Comparison between inferior vena cava ultrasound, lung ultrasound, bioelectric impedance analysis, and natriuretic peptides in chronic heart failure

Curbelo, José; Rodríguez-Cortés, Pablo; Aguilera, Maria; Gil-Martínez, P.; Martin, Daniel S.; Fernández, Carmen Suárez

doi:10.1080/03007995.2018.1519502

Cited by 33 publications

(32 citation statements)

References 45 publications

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“…In another study, in which LUS findings, IVCUS findings, and N‐terminal pro‐BNP levels of 99 patients with HF were monitored on an outpatient basis for 1 year, and the rates of hospital admission and death were calculated, patients who were hospitalized or died were compared with those who remained stable for HF for 1 year. As a result, patients who were admitted to the hospital or died of HF had significantly more numerous B‐lines on LUS imaging, had significantly greater inspiratory and expiratory IVC measurements, had a lower IVCCI, and had significantly greater N‐terminal pro‐BNP levels 29 . Our study revealed that the IVCCI was greater in patients discharged from the ED than those admitted to the hospital (23 ± 12 versus 18 ± 9).…”

Section: Discussionmentioning

confidence: 63%

Role of Point‐of‐Care Lung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure

Hacıalioğulları

Yılmaz²,

Yılmaz

et al. 2020

J of Ultrasound Medicine

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Objectives This prospective study was performed to evaluate the diagnostic role of point‐of‐care lung ultrasound (LUS) and inferior vena cava (IVC) ultrasound in patients with acute decompensated heart failure (ADHF). Methods A prospective cohort study was conducted between January 2018 and November 2018 on patients with a diagnosis of ADHF in the emergency department (ED). On admission, LUS findings, inspiratory and expiratory IVC diameters, and the inferior vena cava collapsibility index (IVCCI) were obtained. After therapeutic interventions, third‐hour changes in LUS and the IVC index and the treatment response were assessed. Results Eighty patients were enrolled. Forty‐six (58%) patients had an ejection fraction (EF) greater than 40%, and 34 (42%) had an EF of less than 40%. Significant differences were detected between the admission and third‐hour inspiratory IVC diameter, expiratory IVC diameter, and IVCCI (P = .001). There was no correlation between the EF and inspiratory IVC diameter (r = −0.03; P = .976), expiratory IVC diameter (r = −109; P = .336), or IVCCI (r = −0.72; P = .523) and between the B‐type natriuretic peptide level and inspiratory IVC diameter (r = −0.58; P = .610), expiratory IVC diameter (r = −0.33; P = .774), or IVCCI (r = −0.78; P = .493) either. A comparison of admission and third‐hour numbers of B‐lines on LUS imaging showed a significant decrease in the number of B‐lines in all zones at the end of 3 hours (P = .001). A significant difference existed between the hospitalized and discharged patients with respect to IVC diameters and number of B‐lines. Conclusions In the ED setting, an assessment of B‐lines and measurement of IVC diameters are better markers than the B‐type natriuretic peptide level, EF, or chest x‐ray for diagnosis of ADHF and can be used to make decisions for hospitalization or discharge from the ED.

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Section: Discussionmentioning

confidence: 63%

Role of Point‐of‐Care Lung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure

Hacıalioğulları

Yılmaz²,

Yılmaz

et al. 2020

J of Ultrasound Medicine

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“…Experts’ comments [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ,…”

Section: Recommendationsunclassified

Recommendations for Lung Ultrasound in Internal Medicine

et al. 2020

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A growing amount of evidence prompts us to update the first version of recommendations for lung ultrasound in internal medicine (POLLUS-IM) that was published in 2018. The recommendations were established in several stages, consisting of: literature review, assessment of literature data quality (with the application of QUADAS, QUADAS-2 and GRADE criteria) and expert evaluation carried out consistently with the modified Delphi method (three rounds of on-line discussions, followed by a secret ballot by the panel of experts after each completed discussion). Publications to be analyzed were selected from the following databases: Pubmed, Medline, OVID, and Embase. New reports published as of October 2019 were added to the existing POLLUS-IM database used for the original publication of 2018. Altogether, 528 publications were systematically reviewed, including 253 new reports published between September 2017 and October 2019. The new recommendations concern the following conditions and issues: pneumonia, heart failure, monitoring dialyzed patients’ hydration status, assessment of pleural effusion, pulmonary embolism and diaphragm function assessment. POLLUS-IM 2020 recommendations were established primarily for clinicians who utilize lung ultrasound in their everyday clinical work.

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“…A prospective study compared multiple techniques including IVC diameter, lung ultrasound, bioimpedance analysis, and NT-proBNP to monitor a cohort of HF patients. On multivariate analysis, they found that IVC collapse, NT-proB-NP, and lung ultrasound, but not bioimpedance analysis, were useful in predicting patients at high rates of readmission [16]. New prospective data were recently published, which studied IVC diameter and CI at discharge and hospital follow-up, concluded that larger IVC diameters with less collapsibility were significantly associated with 90-day readmission [17].…”

Section: Evaluation Of Hfmentioning

confidence: 99%

Utilization of Ultrasound to Assess Volume Status in Heart Failure

Khan

Shadi

et al. 2020

J Clin Med Res

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Heart failure (HF) represents a significant financial burden to the US health care system, affecting approximately 5.7 million Americans. By 2030, the prevalence of HF is expected to increase by 23%. Clinicians generally evaluate volume status in patients with HF by visualizing jugular venous distension to estimate right atrial pressure; a method with an estimated accuracy of only 50%. Currently, the only endorsed methods for acute HF diagnosis in the 2017 American College of Cardiology (ACC) guidelines are brain natriuretic peptide (BNP) or Nterminal pro-B-type natriuretic peptide (NT-proBNP), pre-discharge BNP or NT-proBNP, and myocardial fibrosis markers. However, serial testing of BNP to monitor therapy remains controversial. Moreover, an elevated BNP cannot be attributed solely to a cardiac cause. Given the limitations of the current methods, a robust tool is needed to reliably assess volume status in HF patients. It is now known that hemodynamic congestion from increases in intracardiac pressure occurs days to weeks prior to the onset of typical HF symptoms, such as weight gain and shortness of breath. It has been postulated that assessing the inferior vena cava (IVC) diameter with a portable ultrasound, may be the simple, reliable, and cost-effective method of evaluating right atrial pressure, and thus, the severity of HF. Given this exciting new tool in assessing volume status in patients with HF, we pose the question of whether this imaging modality can be used to risk-stratify patients and guide management. The aim of this paper is to highlight the many benefits of portable ultrasound in assessing volume status in this population, and to discuss whether this imaging modality can help guide physicians in the management of their HF patients.

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Comparison between inferior vena cava ultrasound, lung ultrasound, bioelectric impedance analysis, and natriuretic peptides in chronic heart failure

Abstract: Evaluation of congestion in outpatients with chronic HF may be based on NTproBNP, IVC ultrasound, or lung ultrasound; they are useful in identifying patients at high risk of hospitalization or death due to HF.

Cited by 33 publications

References 45 publications

Role of Point‐of‐Care Lung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure

Role of Point‐of‐Care Lung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure

Recommendations for Lung Ultrasound in Internal Medicine

Utilization of Ultrasound to Assess Volume Status in Heart Failure

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