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European Journal of Echocardiography 2005 6(5):358-362; doi:10.1016/j.euje.2004.12.007
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Copyright © 2005, The European Society of Cardiology

The anteroposterior pericardial sac diameter measured by echocardiography correlates with the volume of pericardial effusion and with effort dyspnea

Aviv Magera,b,*, Yochai Birnbauma,b, Yehuda Adlera,b, Shula Imbara, Boris Strasberga,b and Alexander Battlera,b

aDepartment of Cardiology, Rabin Medical Center-Beilinson Campus, Petah Tiqva, Israel
bSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Received 3 August 2004; received in revised form 12 December 2004; accepted after revision 29 December 2004.

avivm{at}clalit.org.il

* Corresponding author. Department of Cardiology, Rabin Medical Center-Beilinson Campus, Petah Tiqva 49100, Israel. Tel.: +972 3 9377107; fax: +972 3 9249850.


  Abstract

Aims

To examine the value of the anteroposterior pericardial sac diameter (APD) for prediction of the volume of pericardial effusion.

Methods and results

We measured the APD by echocardiography before 52 pericardiocentesis procedures and correlated it with the aspirate volume, etiology, symptoms, and clinical outcome. The volume of the aspirate ranged from 60 to 2300ml (median 650ml). The APD (range 8.0cm–15.9cm, median 12cm) correlated well with the cubic root of the volume of the effusion [volume=(0.8APD–0.6)3, r2=0.533, p<0.01]. An APD≥12cm had a positive predictive value of 88% and a negative predictive value of 83% for effusion volume above the sample median (≥650ml) and a positive predictive value of 100% for effusion in the middle or upper aspirate volume tertiles. Effort dyspnea was more common among patients with APD≥12.0cm (n=13) than in those with APD<12.0cm (n=11) (p=0.007). One-year survival after pericardiocentesis was closely related to the severity of the underlying etiology and was not influenced by the volume of the effusion before aspiration.

Conclusions

The APD is a simple, valuable method for non-invasive prediction of pericardial fluid volume. A greater APD is associated with, and may explain, effort dyspnea.

Keywords: Pericardial effusion; Echocardiography; Outcome


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