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Prognostic Value of Lung Ultrasound B-Lines in Systemic Sclerosis.
Gargani, Luna; Bruni, Cosimo; Romei, Chiara; Frumento, Paolo; Moreo, Antonella; Agoston, Gergely; Guiducci, Serena; Bellando-Randone, Silvia; Lepri, Gemma; Belloli, Laura; Della Rossa, Alessandra; Delle Sedie, Andrea; Stagnaro, Chiara; De Nes, Michele; Salvadori, Stefano; Mosca, Marta; Falaschi, Fabio; Epis, Oscar; Picano, Eugenio; Matucci-Cerinic, Marco.
Afiliación
  • Gargani L; Institute of Clinical Physiology, National Research Council, Pisa, Italy. Electronic address: gargani@ifc.cnr.it.
  • Bruni C; Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy.
  • Romei C; 2nd Radiology Unit, Azienda Ospedaliero Universitaria Pisa, Italy.
  • Frumento P; Department of Political Sciences, University of Pisa, Pisa, Italy.
  • Moreo A; Department of Political Sciences, University of Pisa, Pisa, Italy.
  • Agoston G; Cardiology and Rheumatology Department, Niguarda Hospital, Milan, Italy.
  • Guiducci S; Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy.
  • Bellando-Randone S; Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy.
  • Lepri G; Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy.
  • Belloli L; Department of Political Sciences, University of Pisa, Pisa, Italy.
  • Della Rossa A; Department of Family Medicine, University of Szeged, Szeged, Hungary and Rheumatology Unit, University of Pisa, Pisa, Italy.
  • Delle Sedie A; Department of Family Medicine, University of Szeged, Szeged, Hungary and Rheumatology Unit, University of Pisa, Pisa, Italy.
  • Stagnaro C; Department of Family Medicine, University of Szeged, Szeged, Hungary and Rheumatology Unit, University of Pisa, Pisa, Italy.
  • De Nes M; Institute of Clinical Physiology, National Research Council, Pisa, Italy.
  • Salvadori S; Institute of Clinical Physiology, National Research Council, Pisa, Italy.
  • Mosca M; Department of Family Medicine, University of Szeged, Szeged, Hungary and Rheumatology Unit, University of Pisa, Pisa, Italy.
  • Falaschi F; 2nd Radiology Unit, Azienda Ospedaliero Universitaria Pisa, Italy.
  • Epis O; Department of Political Sciences, University of Pisa, Pisa, Italy.
  • Picano E; Institute of Clinical Physiology, National Research Council, Pisa, Italy.
  • Matucci-Cerinic M; Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy.
Chest ; 158(4): 1515-1525, 2020 10.
Article en En | MEDLINE | ID: mdl-32360727
BACKGROUND: A high percentage of systemic sclerosis (SSc) patients experience interstitial lung disease (ILD) during the disease course. Recent data have shown that lung ultrasound (LUS) can assess ILD by the evaluation of B-lines, the sonographic sign of pulmonary interstitial involvement. RESEARCH QUESTION: To establish the prognostic value of B-lines in a large number of patients with SSc. STUDY DESIGN AND METHODS: A total of 396 consecutive patients with SSc, who were enrolled at three Rheumatology Departments, underwent a comprehensive LUS examination on the anterolateral and posterior chest for a total of 58 scanning sites. All available clinical, imaging, and functional data were recorded. Patients were followed after enrolment to establish the prognostic role of LUS. RESULTS: The median number of B-lines was higher in patients with the diffuse cutaneous subset (44 vs 17 B-lines; P < .0001), topoisomerase I autoantibodies (39 vs 16 B-lines; P < .0001), and the presence of ILD at chest high-resolution CT (45 vs 9 B-lines; P < .0001). At multivariable analysis, the number of posterior B-lines ≥5 was associated with new development or worsening ILD (hazard ratio, 3.378; 95% CI, 1.137-9.994; P = .028), with additional value over topoisomerase I positivity. The prognostic value was further confirmed in the subgroup of patients with known ILD at baseline (hazard ratio, 1.010; 95% CI, 1.003-1.018; P = .008). INTERPRETATION: Lung ultrasound B-lines are associated with worsening or development of pulmonary deterioration. In the near future, LUS might become part of the diagnostic and prognostic armamentarium in patients with SSc, which would allow a more sustainable and user-friendly approach to this very fragile population.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Esclerodermia Sistémica / Enfermedades Pulmonares Intersticiales Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Chest Año: 2020 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Esclerodermia Sistémica / Enfermedades Pulmonares Intersticiales Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Chest Año: 2020 Tipo del documento: Article