Mediastinal lymphadenopathy in patients undergoing cardiac transplant evaluation

We evaluated the association between hemodynamic parameters of chronic congestive heart failure (CHF) and mediastinal lymphadenopathy (MLA) in heart transplantation (HT) candidates and the effect of HT on MLA. We also described the results of lymph node (LN) biopsies of MLA in the patients. Patients...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Chest Jg. 139; H. 6; S. 1451
Hauptverfasser: Pastis, Jr, Nicholas J, Van Bakel, Adrian B, Brand, Timothy M, Ravenel, James G, Gilbert, Gregory E, Silvestri, Gerard A, Judson, Marc A
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.06.2011
Schlagworte:
Adult
Aged
Female
Heart Failure - complications
Heart Failure - pathology
Heart Failure - surgery
Heart Transplantation
Humans
Lymphatic Diseases - etiology
Lymphatic Diseases - pathology
Male
Mediastinal Diseases - etiology
Mediastinal Diseases - pathology
Middle Aged
Retrospective Studies
Risk Factors
Sentinel Lymph Node Biopsy
Tomography, X-Ray Computed
Treatment Outcome
ISSN:1931-3543, 1931-3543
Online-Zugang:Weitere Angaben
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:We evaluated the association between hemodynamic parameters of chronic congestive heart failure (CHF) and mediastinal lymphadenopathy (MLA) in heart transplantation (HT) candidates and the effect of HT on MLA. We also described the results of lymph node (LN) biopsies of MLA in the patients. Patients who underwent HT evaluation over an 8-year period and had chest CT scans were evaluated retrospectively. Data collected included LN sizes pre-HT and post-HT, echocardiographic measurements, radionuclide-derived ejection fraction, and right-sided heart catheterization hemodynamics. MLA was defined as LNs > 1 cm in smallest dimension. Of 118 patients, 53 patients had MLA. MLA had weak statistically significant correlations with elevated mean pulmonary artery pressure (MPAP), mitral regurgitation (MR), tricuspid regurgitation (TR), right atrial pressure (RAP), and pulmonary capillary wedge pressure (PCWP). Thirty-six patients with MLA underwent HT, and nine of the 36 had post-HT chest CT scans. All nine patients showed a decrease in LN size post-HT (mean LN diameter pre-HT = 1.16 ± 0.137 cm, post-HT = 0.75 ± 0.32 cm). Seven of 53 patients with MLA underwent biopsies. Four had benign LNs, one had sarcoidosis, and two had lung cancer. MPAP, MR, TR, RAP, and PCWP had weak statistically significant correlations with MLA. HT led to regression of MLA in patients who underwent CT scans post-HT, implying that MLA is related to CHF. However, we also identified clinically important causes of MLA; therefore, biopsy should be considered if enlarged LNs fail to regress after maximal medical management of CHF.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1931-3543
1931-3543
DOI:10.1378/chest.10-1386