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Prevalence of renal artery stenosis in flash pulmonary oedema: determination using gadolinium-enhanced MRA.
McMahon, Colm J Hennessy, Martina Boyle, Gerard Feely, John Meaney, James F M
McMahon, Colm J
Hennessy, Martina
Boyle, Gerard
Feely, John
Meaney, James F M
Advisors
Editors
Other Contributors
Date
2012-02-01T10:45:55Z
Date Submitted
Keywords
Other Subjects
Subject 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
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
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
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
ISSN
1879-0828 (Electronic)
0953-6205 (Linking)
0953-6205 (Linking)
eISSN
ISBN
DOI
10.1016/j.ejim.2010.04.003
PMID
20816598