Prevalence and Prognostic Significance of Pericardial Effusion in Native Valve Endocarditis Based on Data From the Iranian Registry of Infective Endocarditis (IRIE)

Abstract

Background: The presence of pericardial effusion (PE) in the setting of infective endocarditis (IE) may<br />be a sign of more severe IE. In this study, we aimed to determine the prevalence and prognostic<br />significance of PE in patients with native valve IE.<br />Methods: The Iranian Registry of Infective Endocarditis (IRIE) is a single-center observational<br />hospital-based study of patients with IE. Between 2002 and 2015, all patients with a diagnosis<br />of IE who had been enrolled in the IRIE were evaluated.<br />Results: A total of 445 patients (68.3% male) were enrolled in this registry, and 221 (49.7%) patients<br />had PE. PE was more prevalent in the patients with native valve IE and those with right-heart<br />involvement (65% in right-heart IE vs 50% in left-heart IE; P=0.002). The rate of in-hospital<br />mortality was 20% and 19.2% in the patients with and without PE, respectively, and the<br />presence of PE was not a predictor of in-hospital death in our multivariate analyses.<br />Additionally, there was no relationship between the rates of IE-related complications and the<br />severity of PE. However, the prevalence of PE was higher in the patients with right-sided IE as<br />well as in those with aortic root abscess and systemic emboli at presentation.<br />Conclusions: The prevalence of PE in the setting of IE was relatively high in the present study. Most<br />cases of PE had mild effusion, and there was no relationship between the severity of PE and IErelated complications as well as in-hospital mortality.