Lung Ultrasound: The Cardiologists' New Friend

Miglioranza, Marcelo Haertel; Sousa, Antônio Carlos Sobral; Araujo, Caroline de Souza Costa; Almeida-Santos, Marcos Antônio; Gargani, Luna

doi:10.5935/abc.20170169

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Pulmonary congestion is one of the main causes leading to urgent HF hospitalization and subsequent poor patient outcomes 3,4 . Lung ultrasound (LUS) detects pulmonary congestion with high sensitivity and specificity, which is independently associated with worse prognosis in patients with chronic HF or acutely decompensated HF (ADHF) [5][6][7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Association between right-sided cardiac function and ultrasound-based pulmonary congestion on acutely decompensated heart failure: findings from a pooled analysis of four cohort studies

et al. 2020

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BackgroundRight ventricular (RV) dysfunction and RV-pulmonary artery (PA) uncoupling are associated with the development of pulmonary congestion during exercise. However, there is limited information regarding the association between these right-sided cardiac parameters and pulmonary congestion in acutely decompensated heart failure (HF). MethodsWe performed an individual patient meta-analysis from four cohort studies of hospitalized patients with HF who had available lung ultrasound (B-lines) data on admission and/or at discharge. RV function was assessed by tricuspid annular plane systolic excursion (TAPSE), RV-PA coupling was defined as the ratio of TAPSE to PA systolic pressure (PASP). ResultsAdmission and discharge cohort included 319 patients (75.8±10.1 years, 46% women) and 221 patients (77.9±9.0 years, 47% women), respectively. Overall, higher TAPSE was associated with higher ejection fraction, lower PASP, b-type natriuretic peptide and B-line counts. By multivariable analysis, worse RV function or RV-PA coupling were associated with higher B-line counts on admission and at discharge, and with a less reduction in B-line counts from admission to discharge. Higher B-line counts at discharge were associated with a higher risk of the composite of all-cause mortality and/or HF re-hospitalization [adjusted-HR=1.13 (1.09-1.16), p<0.001]. Furthermore, the absolute risk increase related to high B-line counts at discharge was higher in patients with lower TAPSE. ConclusionsIn patients with acutely decompensated HF, impaired RV function and RV-PA coupling were associated with severe pulmonary congestion on admission, and less resolution of pulmonary congestion during hospital stay.Worse prognosis related to residual pulmonary congestion was enhanced in patients with RV dysfunction.

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Section: Introductionmentioning

confidence: 99%

Association between right-sided cardiac function and ultrasound-based pulmonary congestion on acutely decompensated heart failure: findings from a pooled analysis of four cohort studies

et al. 2020

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“…Management of patients in the acute cardiac care setting is often challenging and obviously time-sensitive. The vast majority of those patients have comorbidities such as COPD, which present with a similar clinical picture, making the differential diagnostic puzzle even more complicated [ 9 ]. It is well known that a holistic assessment of acute cardiovascular pathology requires a multi-organ approach [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

It’s Not All about Echocardiography. Open the Lung Window for the Cardiac Emergencies

et al. 2021

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In the acute cardiac care setting, undifferentiated clinical presentations such as dyspnea, chest pain, shock, and cardiac arrest are common diagnostic challenges for the clinician. Lung ultrasonography is a well-established diagnostic tool which can be integrated in simplified decision making algorithms during the initial approach of the patient, in order to differentiate accurately cardiac from non-cardiac causes and improve the management of time-sensitive cardiovascular emergencies.

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Lung Ultrasound: new Opportunities for a Cardiologist

et al. 2020

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This review focused on ultrasound examination of lungs, a useful complement to transthoracic echocardiography (EchoCG), which is superior to chest X-ray in the diagnostic value. The lung acoustic window always remains open and allows obtaining high-quality images in most cases. For a cardiologist, the major points of the method application are determination of pleural effusion and lung congestion. This method has a number of advantages: it is time-saving; cost-effective; portable and accessible; can be used in a real-time mode; not associated with radiation; reproducible; and highly informative. The ultrasound finding of wet lungs would indicate threatening, acute cardiac decompensation long before appearance of clinical, auscultative, and radiological signs of lung congestion. Modern EchoCG should include examination of the heart and lungs as a part of a single, integrative ultrasound examination.

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Lung Ultrasound: The Cardiologists' New Friend

Cited by 4 publications

References 29 publications

Association between right-sided cardiac function and ultrasound-based pulmonary congestion on acutely decompensated heart failure: findings from a pooled analysis of four cohort studies

Association between right-sided cardiac function and ultrasound-based pulmonary congestion on acutely decompensated heart failure: findings from a pooled analysis of four cohort studies

It’s Not All about Echocardiography. Open the Lung Window for the Cardiac Emergencies

Lung Ultrasound: new Opportunities for a Cardiologist

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