Pulmonary Congestion by Lung Ultrasound in Ambulatory Patients With Heart Failure With Reduced or Preserved Ejection Fraction and Hypertension.

Autor: Dwyer KH; Department of Emergency Medicine, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island., Merz AA; Harvard Medical School, Boston, Massachusetts., Lewis EF; Harvard Medical School, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts., Claggett BL; Harvard Medical School, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts., Crousillat DR; Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts., Lau ES; Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts., Silverman MB; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts., Peck J; Royal College of Surgeons in Ireland, Dublin, Ireland., Rivero J; Harvard Medical School, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts., Cheng S; Harvard Medical School, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts., Platz E; Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: eplatz@bwh.harvard.edu.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2018 Apr; Vol. 24 (4), pp. 219-226. Date of Electronic Publication: 2018 Mar 01.
DOI: 10.1016/j.cardfail.2018.02.004
Abstrakt: Background: Although pulmonary congestion can be quantified in heart failure (HF) by means of lung ultrasonography (LUS), little is known about LUS findings (B-lines) in different HF phenotypes. This prospective cohort study investigated the prevalence and clinical and echocardiographic correlates of B-lines in ambulatory HF patients with preserved (HFpEF) or reduced (HFrEF) ejection fraction compared with hypertensive patients. We related LUS findings to 12-month HF hospitalizations and all-cause mortality.
Methods and Results: We used LUS to examine hypertensive (n = 111), HFpEF (n = 46), and HFrEF (n = 73) patients (median age 66 y, 56% male, 79% white, and median EF 55%) undergoing clinically indicated outpatient echocardiography. B-line number was quantified offline, across 8 chest zones, blinded to clinical and echocardiographic characteristics. The proportion of patients with ≥3 B-lines was lower in hypertensive patients (13.5%) compared with both HFrEF (45.2%, P < .001) and HFpEF (34.8%; P = .05). HF patients with ≥3 B-lines had a higher risk of the composite outcome (age- and sex-adjusted hazard ratio 2.62, 95% confidence interval 1.15-5.96; P = .022).
Conclusions: When performed at the time of outpatient echocardiography, LUS findings of pulmonary congestion differ between patients with known HF and those with hypertension, and may be associated with adverse outcomes.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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