Morales-Rull JL, et al. - The intent of the experts was to contemplate the prevalence, clinical characteristics and prognostic implications of pleural effusions (PEs) in acute decompensated heart failure (ADHF). The presence of PEs was revealed on chest radiographs in approximately half of ADHF subjects. These PEs were primarily determined to be bilateral or right-sided. The effusions predominated in males with elevated systolic pulmonary artery pressure (sPAP) on echocardiography and high serum levels of the amino-terminal fraction of the pro-brain natriuretic peptide (NT-pro-BNP) and did not independently speculate the 1-year mortality.

Methods

• The scheme of this research was a retrospective review study.
• A total of 3,245 consecutive patients with ADHF were selected from the Spanish RICA Registry.
• A comparative analysis was performed of the clinical characteristics of those with or without PEs on chest radiographs and a predictive PE model was generated.

Results

• It was determined that the patient's median age was 80 years and 60% had a left ventricular ejection fraction (LVEF) >50%.
• As per the outcomes, PEs were revealed in 46% of the cases, and their distribution was as follows: 58% bilateral, 27% right-sided and 14% left-sided.
• In a multivariate analysis, a correlation was disclosed between male gender (OR 2.18; 95%CI 1.23-3.87), serum amino-terminal fraction of the pro-brain natriuretic peptide (NT-pro-BNP) levels >3500 pg/ml (OR 2.2; 95%CI 1.25-3.77), estimated systolic pulmonary artery pressure (sPAP) >55 mm Hg by echocardiography (OR 2.05; 95%CI 1.12-3.75), and serum prealbumin <15 mg/l (OR 1.96; 95%CI 1.08-3.52) with PE development.
• It was illustrated that serum NT-proBNP >8000 pg/ml, and systolic arterial pressure <110 mm Hg, but not PEs, independently speculated the overall 1-year mortality.