Article Figures & Data
Tables
Characteristics All Patients (n=274) Low (45–64 Years) (n=97) Medium (65–79 Years) (n=121) High (80–95 Years) (n=56) BNP = serum B-type natriuretic peptide. a P <.01 among groups in low, medium, and high age-groups. b P <.001 among groups in low, medium, and high age-groups. c P <.05 among groups in low, medium, and high age-groups. Age, years 69.2±12 56±9.8 73.1±4.1 83.7 ± 3.5 Men, No. (%) 77 (28) 34 (35) 28 (23) 15 (27) Current or previous smoker, No. (%)Treatment 48 (18) 21 (22) 18 (15) 9 (16) Hypertension, No. (%) 225 (82) 78 (80) 97 (80) 50 (89) Dyslipidemia, No. (%)a 87 (32) 34 (35) 45 (37) 8 (14) Arrhythmia, No. (%) 39 (14) 16 (16) 14 (12) 9 (16) Stable angina pectoris, No. (%) 26 (9) 4 (4) 16 (13) 6 (11) Diabetes mellitus, No. (%) 24 (8) 9 (9) 9 (7) 6 (11) Third heart sound, No. (%) 4 (1) 0 (0) 3 (2) 1 (2) Venous insufficiency, No. (%)b 58 (21) 9 (9) 26 (21) 23 (41) Leg edema, No. (%)c 33 (12) 6 (6) 15 (12) 12 (21) Left ventricular ejection fraction, % 61.2±7.1 61.9±6.5 60.9± 7.1 60.8±7.8 Serum creatinine, mg/dLc 0.8±0.24 0.73±0.21 0.78±0.21 0.8±0.23 BNP, pg/mLb 31.6±19.1 23.4±17.2 33.1±18.3 42.4±19.8 Age-Group (Years) P Value Pulmonary Crackles Low (n=97) Medium (n=121) High (n=56) Low vs Medium Low vs High Medium vs High NS = nonsignificant. Incidence, No. (%) 11 (11) 42 (34) 39 (70) <.001 <.001 <.001 95% CI, % 5–18 27–40 58–82 Location <.001 <.05 NS Unilateral, No. (%) 10 (10) 23 (19) 20 (36) Bilateral, No. (%) 1 (1) 19 (16) 19 (34) Longitudinal extension NS NS NS Grade 1, No. (%) 9 (9) 35 (29) 34 (61) Grade 2, No. (%) 2 (2) 7 (6) 5 (9) Transverse extension Diffuse type, No. (%) 0 1 (0.8) 2 (4) NS NS NS Pulmonary Crackles Variable Present (n=92) Absent (n=182) P Value BNP = serum B-type natriuretic peptide. Age, years 76.9 ± 7.8 65.3 ± 11.2 <.001 Men, No. (%) 24 (26) 53 (29) NS Current/previous smoker, No. (%) 15 (16) 33 (18) NS Third heart sound, No. (%) 3 (3) 1 (0.5) NS Venous insufficiency, No. (%) 27 (29) 31 (17) <.05 Leg edema, No. (%) 17 (18) 16 (9) <.05 Left ventricular ejection fraction, % 61.1 ± 7.1 61.5 ± 7.9 NS Serum creatinine, mg/dL 0.79 ± 0.21 0.75 ± 0.19 <.1 BNP, pg/mL 36.4 ± 19.6 29.1 ± 19.0 <.01 Parameter OR 95% CI P Value BNP = serum B-type natriuretic peptide; CI = confidence interval, OR = odds ratio. Age per 10 years 3.23 2.22–4.70 <.001 Venous insufficiency 1.02 0.499–2.08 .961 Leg edema 1.43 0.597–3.41 .425 Serum creatinine 1.29 0.314–5.26 .727 BNP 0.997 0.981–1.01 .731
Additional Files
The Article in Brief
Background Pulmonary crackles (also called rales) are explosive respiratory sounds that occur when breathing in. Although they can be a sign of heart failure, little is known about pulmonary crackles in patients at risk of developing cardiovascular disease. In this study, researchers examine the characteristics of pulmonary crackles in patients who are at high risk for congestive heart failure but have not developed heart disease or symptoms of heart failure.
What This Study Found Elderly patients at high risk for developing heart failure frequently have audible pulmonary crackles, even when there are no signs of cardiac dysfunction or lung disease. In cardiovascular patients with apparently normal heart function, the risk of pulmonary crackles increases 3-fold every 10 years after 45 years of age.
Implications
- It is important to recognize "age-related" crackles so that they are not mistakenly identified as a sign of heart failure deterioration. Other clinical tests should be run to determine whether crackles are related to cardiac dysfunction
Jump to section
Related Articles
Cited By...
- Diagnostic utility of appetite loss in addition to existing prediction models for community-acquired pneumonia in the elderly: a prospective diagnostic study in acute care hospitals in Japan
- The Agreement between Auscultation and Lung Ultrasound in Hemodialysis Patients: The LUST Study
- Neglected evidence in idiopathic pulmonary fibrosis: from history to earlier diagnosis
- Velcro crackles: the key for early diagnosis of idiopathic pulmonary fibrosis?
- In This Issue: Doctor-Patient, Doctor-System, Doctor-Public