Pleural Effusion in Severe Aortic Stenosis: Marker of an Adverse Haemodynamic Constellation and Poor Prognosis

Figures

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  Figure 1. Examples of chest radiographs for each patient category. (A) No pleural effusion: 62 year‐old female, indexed aortic valve area (AVAi) = 0.45 cm2/m2, left ventricular ejection fraction (LVEF) = 60%, no mitral regurgitation (MR), mean right atrial pressure (mRAP) = 6 mmHg, mean pulmonary artery pressure (mPAP) = 16 mmHg, mean pulmonary artery wedge pressure (mPAWP) = 12 mmHg, pulmonary vascular resistance (PVR) = 0.9 Wood units (WU), cardiac index (CI) = 2.4 L/min/m2. (B) Unilateral PE: 74 year‐old male, AVAi = 0.50 cm2/m2, LVEF = 60%, mild MR, mRAP = 7 mmHg, mPAP = 24 mmHg, mPAWP = 17 mmHG, PVR = 1.7 WU, CI = 2.0 L/min/m2. (C) Bilateral PE: 79 year‐old male, AVAi = 0.45 cm2/m2, LVEF = 35%, mild to moderate MR, mRAP = 9 mmHg, mPAP = 32 mmHg, mPAWP = 19 mmHg, PVR = 2.4 WU, CI = 2.3 L/min/m2.

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  Figure 2. Indexed aortic valve area (AVAi; panel A), key haemodynamics (panels B–E), and plasma albumin (as marker of plasma oncotic pressure; panel F) in patients with bilateral (red) pleural effusion (PE), unilateral PE (blue) and no PE (green). The error bars represent means with standard deviations. mPAWP, mean pulmonary artery wedge pressure; mRAP, mean right atrial pressure; PVR, pulmonary vascular resistance [unit is Wood units (WU)]. Post hoc tests: *P < 0.05 bilateral versus no PE, # P < 0.05 unilateral versus no PE, § P < 0.05 bilateral versus unilateral PE.

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  Figure 3. Kaplan–Meier plots showing cumulative events (mortality) for patients with bilateral (red) pleural effusion (PE), unilateral PE (blue) and no PE (green). For details, please see text.