diagnostic work-up of an incidentally identified PE are based on expert opinion. To increase evidence, this study aimed to determine the prevalence and determinants of PE in a population-based cohort.
Methods and results. The STAAB cohort study recruited a representative sample of the population of Würzburg, aged 30-79 years, and free from known heart failure. Participants underwent quality-controlled transthoracic echocardiography including a dedicated evaluation regarding the presence or absence of PE. Out of n=4965 individuals (55 ± 12 years, 52% women) who were included in the study, n=134 (2.7%; 54 ± 11 years, 66% women) exhibited PE with a median diameter of 2.7 mm (quartiles 2.0, 4.1 mm). In a multivariate logistic regression analysis, Body Mass Index (BMI) (inverse association) and NT-proBNP (positive association) independently determined the presence of PE, while inflammation, malignancy, and rheumatoid disease were unrelated to PE.
Conclusion: In our population-based sample, PE was detected in 2.7% of individuals. The presence of PE did not exhibit any significant association with inflammation or malignancy, while BMI emerged as the strongest determinant of PE. However, individuals with PE had higher levels of NT-proBNP, suggesting potential myocardial involvement. The reasons why women with lower BMI were more susceptible to PE warrant further research.Table 1. Baseline characteristics of STAAB participants with and without pericardial effusion (PE)
|
|
Participants |
Participants |
P -value |
|
Age, years |
54 (11) |
55 (12) |
ns |
|
Female sex, n (%) |
88 (66) |
2516 (52) |
0.002 |
|
Body mass index, kg/m2 |
24 (4) |
27 (5) |
<0.001 |
|
hs-CRP, mg/L |
0.8 (0.5, 2.2) |
1.2 (0.6, 2.6) |
ns |
|
hs-troponin I, pg/ml |
2.2 (1.5, 3.6) |
2.3 (1.5, 3.8) |
ns |
|
NT-proBNP, pg/ml |
80 (48, 119) |
66 (36, 115) |
0.030 |
|
Rheumatoid disease, n (%) |
3 (2) |
178 (4) |
ns |
|
Malignancy, n (%) |
9 (7) |
436 (9) |
Ns |
hs = high-sensitive
Table 2. Determinants of Pericardial Effusion in general population (logistic regression)
|
|
Univariate regression |
Multivariate regression | ||
|
Variable |
Regression Coefficient |
P value |
Regression Coefficient |
P value |
|
Age, years |
–0.003 |
0.682 |
|
|
|
Female sex |
0.565 |
0.002 |
0.188 |
0.348 |
|
Body mass index, kg/m2 |
-0.140 |
<0.001 |
-0.120 |
<0.001 |
|
hs CRP, mg/L, |
-0.008 |
0.714 |
|
|
|
ln-NT-proBNP, pg/ml |
0.225 |
0.015 |
0.237 |
0.024 |
|
hs Troponin I, pg/ml |
-0.016 |
0.430 |
|
|
|
Malignancy |
-0:322 |
0:356 |
|
|
|
Rheumatoid Disease |
-0:512 |
0:385 |
|
|
hs = high-sensitive; ln = natural log