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Carasso S, Grosman-Rimon L, Nassar A, Kusniec F, Ghanim D, Elbaz-Greener G, Kinany W, Sudarsky D, Hazanov E, Amir O. Serum BNP levels are associated with malignant pericardial effusion. IJC HEART & VASCULATURE 2019; 23:100359. [PMID: 31008182 PMCID: PMC6458500 DOI: 10.1016/j.ijcha.2019.100359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/24/2019] [Accepted: 03/27/2019] [Indexed: 11/30/2022]
Abstract
Introduction The development of malignant pericardial effusion indicates a poor prognosis and is the leading cause of cardiac tamponade. The objectives of the study were to examine the levels of BNP in traumatic, malignant and non-malignant pericardial effusion etiologies, and to assess the value of serum and pericardial fluid BNP levels in the prognosis of malignant pericardial effusion. Methods A of 56 patients with clinical and echocardiographic diagnosis of pre-tamponade or tamponade who required pericardiocentesis were included in the study. BNP levels were assessed in the serum and within the pericardial fluid. The diagnostic value of BNP levels in discriminating between malignant and non- malignant etiology of pericardial effusion was examined using a receiver-operating characteristic (ROC). Results Pericardial fluid BNP levels were similar across all etiology groups. In patients with malignant etiology, the amount of pericardial fluid was high and their serum BNP levels were relatively low. BNP levels were strong predictors of malignant pericardial effusion, and the cut-off point of BNP ≤ 250 pg/ml demonstrated the highest sensitivity (90.0%) for malignant etiology. Conclusions Low serum BNP levels were significantly associated with malignancy in patients undergoing pericardiocentesis for pericardial effusions. Serum BNP levels <250 pg/ml may trigger more extensive diagnostic testing for malignant pericardial effusion in patients with small pericardial effusion who are not considered for pericardiocentesis due to small effusion, in whom the etiology is unclear.
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Affiliation(s)
- Shemy Carasso
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Liza Grosman-Rimon
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Ali Nassar
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
| | - Fabio Kusniec
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Diab Ghanim
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Gabby Elbaz-Greener
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Wadi Kinany
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Doron Sudarsky
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
| | - Evgeni Hazanov
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
| | - Offer Amir
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
- Corresponding author at: Cardiovascular Institute, Baruch Padeh Medical Center, Poriya, Tiberias, Israel & The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel.
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Santas E, Sandino J, Chorro FJ, Méndez J, Miñana G, Núñez E, Sanchis J, Núñez J. Prognostic implications of pericardial effusion in acute heart failure: Does size matter? Int J Cardiol 2015; 184:259-261. [PMID: 25726903 DOI: 10.1016/j.ijcard.2015.02.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/21/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Enrique Santas
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Justo Sandino
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Francisco J Chorro
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - José Méndez
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Gema Miñana
- Servicio de Cardiología, Hospital de Manises, Valencia, Spain
| | - Eduardo Núñez
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Juan Sanchis
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Julio Núñez
- Servicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain.
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