RESULTS: The STAAB (Characteristics and Course of Heart Failure Stages A/B and Determinants of Progression) cohort study recruited a representative sample of the population of Würzburg, aged 30 to 79 years. Participants underwent quality-controlled transthoracic echocardiography including the dedicated evaluation of the pericardial space. Of 4965 individuals included at baseline (mean age, 55±12 years; 52% women), 134 (2.7%) exhibited an incidentally diagnosed PE (median diameter, 2.7 mm; quartiles, 2.0-4.1 mm). In multivariable logistic regression, lower body mass index and higher NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels were associated with PE at baseline, whereas inflammation, malignancy, and rheumatoid disease were not. Among the 3901 participants attending the follow-up examination after a median time of 34 (30-41) months, PE was found in 60 individuals (1.5%; n=18 new PE, n=42 persistent PE). Within the follow-up period, 37 participants died and 93 participants reported a newly diagnosed malignancy. The presence of PE did not predict all-cause death or the development of new malignancy.
CONCLUSIONS: Incidental PE was detected in about 3% of individuals, with the vast majority measuring <10 mm and completely resolving. PE was not associated with inflammation markers, death, incident heart failure, or malignancy. Our findings corroborate the view of current guidelines that a small PE in asymptomatic individuals can be considered an innocent phenomenon and does not require extensive short-term monitoring.
结果:STAAB(心力衰竭A/B阶段的特征和过程以及进展的决定因素)队列研究招募了维尔茨堡人口的代表性样本,30至79岁。参与者接受了质量控制的经胸超声心动图检查,包括对心包空间的专门评估。在基线纳入的4965名个体中(平均年龄,55±12岁;52%的女性),134(2.7%)表现出偶然诊断的PE(中位直径,2.7毫米;四分位数,2.0-4.1毫米)。在多变量逻辑回归中,较低的体重指数和较高的NT-proBNP(N末端B型利钠肽前体)水平与基线时的PE相关,而炎症,恶性肿瘤,和类风湿疾病没有。在中位时间为34(30-41)个月后参加随访检查的3901名参与者中,在60个人中发现了PE(1.5%;n=18个新PE,n=42持久性PE)。在后续期内,37名参与者死亡,93名参与者报告了新诊断的恶性肿瘤。PE的存在并不能预测全因死亡或新恶性肿瘤的发展。
结论:在约3%的个体中检测到偶然的PE,与绝大多数测量<10毫米和完全解决。PE与炎症标志物无关,死亡,突发心力衰竭,或者恶性肿瘤。我们的发现证实了当前指南的观点,即无症状个体中的小PE可以被认为是无辜的现象,不需要广泛的短期监测。