Prognostic value of multimodal assessment of congestion in acute heart failure

Rubio-Gracia, Jorge; Giménez-López, Ignacio; Josa-Laorden, Claudia; Sánchez‐Marteles, Marta; Garcés-Horna, V.; Laiglesia, Fernando José Ruiz; Legarre, P. Sampériz; Juana, E. Bueno; Amores-Arriaga, Beatriz; Pérez-Calvo, Juan Ignacio

doi:10.1016/j.rceng.2019.10.013

Cited by 5 publications

(5 citation statements)

References 44 publications

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“…In contrast, Marini C et al did not show that pharmacological treatment of AHF under pulmonary ultrasound guidance had an impact on patient mortality at 90-day follow-up [35]. Also, other investigators did not confirm that the severity of lung ultrasound lesions influenced the prognosis of patients hospitalized for cardiovascular decompensation, while NTproBNP levels proved to be an independent prognostic factor [36]. According to other authors, both elevated NTproBNP levels and B-line counts ≥15 were associated with the risk of death and hospitalization for heart failure [37].…”

Section: Discussionmentioning

confidence: 93%

The Importance of Lung Ultrasound and IGFBP7 (Insulin-like Growth Factor Binding Protein 7) Assessment in Diagnosing Patients with Heart Failure

Szyszkowska,

Olesiewicz,

Płońska-Korabiewska

et al. 2024

JCM

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Background: In daily practice, there are problems with adequately diagnosing the cause of dyspnea in patients with heart failure with preserved and mildly reduced ejection fractions (HFpEF and HFmrEF). This study aimed to assess the usefulness of lung ultrasound in diagnosing HFpEF and HFmrEF and determine its correlation with IGFBP7 (insulin-like growth factor binding protein 7), NTproBNP (N-terminal pro–B-type natriuretic peptide), and echocardiographic markers. Methods: The research was conducted on 143 patients hospitalized between 2018 and 2020, admitted due to dyspnea, and diagnosed with HFpEF and HFmrEF. Venous blood was collected from all participants to obtain basic biochemical parameters, NTproBNP, and IGFBP7. Moreover, all participants underwent echocardiography and transthoracic lung ultrasound. Two years after hospitalization a follow-up telephone visit was performed. Results: The number of B-lines in the LUS ≥ 16 was determined with a sensitivity of—73% and specificity of—62%, indicating exacerbation of heart failure symptoms on admission. The number of B-lines ≥ 14 on admission was determined as a cut-off point, indicating an increased risk of death during the 2-year follow-up period. The factors that significantly impacted mortality in the study patient population were age and the difference between the number of B-lines on ultrasound at admission and at hospital discharge. IGFBP7 levels had no significant effect on the duration of hospitalization, risk of rehospitalization, or mortality during follow-up. Conclusions: Lung ultrasonography provides additional diagnostic value in patients with HFpEF or HFmrEF and exacerbation of heart failure symptoms. The number of B-lines ≥ 14 may indicate an increased risk of death.

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Section: Discussionmentioning

confidence: 93%

The Importance of Lung Ultrasound and IGFBP7 (Insulin-like Growth Factor Binding Protein 7) Assessment in Diagnosing Patients with Heart Failure

Szyszkowska,

Olesiewicz,

Płońska-Korabiewska

et al. 2024

JCM

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“…En un paciente con IC crónica la presencia de signos clínicos de congestión traduce un estado de sobrecarga de volumen, y se correlaciona con mayor gravedad del cuadro y peor pronóstico 7 , especialmente si estos no responden de forma adecuada a la intensificación del tratamiento. En la actualidad se disponen de diferentes herramientas que pue-den ayudar en el reto clínico que supone la identificación del estado congestivo en pacientes con IC 8 , lo que incluye, entre otras, las técnicas de imagen y los biomarcadores; aun así, cabe resaltar el valor diagnóstico y pronóstico que continúa teniendo una detallada exploración física en la consulta 7 . Las descompensaciones congestivas constituyen el motivo más frecuente de hospitalización por agudización en los pacientes con IC; la necesidad de ingreso por este motivo se correlaciona con un incremento de la mortalidad, que es más marcado durante el periodo inmediato tras una hospitalización reciente 9 y en caso de hospitalizaciones recurrentes 10 .…”

Section: Discussionunclassified

Valor pronóstico de un nuevo modelo de evaluación clínica de pacientes ambulatorios con insuficiencia cardiaca

et al. 2022

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“…The LUS showed higher sensitivity ratio 1.2 (95% CI, 1.08-1.34; p < 0.001) compared with CxR [62,63,71], computerized tomography (CT) , and echocardiogram [74] in the diagnosis of HF, and using LUS with the clinical evaluation reduced diagnostic errors as compared to [CxR+Nt-proBNP] combination [64]. However, mortality was associated to significantly lower IVC collapse [65,70,71], and a greater number of lung B-lines; and higher NT-proBNP levels [65,[68][69][70] without differences in the BIA parameters. Among the most individuals with ambulatory follow-up and preserved ejection fraction [66,73], the submaximal exercise increases B-lines number to level of higher probability of 12-month all-cause death or/ and higher probability of HF decompensation [45,[50][51][52]56,61].…”

Section: Risk Of Readmission and Mortality With 3month Follow-upmentioning

confidence: 99%

Prognostic significance of Lung ultrasound for Heart Failure Patient Management in Primary Care. A Systematic Review

Panisello-Tafalla,

Montoya,

Caballol-Angelats

et al. 2024

Preprint

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Heart failure (HF) affects about 60 million people worldwide, making it one of the chronic conditions with the greatest health and economic impact. The primary objective was to assess the efficacy of lung ultrasound (LUS) in the management of HF in order to intervene early and reduce the rate of hospital readmissions. A systematic search was conducted on PubMed, Embase, Google Scholar, Web of Science, and Scopus, including clinical trials, meta-analysis, systematic reviews, and original articles from 2019/1/1-2023/12/31, about LUS for the assessment of HF, on an outpatient basis, for HF diagnosis or/and decompensation. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 873 articles were identified of which 33 articles were selected: [n=19] focused on prognostic assessment of HF, [n=11] centred on multimodal diagnostic assessments, and [n=2] addressing therapeutic guidance for HF diagnosis. LUS exhibits advantages in the detection of sub-clinical congestion linked to prognostic significance in re-admission and mortality during out-patient follow-up, after hospital discharge, and in complex scenarios as the patients' homes or institutional long-term care facilities. However, there are considerable uncertainties in their interpretation and monitoring changes due to its lack of standardization. The need for an updated international consensus on the use of LUS seems obvious.

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Prognostic value of multimodal assessment of congestion in acute heart failure

Cited by 5 publications

References 44 publications

The Importance of Lung Ultrasound and IGFBP7 (Insulin-like Growth Factor Binding Protein 7) Assessment in Diagnosing Patients with Heart Failure

The Importance of Lung Ultrasound and IGFBP7 (Insulin-like Growth Factor Binding Protein 7) Assessment in Diagnosing Patients with Heart Failure

Valor pronóstico de un nuevo modelo de evaluación clínica de pacientes ambulatorios con insuficiencia cardiaca

Prognostic significance of Lung ultrasound for Heart Failure Patient Management in Primary Care. A Systematic Review

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