Update on the Value of Lung Ultrasound Examination in Acute Decompensated Heart Failure Patients with Various Left Ventricular Ejection Fraction

Zhang, Hui; Zhu, Yunlong; Li, Na; Zeng, Jianping

doi:10.31083/j.rcm2310350

Cited by 1 publication

(1 citation statement)

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“…Lung ultrasound (LUS) is a helpful tool to detect pulmonary congestion and can be used to guide the diagnosis, treatment and to define prognosis of acute or chronic HF patients with reduced ejection fraction (HFrEF), with preserved ejection fraction (HFpEF) and HFmrEF. [6][7][8][9] The number of LUS detected B-lines (LUS-BL) associated with the severity of pulmonary congestion. Previous single-centre prospective study showed that the number of LUS-BL assessed early during hospitalisation and at discharge was an independent risk factor for adverse in-hospital and after discharge outcomes in acute HF patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of lung ultrasound detected B-lines on hospitalised ischaemic heart failure with mildly reduced ejection fraction patients

Zhang,

Zhou,

Cheng

et al. 2023

Open Heart

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ObjectivesPrognostic impact of lung ultrasound-derived B-lines (LUS-BL) in heart failure with mildly reduced left ventricular ejection fraction (HFmrEF) patients remains elusive. We evaluated the correlation between LUS-BL and prognosis in HFmrEF patients.MethodsThis is a subgroup analysis based on our previously published retrospective study with 1691 HFmrEF patients. This subgroup analysis involved 574 patients with LUS-BL results at admission. After discharge, patients underwent clinical follow-up for a minimum of 1 year through telephone, clinical visits or community visits. The primary endpoint was defined as cardiovascular (CV) event, including CV-related mortality or HF hospitalisation at 90 days and 1 year after discharge.ResultsCV event at 90 days was significantly increased with higher LUS-BL number (0, 1–2, 3–9 and ≥10: 20%, 14%, 18% and 33%, p=0.008), while CV event rate at 1 year was similar among groups (45% vs 45% vs 42% vs 50%, p=0.573). Older age, hypertension (HR=2.06, 95% CI 1.31 to 3.25), higher right ventricular diameter (>23 mm, HR=2.008, 95% CI 1.37 to 2.94), increased ratio of early transmitral flow velocity to early mitral annular velocity (>24, HR=1.79, 95% CI 1.11 to 2.26) and higher LUS-BL number (>11, HR=1.510, 95% CI 1.01 to 2.26) were identified as independent determinants associated with increased risk of CV event at 90 days after discharge. The Harrell’s C-Statistic analysis, based on the Cox regression models, demonstrated a significant improvement in the predictive ability of the model that incorporated both clinical and echocardiographic risk factors along with LUS-BL (areas under the curve (AUC)=0.72) compared with the model comprising only clinical risk factors and LUS-BL (AUC=0.69, p=0.036), or to the model with echocardiographic risk factors and LUS-BL (AUC=0.68, p=0.025).ConclusionIn HFmrEF patients with ischaemic heart disease, admission LUS-BL>11 is independently associated with an increased risk of CV event at 90 days following discharge.

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Section: Introductionmentioning

confidence: 99%