Prevalence and prognosis of pericardial effusion in patients affected by pectus excavatum: A case-control study

• Published in: International journal of cardiology Vol. 344; pp. 179 - 183
• Main Authors: Conte, Edoardo, Agalbato, Cecilia, Lauri, Gianfranco, Mushtaq, Saima, Carollo, Chiara, Bonomi, Alice, Zanotto, Lorenza, Melotti, Eleonora, Dalla Cia, Alessia, Guglielmo, Marco, Baggiano, Andrea, Annoni, Andrea, Formenti, Alberto, Mancini, Elisabetta, D'Angelo, Antonio Maria, Rota, Alessandra, Assanelli, Emilio, Sforza, Chiarella, Pontone, Gianluca, Pepi, Mauro, Andreini, Daniele, Brucato, Antonio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2021
• Subjects: Cardiac Tamponade; Case-Control Studies; Female; Funnel Chest - diagnostic imaging; Funnel Chest - epidemiology; Humans; Male; Pectus excavatum; Pericardial effusion; Pericardial Effusion - diagnostic imaging; Pericardial Effusion - epidemiology; Pericardial Effusion - surgery; Pericardiocentesis; Prevalence; Prognosis; Retrospective Studies; Pectus excavatum; Prognosis; Pericardial effusion
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2021.10.005

The presence of pectus excavatum(PEX) has been occasionally associated with pericardial effusion. Aim of the present study was to compare incidence and prognosis of pericardial effusion in a group of unselected patients with PEX vs a control group. From a prospective registry of consecutive patients who underwent chest CT for cardiovascular disease, subjects with a radiological diagnosis of PEX were retrospectively identified (cases); from the same registry patients (controls) without rib cage abnormalities were randomly selected, until a 1:2 ratio was reached. The presence of pericardial effusion at CT was quantified. Follow-up was obtained for a composite end-point: cardiac tamponade, need for pericardiocentesis, need for cardiac surgery for relapsing pericardial effusion. A total of 43 patients with PEX (20 females) and a control group of 86 cases (31 females) without rib cage abnormalities were identified. Pericardial effusion evaluated at CT was significatively more prevalent in patients with PEX vs control group, 37.2% vs 13.9% (p < 0.001), respectively; four patients with PEX (9.3%) had at least moderate pericardial effusion vs no subjects among the controls (p = 0.004). PEX diagnosis was significantly associated to pericardial effusion at multi-variate analysis (OR95%CI 10.91[3.47–34.29], p < 0.001). At a mean follow-up of 6.5 ± 3.4 years no pericardial events were recorded. Our findings support the higher prevalence of pericardial effusion in patients with PEX when compared to a control group. The absence of adverse pericardial events at follow-up suggest the good prognosis of these effusions, that in the appropriate clinical setting might not be considered “idiopathic”. •Pericardial effusion resulted more prevalent among patients with PEX vs controls.•9.3% of PEX patients had moderate/severe pericardial effusion vs 0% of controls.•No pericardial events were recorded in patients with PEX and pericardial effusion.