Document Detail


Acute pulmonary oedema: clinical characteristics, prognostic factors, and in-hospital management.
MedLine Citation:
PMID:  20837636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Acute pulmonary oedema (APE) is the second, after acutely decompensated chronic heart failure (ADHF), most frequent form of acute heart failure (AHF). This subanalysis examines the clinical profile, prognostic factors, and management of APE patients (n = 1820, 36.7%) included in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF).
METHODS AND RESULTS: ALARM-HF included a total of 4953 patients hospitalized for AHF in Europe, Latin America, and Australia. The final diagnosis was made at discharge, and patients were classified according to European Society of Cardiology guidelines. Patients with APE had higher in-hospital mortality (7.4 vs. 6.0%, P = 0.057) compared with ADHF patients (n = 1911, 38.5%), and APE patients exhibited higher systolic blood pressures (P < 0.001) at admission and higher left ventricular ejection fraction (LVEF, P < 0.01) than those with ADHF. These patients also had a higher prevalence of diabetes (P < 0.01), arterial hypertension (P < 0.001), peripheral vascular disease (P < 0.001), and chronic renal disease (P < 0.05). They were also more likely to receive intravenous (i.v.) diuretics (P < 0.001), i.v. nitrates (P < 0.01), dopamine (P < 0.05), and non-invasive ventilation (P < 0.001). Low systolic blood pressure (P < 0.001), low LVEF (<0.05), serum creatinine ≥1.4 mg/dL (P < 0.001), history of cardiomyopathy (P < 0.05), and previous cardiovascular event (P < 0.001) were independently associated with increased in-hospital mortality in the APE population.
CONCLUSION: APE differs in clinical profile, in-hospital management, and mortality compared with ADHF. Admission characteristics (systolic blood pressure and LVEF), renal function, and history may identify high-risk APE patients.
Authors:
John T Parissis; Maria Nikolaou; Alexandre Mebazaa; Ignatios Ikonomidis; Juan Delgado; Fabio Vilas-Boas; Ioannis Paraskevaidis; Antony Mc Lean; Dimitrios Kremastinos; Ferenc Follath
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-13
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-22     Completed Date:  2011-03-14     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1193-202     Citation Subset:  IM    
Affiliation:
Heart Failure Clinic and Second Cardiology Department, Attikon University Hospital, University of Athens, Athens, Greece. jparissis@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Comorbidity
Creatinine / blood
Female
Heart Failure / epidemiology,  etiology,  physiopathology,  therapy
Hospital Mortality
Humans
Male
Middle Aged
Prognosis
Pulmonary Edema / complications,  epidemiology,  physiopathology*,  therapy
ROC Curve
Stroke Volume
Ventricular Dysfunction, Left / epidemiology
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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