Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Characteristics and Clinical Outcomes of Cancer Patients who Developed Constrictive Physiology After Pericardiocentesis

  • Hyukjin Park (Department of Cardiology, Chonnam National University Hwasun Hospital) ;
  • Hyun Ju Yoon (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Nuri Lee (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Jong Yoon Kim (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Hyung Yoon Kim (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Jae Yeong Cho (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Kye Hun Kim (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Youngkeun Ahn (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Myung Ho Jeong (Department of Cardiology, Chonnam National University School/Hospital) ;
  • Jeong Gwan Cho (Department of Cardiology, Chonnam National University School/Hospital)
  • Received : 2021.06.21
  • Accepted : 2021.10.06
  • Published : 2022.01.01
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Abstract

Background and objectives: This study aimed to identify the characteristics and clinical outcomes of cancer patients who developed constrictive physiology (CP) after percutaneous pericardiocentesis. Methods: One-hundred thirty-three cancer patients who underwent pericardiocentesis were divided into 2 groups according to follow-up echocardiography (CP vs. non-CP). The clinical history, imaging findings, and laboratory results, and overall survival were compared. Results: CP developed in 49 (36.8%) patients after pericardiocentesis. The CP group had a more frequent history of radiation therapy. Pericardial enhancement and malignant masses abutting the pericardium were more frequently observed in the CP group. Fever and ST segment elevation were more frequent in the CP group, with higher C-reactive protein levels (6.6±4.3mg/dL vs. 3.3±2.5mg/dL, p<0.001). Pericardial fluid leukocytes counts were significantly higher, and positive cytology was more frequent in the CP group. In baseline echocardiography before pericardiocentesis, medial e' velocity was significantly higher in the CP group (8.6±2.1cm/s vs. 6.5±2.3cm/s, p<0.001), and respirophasic ventricular septal shift, prominent expiratory hepatic venous flow reversal, pericardial adhesion, and loculated pericardial fluid were also more frequent. The risk of all-cause death was significantly high in the CP group (hazard ratio, 1.53; 95% confidence interval,1.10-2.13; p=0.005). Conclusions: CP frequently develops after pericardiocentesis, and it is associated with poor survival in cancer patients. Several clinical signs, imaging, and laboratory findings suggestive of pericardial inflammation and/or direct malignant pericardial invasion are frequently observed and could be used as predictors of CP development.

Keywords

Acknowledgement

This study was supported by a grant (HCRI20050) Chonnam National University Hwasun Hospital Biomedical Research Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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