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Prevalence, Characteristics, and Outcomes of Patients Presenting With Cardiogenic Unilateral Pulmonary Edema

Circulation (New York, N.Y.), 2010-09, Vol.122 (11), p.1109-1115 [Peer Reviewed Journal]

2015 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.109.934950 ;PMID: 20805429 ;CODEN: CIRCAZ

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Title:
Prevalence, Characteristics, and Outcomes of Patients Presenting With Cardiogenic Unilateral Pulmonary Edema
Author: ATTIAS, David ; MANSENCAL, Nicolas ; AUVERT, Bertran ; VIEILLARD-BARON, Antoine ; DELOS, Aurélie ; LACOMBE, Pascal ; N'GUETTA, Roland ; JARDIN, François ; DUBOURG, Olivier
Subjects: Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Cardiology. Vascular system ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Electrocardiography ; Female ; Humans ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Mitral Valve Insufficiency - complications ; Multivariate Analysis ; Pneumology ; Prevalence ; Prognosis ; Pulmonary Edema - diagnosis ; Pulmonary Edema - epidemiology ; Pulmonary Edema - physiopathology ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Retrospective Studies ; Stroke Volume - physiology
Is Part Of: Circulation (New York, N.Y.), 2010-09, Vol.122 (11), p.1109-1115
Description: Cardiogenic unilateral pulmonary edema (UPE) is a rare entity, frequently leading to initial misdiagnosis. We sought to assess the prevalence of UPE and to determine its impact on prognosis compared with bilateral pulmonary edema. We studied the characteristics and outcomes of patients admitted to our institution for cardiogenic pulmonary edema during an 8-year period. The study population included 869 consecutive patients. The prevalence of UPE was 2.1%: 16 right-sided UPE (89%) and 2 left-sided UPE (11%). In patients with UPE, blood pressure was significantly lower (P≤0.01), whereas noninvasive or invasive ventilation and catecholamines were used more frequently (P=0.0004 and P<0.0001, respectively). The prevalence of severe mitral regurgitation in patients with bilateral pulmonary edema and UPE was 6% and 100%, respectively (P<0.0001). In patients with UPE, use of antibiotic therapy and delay in treatment were significantly higher (P<0.0001 and P=0.003, respectively). In-hospital mortality was 9%: 39% for UPE versus 8% for bilateral pulmonary edema (odds ratio, 6.9; 95% confidence interval, 2.6 to 18; P<0.001). In multivariate analysis, unilateral location of pulmonary edema was independently related to death whatever the model used (adjusted odds ratio, 6.5; 95% confidence interval, 1.3 to 32; P=0.021 for model A; and adjusted odds ratio, 6.8; 95% confidence interval, 1.1 to 41; P=0.037 for model B). Unilateral pulmonary edema represented 2.1% of cardiogenic pulmonary edema in our study, usually appeared as an opacity involving the right lung, and was always associated with severe mitral regurgitation. Unilateral pulmonary edema is related to an independent increased risk of mortality and should be promptly recognized to avoid delays in treatment.
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
Language: English
Identifier: ISSN: 0009-7322
EISSN: 1524-4539
DOI: 10.1161/CIRCULATIONAHA.109.934950
PMID: 20805429
CODEN: CIRCAZ
Source: Geneva Foundation Free Medical Journals at publisher websites
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Prevalence, Characteristics, and Outcomes of Patients Presenting With Cardiogenic Unilateral Pulmonary Edema

2015 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.109.934950 ;PMID: 20805429 ;CODEN: CIRCAZ

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