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Lung ultrasound in congestion assessment of patients with advanced heart failure referred for heart transplant: Correlations with right heart catheterization findings.
München Barth, Fernanda; Beck-da-Silva, Luís; Ghisleni, Eduarda Chiesa; Butzke, Maurício; Scolari, Fernando Luís; da Silva Matte, Bruno; Biolo, Andréia.
Affiliation
  • München Barth F; Cardiology Division at Hospital de Clínicas de Porto Alegre.
  • Beck-da-Silva L; Cardiology Division at Hospital de Clínicas de Porto Alegre.
  • Ghisleni EC; Post-Graduate Program in Cardiology and Cardiovascular Science at the Medical School of the Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Butzke M; Post-Graduate Program in Cardiology and Cardiovascular Science at the Medical School of the Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Scolari FL; Cardiology Division at Hospital de Clínicas de Porto Alegre.
  • da Silva Matte B; Cardiology Division at Hospital de Clínicas de Porto Alegre.
  • Biolo A; Cardiology Division at Hospital de Clínicas de Porto Alegre.
Am Heart J Plus ; 26: 100250, 2023 Feb.
Article in En | MEDLINE | ID: mdl-38510182
ABSTRACT

Background:

In advanced heart failure (HF), diagnostic performance of physical exam may be poor. Physical examination associated with lung ultrasound (LUS) may be an important tool to facilitate congestion screening.

Objective:

To evaluate performance of LUS for congestion screening in advanced HF referred for transplant, as compared to findings of right heart catheterization (RHC).

Methods:

Prospective study of 23 subjects with advanced HF referred for RHC. LUS was performed in association with clinical congestion score (CCS), analogue-visual dyspnea scale (AVDS) and presence of trepopnea/bendopnea prior to catheterization. Congestion was assessed by the number of B-lines in the LUS, and by findings of physical examination as well as by NT-proBNP serum values.

Results:

Congestion was present in 43.4 % of patients by LUS (B-lines ≥ 15), as compared to 21.7 % by CCS (score greater than or equal to 5), 56.5 % by NT-proBNP (>1000 pg/ml), and 60.8 % by pulmonary capillary wedge pressure (PCWP) (>15 mm Hg). The number of B-lines was correlated to cardiac index (CI) (rho = -0.619; p 0.002), but not with PCWP (rho 0.190; p 0.386), RAP (rho -0.244; p 0.262), CCS (rho 0.198; p 0.36) and neither with NT-proBNP (rho 0.282; p 0.193). Otherwise, NT-proBNP was correlated with PCWP (rho = 0.636; p = 0.001) and with CI (rho -0.667 p 0.001).

Conclusions:

In advanced HF patients referred for transplant, number of B-lines in LUS was not correlated with PCWP or RAP. Advanced HF patients seem to have increased filling pressures, but no interstitial pulmonary congestion that LUS could detect.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Am Heart J Plus Year: 2023 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Am Heart J Plus Year: 2023 Document type: Article