Prevalence of renal artery stenosis in flash pulmonary oedema: determination using gadolinium-enhanced MRA.

Hdl Handle:
http://hdl.handle.net/10147/207830
Title:
Prevalence of renal artery stenosis in flash pulmonary oedema: determination using gadolinium-enhanced MRA.
Authors:
McMahon, Colm J; Hennessy, Martina; Boyle, Gerard; Feely, John; Meaney, James F M
Affiliation:
Department of Diagnostic Imaging, St. James Hospital, Dublin 8, Ireland., colmjmcmahon@yahoo.co.uk
Citation:
Eur J Intern Med. 2010 Oct;21(5):424-8. Epub 2010 May 18.
Journal:
European journal of internal medicine
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207830
DOI:
10.1016/j.ejim.2010.04.003
PubMed ID:
20816598
Abstract:
PURPOSE: The primary purpose was to determine the prevalence of renal artery stenosis (RAS) in patients presenting with acute ("flash") pulmonary oedema (FPE), without identifiable cause using contrast-enhanced magnetic resonance angiography (CE-MRA) of renal arteries. A secondary goal was to correlate clinical parameters at presentation with the presence or absence of RAS. MATERIALS AND METHODS: Patients presenting with acute pulmonary oedema without identifiable cause prospectively underwent CE-MRA. >50% renal artery stenosis was considered significant. Clinical parameters (blood pressure, serum creatinine, history of hypertension/hyperlipidaemia) were compared in patients with and without RAS using an unpaired t-test. Results expressed; mean (+/-SD). RESULTS: 20 patients (4 male, 16 female, age 78.5+/-11 years) underwent CE-MRA. 9 patients (45%) had significant RAS (6 (30%) bilateral, 3 (15%) unilateral). Systolic BP was higher in patients with RAS (192+/-38 mm Hg) than those without (134+/-30 mm Hg) (p<.005). Diastolic BP was higher in patients with RAS (102+/-23 mm Hg) than those without (76+/-17 mm Hg) (p<.01). All patients with RAS and 6/11(55%) patients without RAS had a history of hypertension. No significant difference in creatinine or hyperlipidaemia history was observed. CONCLUSION: The prevalence of RAS in patients presenting with FPE is 45%. The diagnosis should be considered in patients presenting with unexplained acute pulmonary oedema, particularly if hypertensive at presentation.
Language:
eng
MeSH:
Acute Disease; Aged; Blood Pressure; Female; Gadolinium/diagnostic use; Humans; Hypertension, Renal/epidemiology/pathology; Magnetic Resonance Angiography/*methods; Male; Predictive Value of Tests; Prevalence; Prospective Studies; Pulmonary Edema/*epidemiology; Renal Artery/*pathology; Renal Artery Obstruction/*epidemiology/*pathology; Severity of Illness Index
ISSN:
1879-0828 (Electronic); 0953-6205 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMcMahon, Colm Jen_GB
dc.contributor.authorHennessy, Martinaen_GB
dc.contributor.authorBoyle, Gerarden_GB
dc.contributor.authorFeely, Johnen_GB
dc.contributor.authorMeaney, James F Men_GB
dc.date.accessioned2012-02-01T10:45:55Z-
dc.date.available2012-02-01T10:45:55Z-
dc.date.issued2012-02-01T10:45:55Z-
dc.identifier.citationEur J Intern Med. 2010 Oct;21(5):424-8. Epub 2010 May 18.en_GB
dc.identifier.issn1879-0828 (Electronic)en_GB
dc.identifier.issn0953-6205 (Linking)en_GB
dc.identifier.pmid20816598en_GB
dc.identifier.doi10.1016/j.ejim.2010.04.003en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207830-
dc.description.abstractPURPOSE: The primary purpose was to determine the prevalence of renal artery stenosis (RAS) in patients presenting with acute ("flash") pulmonary oedema (FPE), without identifiable cause using contrast-enhanced magnetic resonance angiography (CE-MRA) of renal arteries. A secondary goal was to correlate clinical parameters at presentation with the presence or absence of RAS. MATERIALS AND METHODS: Patients presenting with acute pulmonary oedema without identifiable cause prospectively underwent CE-MRA. >50% renal artery stenosis was considered significant. Clinical parameters (blood pressure, serum creatinine, history of hypertension/hyperlipidaemia) were compared in patients with and without RAS using an unpaired t-test. Results expressed; mean (+/-SD). RESULTS: 20 patients (4 male, 16 female, age 78.5+/-11 years) underwent CE-MRA. 9 patients (45%) had significant RAS (6 (30%) bilateral, 3 (15%) unilateral). Systolic BP was higher in patients with RAS (192+/-38 mm Hg) than those without (134+/-30 mm Hg) (p<.005). Diastolic BP was higher in patients with RAS (102+/-23 mm Hg) than those without (76+/-17 mm Hg) (p<.01). All patients with RAS and 6/11(55%) patients without RAS had a history of hypertension. No significant difference in creatinine or hyperlipidaemia history was observed. CONCLUSION: The prevalence of RAS in patients presenting with FPE is 45%. The diagnosis should be considered in patients presenting with unexplained acute pulmonary oedema, particularly if hypertensive at presentation.en_GB
dc.language.isoengen_GB
dc.subject.meshAcute Diseaseen_GB
dc.subject.meshAgeden_GB
dc.subject.meshBlood Pressureen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGadolinium/diagnostic useen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHypertension, Renal/epidemiology/pathologyen_GB
dc.subject.meshMagnetic Resonance Angiography/*methodsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshPulmonary Edema/*epidemiologyen_GB
dc.subject.meshRenal Artery/*pathologyen_GB
dc.subject.meshRenal Artery Obstruction/*epidemiology/*pathologyen_GB
dc.subject.meshSeverity of Illness Indexen_GB
dc.titlePrevalence of renal artery stenosis in flash pulmonary oedema: determination using gadolinium-enhanced MRA.en_GB
dc.contributor.departmentDepartment of Diagnostic Imaging, St. James Hospital, Dublin 8, Ireland., colmjmcmahon@yahoo.co.uken_GB
dc.identifier.journalEuropean journal of internal medicineen_GB
dc.description.provinceLeinster-

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