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) may be a sign of more severe IE. In this study, we aimed to determine the prevalence and prognostic significance of PE in patients with native valve IE. Methods: The Iranian Registry of Infective Endocarditis (IRIE) is a single-center observational hospital-based study of patients with IE. Between 2002 and 2015, all patients with a diagnosis of 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%) patients had PE. PE was more prevalent in the patients with native valve IE and those with right-heart involvement (65% in right-heart IE vs 50% in left-heart IE; P=0.002). The rate of in-hospital mortality was 20% and 19.2% in the patients with and without PE, respectively, and the presence 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 the severity of PE. However, the prevalence of PE was higher in the patients with right-sided IE as well 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. Most 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.