Key result
Mediastinal lymph node enlargement affects ~53% of VHD patients and tracks with pulmonary congestion.
Why the study?
The prevalence, size, and location of mediastinal lymph node enlargement in patients with valvular heart disease and its correlation with ejection fraction were not well characterized.
Observational (n=30)
Mediastinal lymph node enlargement is a common finding on CT in patients with valvular heart disease, particularly in the presence of pulmonary edema or pleural effusion.
Answers are grounded in this paper and cite their sources.
Common mediastinal LAP in VHD with edema or effusion warrants consideration in differentials; leaves open prospective validation of clinical relevance.
Purpose To evaluate the presence, size and location of enlarged mediastinal lymph nodes (LNs) in patients with valvular heart disease (VHD) using computed tomography scans in correlation with ejection fraction (EF). Materials and Methods We retrospectively evaluated 30 patients with VHD, without pre-existing diseases that could cause lymphadenopathy (LAP). The presence, size, and location of LNs greater than 1 cm in short axis diameter were evaluated. The location of mediastinal LNs was recorded according to the International Association for the Study of Lung Cancer. Furthermore, we evaluated the presence of pulmonary edema, pleural effusion, and other thoracic abnormalities and evaluated EF of the heart on transthoracic echocardiography. Results Sixteen patients (53%) had at least 1 enlarged mediastinal LN. The most frequent locations were lower paratracheal (4R, n = 8/4L, n = 6), subcarinal (7, n = 5) and right upper paratracheal (2R, n = 4) regions. The frequency of mediastinal LAP was higher in patients with aortic regurgitation (2 of 2, 100%) followed by mitral regurgitation (8 of 11, 73%); it was also high in patients with pulmonary edema (80%), pleural effusion (81%), or both (77%), as compared to patients without pulmonary edema or pleural effusion (17%) (p = 0.001). Ten of 30 patients showed an abnormal EF of < 55%; among them, 8 had mediastinal LAP. However, the relationship between EF and LAP was not statistically significant (p = 0.058). Conclusion Mediastinal LN enlargement is common in patients with VHD, especially in cases of pulmonary edema and pleural effusion. Enlarged mediastinal LNs were frequently observed with abnormal EF, however, the relationship between EF and mediastinal LAP was not statistically significant.
No takes yet. Share an insight, caveat, or question.
Park et al. (2016) conducted an observational in Valvular heart disease (n=30). Pulmonary edema or pleural effusion vs. Without pulmonary edema or pleural effusion was evaluated on Presence of enlarged mediastinal lymph nodes (>1 cm in short axis) (p=0.001). Mediastinal lymph node enlargement occurred in 53% of VHD patients and was more frequent with pulmonary edema (80%) or pleural effusion (81%) than without (17%; p=0.001).
Synapse has enriched 10 related papers. Consider them for comparative context: