Relation of pericardial effusion to degree of fractional shortening

The prevalence of significant pericardial effusion in patients with left ventricular (LV) dysfunction has not been reported. The goal of this study was to evaluate the prevalence and severity of pericardial effusion in patients with decreased fractional shortening (FS) using a large echocardiographic database. A retrospective analysis of 24,265 echocardiograms performed at our institution from 1984 to 1998 was undertaken. FS was measured in 18,015 of the echocardiograms. The occurrence of pericardial effusion was correlated with the degree of FS, and FS was stratified into 4 groups: (1) >25%, (2) 17.5% to 25%, (3) 10% to 17.5%, and (4) <10%. On the basis of visual estimation, effusion was divided into 3 groups: mild, moderate, and severe. Pericardial effusion was present in 1,632 of the echocardiograms in which FS was measured. Pericardial effusion was significantly more common in patients with FS <25% and was correlated with the severity of decreased FS (group 1: 8.4%; group 2: 12.8%; group 3: 13.2%; group 4: 14.4%; p <0.0001). However, when categorizing pericardial effusion by severity, only mild pericardial effusion was correlated with decreased FS (group 1: 6.6%; group 2: 11.0%; group 3: 11.1%; group 4: 14.0%; p <0000.1). Our results indicate that the occurrence of moderate to severe pericardial effusion cannot be explained by a decrease in LV systolic function.