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Increased E/A Ratio is a Risk Factor for the Formation of Pleural Effusion in Heart Failure

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Abstract

Purpose

Pleural effusion is a common finding in patients with congestive heart failure (CHF). The pathogenesis of pleural effusion in heart failure is multifactorial. However, the role of right and left ventricular function assessed by ECHO cardiogram has not been studied. Therefore, we explored the association between right and left ventricular parameters on echocardiogram in patients with heart failure with and without pleural effusion diagnosed using CT scan of chest.

Methods

A case–control study was utilized to explore the objectives. Using strict exclusion criteria, patients admitted with a single diagnosis of acute CHF were stratified into those with and without pleural effusion using CT scan of chest done at admission. Multiple logistic regression analysis was used to identify significant factors associated with pleural effusion.

Results

Among the 70 patients, 36 (51%) had pleural effusions. The mean E/A ratio in patients with effusion (2.53 ± 1.1) was significantly higher than in patients without effusion (1.15 ± 0.9), p < 0.01. Multiple logistic regression analysis showed that elevated E/A ratio was significantly associated with pleural effusion, OR 3.26 (95% CI 1.57–6.77, p < 0.009). Left ventricular ejection fraction (LVEF), septal Eʹ, lateral Eʹ, and medial E/Eʹ ratio were not significantly different in patients with and without pleural effusion.

Conclusion

Elevated E/A ratio is a risk factor for the formation of pleural effusion in patients with heart failure.

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Acknowledgements

We thank Professor Paul Mills Ph.D., MPH with the Division of Epidemiology, UCSF Fresno, for suggestions on study design, protocols, and statistical analysis. We thank Amit Kalra BS for extraction of data from study subjects

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Correspondence to Jose Joseph Vempilly.

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None of authors have any conflict of interest.

Ethical Approval

This study was approved by the local IRB.

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Rajyaguru, C., Kalra, A., Samim, A. et al. Increased E/A Ratio is a Risk Factor for the Formation of Pleural Effusion in Heart Failure. Lung 198, 229–233 (2020). https://doi.org/10.1007/s00408-019-00308-2

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Keywords

  • Pleural effusion
  • Systolic dysfunction
  • Diastolic dysfunction
  • E/A ratio