Prognostic value of lung ultrasound in patients hospitalized for heart disease irrespective of symptoms and ejection fraction
| Autor: | Matteo Mazzola, Peter S. Pang, Stefano Masi, Patrizia Landi, Luna Gargani, Stefano Taddei, Paolo Frumento, F. Frassi, Elisa Poggianti, Nicolò De Biase, Rosa Sicari, Nicola Riccardo Pugliese |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Heart disease B-lines HFpEF Lung ultrasound Prognosis Pulmonary congestion Humans Lung Stroke Volume Ultrasonography Heart Failure 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine Original Research Articles medicine Diseases of the circulatory (Cardiovascular) system 030212 general & internal medicine Original Research Article Subclinical infection Ejection fraction business.industry Stroke volume medicine.disease medicine.anatomical_structure RC666-701 Heart failure Cardiology B‐lines Differential diagnosis Cardiology and Cardiovascular Medicine business |
| Zdroj: | ESC Heart Failure ESC Heart Failure, Vol 8, Iss 4, Pp 2660-2669 (2021) |
| ISSN: | 2055-5822 |
| Popis: | Aims Lung ultrasound B‐lines are the sonographic sign of pulmonary congestion and can be used in the differential diagnosis of dyspnoea to rule in or rule out acute heart failure (AHF). Our aim was to assess the prognostic value of B‐lines, integrated with echocardiography, in patients admitted to a cardiology department, independently of the initial clinical presentation, thus in patients with and without AHF, and in AHF with reduced and preserved ejection fraction (HFrEF and HFpEF). Methods and results We enrolled consecutive patients admitted for various cardiac conditions. Patients were classified into three groups: (i) acute HFrEF; (ii) acute HFpEF; and (iii) non‐AHF. All patients underwent an echocardiogram coupled with lung ultrasound at admission, according to standardized protocols. We followed up 1021 consecutive inpatients (69 ± 12 years) for a median of 14.4 months (interquartile range 4.6–24.3) for death and rehospitalization for AHF. During the follow‐up, 126 events occurred. Admission B‐lines > 30, ejection fraction 2.8 m/s, and tricuspid annular plane systolic excursion 30 had a strong predictive value in HFpEF and non‐AHF, but not in HFrEF. Conclusions Ultrasound B‐lines can detect subclinical pulmonary interstitial oedema in patients thought to be free of congestion and provide useful information not only for the diagnosis but also for the prognosis in different cardiac conditions. Their added prognostic value among standard echocardiographic parameters is more robust in patients with HFpEF compared with HFrEF. |
| Databáze: | OpenAIRE |
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