Acute pulmonary edema in patients with decompensated heart failure. Role of underlying cardiopathy on the prognosis

Shamagian, Lilian Grigorian; Román, Alfonso Varela; Ramos, Pilar Mazón; Acuña, José María García; Veloso, Pedro Rigueiro; González-Juanàtey, José Ramón

doi:10.1016/j.ijcard.2006.08.110

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…Few data are available concerning the mortality risk of patients with APE 23–31. The ALARM‐HF survey supports the strong prognostic significance of LVEF and systolic blood pressure at admission, which has previously been proposed by small retrospective trials 25–29. The present survey also demonstrates the linear relationship between these parameters.…”

Section: Discussionsupporting

confidence: 84%

Acute pulmonary oedema: clinical characteristics, prognostic factors, and in‐hospital management

Parissis

Nikolaou

Mebazaa

et al. 2010

European J of Heart Fail

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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.

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Section: Discussionsupporting

confidence: 84%

Acute pulmonary oedema: clinical characteristics, prognostic factors, and in‐hospital management

Parissis

Nikolaou

Mebazaa

et al. 2010

European J of Heart Fail

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“…4 Predictors of 1-year mortality appeared also to be age, [12][13][14][15] admission blood pressure, 13,15 anemia, 13 renal failure, 12,13,15 left ventricular dysfunction, and acute coronary syndromes. 14 There are few studies (3), however, that have analyzed a longer follow-up in patients with acutely decompensated heart failure, [15][16][17] with mortality rates of 60.3% 15 and 71%, 16 with similar main predictors than in the 1-year follow-up series. 15 In contrast to acute heart failure, only 2 studies have investigated the 1-year mortality in patients with APE 7,18 and none has analyzed a longer follow-up.…”

Section: Total Mortalitymentioning

confidence: 99%

“…Several recent studies have reported on the 1‐year prognosis of patients with acute heart failure4, 11, 12, 13, 14, 15, 16 and 3 have analyzed longer follow‐up,15, 16, 17 one of them with decompensated heart failure and pulmonary edema 17. In contrast, long‐term follow‐up in patients with well‐defined APE has been limited to 1 year and has been described in only 2 old reports with a reduced number of patients 7, 18.…”

Section: Introductionmentioning

confidence: 99%

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Figueras

Bañeras

Peña‐Gil

et al. 2016

JAHA

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BackgroundLong‐term prognosis of acute pulmonary edema (APE) remains ill defined.Methods and ResultsWe evaluated demographic, echocardiographic, and angiographic data of 806 consecutive patients with APE with (CAD) and without coronary artery disease (non‐CAD) admitted from 2000 to 2010. Differences between hospital and long‐term mortality and its predictors were also assessed. CAD patients (n=638) were older and had higher incidence of diabetes and peripheral vascular disease than non‐CAD (n=168), and lower ejection fraction. Hospital mortality was similar in both groups (26.5% vs 31.5%; P=0.169) but APE recurrence was higher in CAD patients (17.3% vs 6.5%; P<0.001). Age, admission systolic blood pressure, recurrence of APE, and need for inotropics or endotracheal intubation were the main independent predictors of hospital mortality. In contrast, overall mortality (70.0% vs 57.1%; P=0.002) and readmission for nonfatal heart failure after a 45‐month follow‐up (10–140; 17.3% vs 7.6%; P=0.009) were higher in CAD than in non‐CAD patients. Age, peripheral vascular disease, and peak creatine kinase MB during index hospitalization, but not ejection fraction, were the main independent predictors of overall mortality, whereas coronary revascularization or valvular surgery were protective. These interventions were mostly performed during hospitalization index (294 of 307; 96%) and not intervened patients showed a higher risk profile.ConclusionsLong‐term mortality in APE is high and higher in CAD than in non‐CAD patients. Considering the different in‐hospital and long‐term mortality predictors herein described, which do not necessarily involve systolic function, it is conceivable that a more aggressive interventional program might improve survival in high‐risk patients.

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“…Furthermore, National Institute for Health and Clinical Excellence (2003) indicates that it accounts for 5% of all emergency admissions to hospital resulting in 1 million inpatient bed days/year, and therefore makes heart failure a phenomenally important issue for health care. Although the mortality rate is high for congestive heart failure, the risk is actually greater for those who present with acute cardiogenic pulmonary oedema as a symptom (Shamagian et al , 2007). Acute pulmonary oedema (APO) is a serious and life‐threatening complication of congestive heart failure and although heart failure has many causes, including hypertension, myocarditis and arrhythmias to name a few (Lip, 2000; cited in Nicholas, 2004), the most frequent cause is myocardial infarction (Lakasing and Francis, 2006; Ekman et al , 2007; Fiutowski et al , 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Acute pulmonary oedema (APO) is a serious and life‐threatening complication of congestive heart failure and although heart failure has many causes, including hypertension, myocarditis and arrhythmias to name a few (Lip, 2000; cited in Nicholas, 2004), the most frequent cause is myocardial infarction (Lakasing and Francis, 2006; Ekman et al , 2007; Fiutowski et al , 2008). A recent study by Shamagian et al (2007) showed that patients with congestive heart failure and APO resulting from an ischaemic event have less chance of survival. These poor statistics are supported by Ekman et al (2007) who found that, of those patients treated for acute cardiogenic pulmonary oedema, only 35% were alive after 1 year.…”

Section: Introductionmentioning

confidence: 99%

Acute cardiogenic pulmonary oedema: reflecting on the management of an intensive care unit patient

Skinner

McKinney

2011

Nursing in Critical Care

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Acute pulmonary edema in patients with decompensated heart failure. Role of underlying cardiopathy on the prognosis

Cited by 3 publications

References 9 publications

Acute pulmonary oedema: clinical characteristics, prognostic factors, and in‐hospital management

Acute pulmonary oedema: clinical characteristics, prognostic factors, and in‐hospital management

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Acute cardiogenic pulmonary oedema: reflecting on the management of an intensive care unit patient

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