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

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