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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

Improved heart hemodynamics after draining large-volume pleural effusion: a prospective cohort study

Zeitschrift:: BMC Pulmonary Medicine > Ausgabe 1/2018

Autoren:: Zheng Wang, Qi-Zhe Cai, Cheng-Jun Ban, Duo Chen, Li-Li Xu, Xiao-Juan Wang, Zhen Wang, Yuan Yang, Xiu-Zhang Lv, Huan-Zhong Shi

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Electronic supplementary material

The online version of this article (https://doi.org/10.1186/s12890-018-0625-5) contains supplementary material, which is available to authorized users.

Abstract

Background

Pleural effusion (PE) drainage can relieve the symptoms of dyspnea; however, details of the resulting hemodynamic changes remain undefined.

Methods

Subjects older than 12 years with massive PE requiring pleural drainage were included in this study. Hemodynamic parameters were collected using transthoracic echocardiography at pre-drainage, immediately post-drainage, and 24 h after drainage.

Results

We enrolled 47subjects in this prospective study from June 9, 2015 to September 18, 2016 in Beijing Chaoyang Hospital and 28 subjects were analyzed finally. Draining large-volume PE led to a progressive increase in left ventricular end-diastolic volume index, left atrial volume index, right ventricular area, right atrial area, left ventricular ejection fraction, stroke volume, and tricuspid annular plane systolic excursion, both immediately (P < 0.05) and 24 h after drainage (P < 0.05). The cardiac diastolic measurement ratios of early-transmitral flow velocity to diastolic mitral annular velocity and myocardial performance index decreased significantly following drainage (P < 0.05). More parameters were influenced by left-sided PE drainage. The correlation between effusion volume and changes in echocardiographic measurements was not statistically significant.

Conclusions

Improved preload, and systolic and diastolic function is pivotal for hemodynamic change after draining large PE volumes. Subjects experienced improved cardiac hemodynamics following PE drainage, underlining the beneficial therapeutic and subjective effects.

Additional file 1: Transthoracic echo cardiography(TTE). The specific methods describing how the cardiocalic paremeters were measured or calculated using the transthoracic echocardiography. (DOCX 14 kb)

Additional file 2: Table S4. The changes of pre-load parameters by echocardiographic findings before and after drainage of subgroups of pleural effusions. Significant changes were observed on LVdVI for both laterals at both immediate and 24 hours drainage. But RV area and RA area were only observed to increase in the right group without alterations in the left PE. No significant differences were seen between the immediately after drainage and 24 hours after drainage data (with Pc > 0.05). Table S5. The changes of systolic functions by echocardiographic findings before and after drainage of subgroups of pleural effusions. Some systolic measurements, SV and TAPSA changed on both laterals at both time points. While increases in LVEF, FAC and RVFWs were significant only in the left group. In the right group, GLS increased only at 24 hours after drainage. Table S6 The changes of diastolic functions by echocardiographic findings before and after drainage of subgroups of pleural effusions. The diastolic parameter, MPI changed on both sides of PE. The increase in TvE/A and decreases in E/Em and TvA were significant merely in the left group. (DOCX 35 kb)

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Titel: Improved heart hemodynamics after draining large-volume pleural effusion: a prospective cohort study
Autoren:: Zheng Wang
Qi-Zhe Cai
Cheng-Jun Ban
Duo Chen
Li-Li Xu
Xiao-Juan Wang
Zhen Wang
Yuan Yang
Xiu-Zhang Lv
Huan-Zhong Shi
Publikationsdatum: 01.12.2018
DOI: https://doi.org/10.1186/s12890-018-0625-5
Verlag: BioMed Central
Zeitschrift: BMC Pulmonary Medicine BMC series – open, inclusive and trusted
Ausgabe 1/2018
Elektronische ISSN: 1471-2466

Springer Medizin

Electronic supplementary material

Abstract

Background

Methods

Results

Conclusions

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