Lung ultrasound and short-term prognosis in heart failure patients

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• 作者：Chiara Cogliati^a ; ¹ ; ^{chiaracogliati@fastwebnet.it" class="auth_mail" title="E-mail the corresponding author} ; Giovanni Casazza^b ; ¹ ; ^{giovanni.casazza@unimi.it" class="auth_mail" title="E-mail the corresponding author} ; Elisa Ceriani^c ; ¹ ; ^{elisa.ceriani@live.com" class="auth_mail" title="E-mail the corresponding author} ; Daniela Torzillo^a ; ¹ ; ^{danielatorzillo@alice.it" class="auth_mail" title="E-mail the corresponding author} ; Stefano Furlotti^a ; ¹ ; ² ; ^{s.furlotti@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ilaria Bossi^d ; ¹ ; ^{ilariaiaia@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Tarcisio Vago^e ; ¹ ; ^{vago.tarcisio@hsacco.it" class="auth_mail" title="E-mail the corresponding author} ; Giorgio Costantino^c ; ¹ ; ^{giorgio.costantino@unimi.it" class="auth_mail" title="E-mail the corresponding author} ; Nicola Montano^c ; ¹ ; ^{nicola.montano@unimi.it" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Lung ultrasound ; Heart failure ; Prognosis ; B-lines
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 September 2016
• 年：2016
• 卷：218
• 期：Complete
• 页码：104-108
• 全文大小：314 K

文摘

Heart failure (HF) is the leading cause of hospitalization for patients older than 65 years, with a 30-day readmission rate of 20–25%. Although several markers have been evaluated to stratify timing of follow-up after an acute decompensation is mostly based on clinical judgment.

Lung ultrasound (LUS) has been demonstrated to be a valid tool for the assessment and monitoring of pulmonary congestion. Aim of our study was to evaluate if LUS performed in HF patients at discharge could predict 100-day hospital readmission or death.

Methods

One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive (≥ 3 B-lines) sector. Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 100-day events.

Results

Follow-up was obtained in 149 patients. Thirty-four events were recorded. Sonographic score was significantly associated with events (HR 1.19; CI 1.05 to 1.34; p = 0.005). On average, the increase of 1 point in the sonographic score was associated with an increase of approximately 24% in the risk of event within 100 days. At multivariate analysis NTproBNP remained the only independent prognostic factor.

Conclusions

We confirmed that B-lines at discharge are a prognostic marker for hospital readmission and death at 100 days in HF patients. Nevertheless, further randomized clinical studies are needed to definitely support the routine use of LUS in the clinical management of HF patients, in combination or not with NT-proBNP.