Heart failure & cardiomyopathies
Pleural Effusion and Invasive Hemodynamic Measurements in Advanced Heart Failure
Authors' conclusion
In patients with left ventricular ejection fraction ≤45% undergoing right heart catheterization as part of advanced heart failure work-up, pleural effusion was associated with higher PCWP and central venous pressure and lower serum albumin.
Study context
- Population
- Patients with advanced HF (LVEF ≤45%) undergoing right heart catheterization, Rigshospitalet, Denmark, 2002–2020
- Participants
- 346 patients
- Exposure
- Pleural effusion vs no pleural effusion
- Pleural effusionn = 162
- Outcome
- Association of presence and size of pleural effusion with central hemodynamics, including pulmonary capillary wedge pressure (PCWP)
Methodological detailsobservational, single-centre
- Observational
- Single-centre
Main finding
As reported in the abstract
Difference, mm Hg (CI)P value
Pleural effusionvs No pleural effusionPCWP
4.3(2.5–6.1)
P < 0.001Pleural effusionvs No pleural effusioncentral venous pressure
2.4(1.2–3.6)
P < 0.001Odds ratio (CI)P value
PCWP (higher)association with pleural effusion; multivariable, adjusted for age, sex, HF medications
1.06(1.03–1.10)
P < 0.001Central venous pressure (higher)association with pleural effusion; multivariable, adjusted for age, sex, HF medications
1.09(1.05–1.15)
P < 0.001- Pleural effusion prevalence
- 162 (47%)
- Medium effusion
- 38 (24%)
- Large effusion
- 30 (19%)
Observational data: associations, not effects.
Further findings
Factors associated with medium/large pleural effusion (subgroup with serum albumin data)
| OR (CI) | P value | ||
|---|---|---|---|
| PCWP | 1.06 (1.01–1.11) | P = 0.032 | |
| Central venous pressure | 1.14 (1.06–1.23) | P < 0.001 | |
| Serum albumin level | 0.89 (0.83–0.95) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
- Factors associated with medium/large pleural effusion (subgroup with serum albumin data): subgroup of 204 (63%) patients
Filling pressures, medium/large vs small effusion
- Medium/large effusion had statistically significantly higher filling pressures than small effusion
Original publication
Pleural Effusion and Invasive Hemodynamic Measurements in Advanced Heart Failure. Circ Heart Fail. Published 6 August 2024. doi:10.
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