083: Medical hypothesis: heart rate on admission and CRP are correlated, in acute pericarditis: a link between heart rate and pericardial inflammation?

IntroductionRest is usually recommended in acute pericarditis, as it could help to lower heart rate (HR) and contribute to limit “mechanical inflammation”. Whether HR on admission could be correlated and perhaps participate to inflammation has not been reported.MethodsBetween March 2007 and February 2010, we conducted a retrospective study on all patients admitted in our center for acute pericarditis. Diagnosis criteria included 2 among the following: typical chest pain, friction rub, pericardial effusion on cardiac echography, or typical ECG findings. Primary endpoint was biology: CRP on admission, on days 1, 2, 3, and especially peak. We evaluated also recurrences and clinical events during hospitalization and at one month.ResultsWe included 73 patients. Median age was 38.0 y (CI 25-75% 28.0-51.0) and median hospitalization duration was 2.0 d (1.5-3.0). 27% of the patients presented pericardial effusion. Heart rate on admission was 88.0 bpm (CI 25-75%: 76.0-100.0) and on discharge 72.0 (65.0-80.0)). Heart rate on admission was significantly correlated with CRP on admission (r=0.34, n=69; p=0.004), CRP peak (r=0.54; n=61; p<0.0001), CRP on discharge (r=0.32; p=0.021) and temperature on admission (r=0.40; n=39; p=0.01). Multivariate analysis showed that HR on admission is associated with an elevated CRP peak, independently of temperature on admission. Fever was scarcely observed (19.5%), and was neither correlated to HR nor CRP, after multivariate analysis.ConclusionIn acute pericarditis, HR on admission is independently correlated with CRP levels. These observations could suggest a link between HR and pericardial inflammation