B‐Lines in Assessment of Pulmonary Hypertension in Patients With Interstitial Lung Diseases

Abstract

ulmonary hypertension is a common and important complication of interstitial lung diseases, which substantially affects the exercise tolerance and survival of patients with these diseases. Right heart catheterization is the reference standard for measurement of pulmonary artery (PA) pressure; however, it is an invasive technique and is not always performed for patients with interstitial lung diseases. Transthoracic echocardiography is a useful technique for noninvasive estimation of PA pressure 1,2 through tricuspid regurgitation or pulmonary valve regurgitation and is readily available anywhere. -Zhi Zheng, PhD, MD, Quan Zheng, MS, Jing Zhou, BS, Bin Yang, PhD, MD Received October 23, 2014, Xiao ORIGINAL RESEARCHObjectives-This study was conducted to evaluate the value of sonographic B-lines (previously called "comet tail artifacts") in assessment of pulmonary hypertension in patients with interstitial lung diseases.Methods-One hundred thirty-four patients with clinically diagnosed interstitial lung diseases complicated by pulmonary hypertension underwent transthoracic lung sonography and Doppler echocardiography for assessment of the presence of B-lines, the distance between them, and the pulmonary artery (PA) systolic pressure. A correlation analysis and a receiver operating characteristic curve analysis were performed.Results-All patients had diffuse bilateral B-lines. The maximum number of B-lines seen in any positive zone (not a summation) was significantly correlated with the severity of PA systolic pressure (r = 0.812; P < .0001), and a linear regression equation could be demonstrated: that is, y = 6.06 x + 17.57, where x and y represent the number of Blines and PA systolic pressure, respectively. A cutoff of more than 4 B-lines seen in any positive zone had 89.5% sensitivity, 85.0% specificity, and 87.2% accuracy in predicting elevated PA pressure (>30 mm Hg).Conclusions-The number of B-lines is useful in assessment of pulmonary hypertension, especially when tricuspid regurgitation and pulmonary valve regurgitation do not exist or cannot be satisfactorily measured by Doppler echocardiography.

Double Doppler Tei index combined with lung ultrasound to evaluate the right ventricular function and lung condition in neonates with pulmonary hypertension

“…Previous literature has reported that the number of pulmonary ultrasound B lines is highly correlated with the severity of pulmonary edema 19,20 . There was also a positive correlation between pulmonary B lines with pulmonary artery pressure 21 . However, newborn infants' lung volume and coastal space were small, and the number of lung B lines was sometimes difficult to distinguish and accurately count.…”

“…19,20 There was also a positive correlation between pulmonary B lines with pulmonary artery pressure. 21 However, newborn infants' lung volume and coastal space were small, and the number of lung B lines was sometimes difficult to distinguish and accurately count. The proposal of LUS provides quantitative indicators for clinical practice, which could reflect the more comprehensive and systematic nature and severity of lung lesions.…”

Contribution of cardiopulmonary ultrasound in monitoring disease progression and curative effect in rat model of monocrotaline-induced pulmonary arterial hypertension

“…And previous studies had applied CPUS to analyze the relationship between B-line and pulmonary artery pressure in patients with interstitial pulmonary disease. The result had shown that the number of B-line was positively correlated with the systolic pulmonary artery pressure [29]. In this study, we used CPUS to monitoring disease progression and curative effect in rat model of monocrotaline-induced PAH.…”