Objective:arterial hypertension is a major pandemic in the modern world and is a common cause of heart failure. Identification of pulmonary and venous congestion is relevant in patients with arterial hypertension(AH) and decompensated heart failure (DHF)Design and method:to assess the severity and dynamics of venous congestion (VC) by VExUS (including the study of the inferior vena cava (IVC), porto-hepatic and renal blood flow), and pulmonary congestion (PC) by LUS (with B-lines assessment according to 8-zone method) in patients with AH and DHF at admission to hospital and at discharge. The PC was defined as the sum of B-lines of more than 5 (6–15, 16–30 and> 30 - light, moderate and severe pulmonary congestion, respectively). Standard examinations and assessment of VC and LUS were performed in 52 patients with AH and DHF in the first 48 hours after admission and at discharge (men 48%, age 70 ± 11 years (M ± SD), atrial fibrillation 60%, diabetes 40%, chronic anemia 27%, left ventricle ejection fraction (LVEF) 50 [40; 57] %, EF < 40% - 29%, NTproBNP 1421 [754; 2024] pg/ml (Me; IQR)). To assess the severity of clinical symptoms and signs of congestion, the composite congestion score (CCS) was assessed: 0 - no congestion; 1–2-moderate; > = 3 severe congestion.Results:at admission, 27% of patients had moderate congestion according to CCS scale, 65% had severe congestion. In 31%, 13% and 17% of patients, mild, moderate and severe VC was revealed, respectively. Mild, moderate and severe PC was detected in 21%, 27% and 48% of patients, respectively. Congestion was present in 50% of patients at discharge according to CCS scale (moderate-42%, severe-8%). VC persisted in 38% of patients:mild in 20%, moderate–in 12%, severe–in 6% of cases. At discharge, PC was still present in 44% of patients. 15% of patients had mild PC, 20%-moderate and 9%-severe. VC and PC significantly correlated with NT-proBNP (r = 0.3,p = 0.03 and r = 0.41,p = 0.003,respectively) and with each other (r = 0.35,p = 0.01)Conclusions:Correlations between venous congestion assessed by VEXUS protocol and PC by LUS with NtproBNP in patients with AH and DHF were revealed

Objective:comprehensive assessment of venous congestion (VC) is relevant in patients with arterial hypertension (AH) and decompensated heart failure (DHF).Design and method: to assess the incidence and severity of VC according to the VExUS protocol (assessment of the IVC diameter, the shape of the portohepatic and renal veins blood flow) and to assess the relationship of VC to the liver stiffness (LS), estimated by transient elastography (TE), in patients with AH and DHF on admission and their dynamic changes during ospitalisation. The METAVIR scale was used to interpret the stages of fibrosis.Routine clinical assessment, VExUS, TE was performed in 52 patients with AH and DHF (men 48%, age 70 ± 11 years (M ± SD), atrial fibrillation 60%, diabetes 40%, chronic anemia 27%, left ventricle ejection fraction (EF LV) 50 [40; 57] %, EF < 40% - 29%,NTproBNP 1421 [754; 2024] pg/ml (Me; IQR)). Exclusion criteria: primary chronic liver disease or acute hepatitis, severe tricuspid regurgitationResults:on admission mild, moderate and severe venous congestion were detected in 31%, 13%, 17% of patients, respectively. 79% of patients had increased liver stiffness - 22% had F1 / F2, 17% had F3 and 40% had F4.At discharge, venous congestion was observed in 38% of patients. Mild, moderate and severe venous congestion was detected in 20%, 12%, 6% of cases respectively. An increase in liver stiffness at discharge was detected in 54%. 29% of patients had F1 / F2, 13% had F3, and 12% had F4.The dynamics of clinical signs of congestion on admission and at discharge is presented in Diagram 1.A significant correlation between severity of VC and degree of increase in LS was observed (r = 0.43, p = 0.001). There is a positive correlation between the LS and VC with NT-proBNP (r = 0.47, p = 0.04 and r = 0.30, p = 0.03, respectively), a significant negative correlation between the severity of VC and LVEF (r = -0.49; p = 0.000), and between the degree of LS with LVEF (r = -0.33; p = 0.018).Conclusions: Correlations were revealed between venous congestion, by VEXUS protocol, and LS in TE with LVEF in patients with AH and DHF