Quantification of pleural effusions on thoracic ultrasound in acute heart failure

Lindner, Moritz; Thomas, Richard; Claggett, Brian; Lewis, Eldrin F.; Groarke, John D.; Merz, Allison A.; Silverman, Montane B; Swamy, Varsha; Rivero, Jose; Hohenstein, Christian; Solomon, Scott D.; McMurray, John J.V.; Steigner, Michael L.; Platz, Elke

doi:10.1177/2048872620901835

Cited by 22 publications

(32 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2012, a council of experts recommended the use of the 8-zone protocol for the assessment of interstitial syndrome. 16 Our study has some limitations. There were a small number of studies meeting inclusion criteria, and the studies found were heterogeneous in terms of the study period, the number of zones visualized, the cut-off point of B lines, the scales used, and the follow-up time.…”

Section: Discussionmentioning

confidence: 89%

“…High pre-discharge lung ultrasound pleural effusion scale scores (47% residual effusion present) were not associated with increased readmission or death at 90 days (adjusted HR 10 5.95% CI 0.92-1.19; p = 046) while a finding of ≥7 B-lines at discharge was independently associated (adjusted HR 2.43, 95% CI 1.11-5.37; p = 0.027). 16…”

Section: Resultsmentioning

confidence: 99%

“…Studies in the field of acute heart failure with bedside ultrasound evaluation of the vena cava show that patients with plethoric vena cava (greater than 21 mm) and who do not collapse on inspiration have a higher readmission and mortality rate. 16 This parameter can be very important in assessing the degree of pulmonary hypertension and presence of right congestion in patients with acute HF. It can be used in conjunction with lung ultrasound to complement the overall congestion of patients.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic value of B lines detected with lung ultrasound in acute heart failure. A systematic review

Dubón-Peralta

Lorenzo-Villalba

García-Klepzig

et al. 2021

J of Clinical Ultrasound

View full text Add to dashboard Cite

Pulmonary ultrasound is a simple diagnostic tool with immediate results for the assessment of pulmonary congestion in patients with heart failure (HF), allowing optimization of treatment by monitoring the dynamic changes identified. We aimed to evaluate the prognostic significance of the presence of B lines detected by lung ultrasound during hospitalization for heart failure. A search was conducted for scientific articles in PubMed, Embase, Google Scholar, and Cochrane databases including clinical trials, reviews, systematic reviews, and original articles that were related to the prognostic value of lung ultrasound in patients with HF in the last 5 years from 2016 to 2021. Studies including individuals aged ≥18 years evaluating the prognostic value of lung ultrasound in HF were included. Fourteen articles met inclusion criteria for analysis (three reviews, three systematic reviews with meta-analysis, six prospective studies, and two retrospective studies). The presence of more than 30-40 B lines at admission were considered a risk factor for readmission or mortality as was persistent pulmonary congestion with the presence of ≥15 B-lines. The presence of pulmonary congestion detected by lung ultrasound in acute heart failure has prognostic significance in terms of mortality and hospital readmission. Clinical trials are needed to evaluate whether diuretic therapy guided by lung ultrasound and the presence of B lines can reduce readmission and mortality in these patients.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic value of B lines detected with lung ultrasound in acute heart failure. A systematic review

Dubón-Peralta

Lorenzo-Villalba

García-Klepzig

et al. 2021

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

“…Pleural effusions (PEs) scoring method: A semiquantitative score from 0 to 4 points was assigned for each hemithorax and 0 to 8 for both thoraces; thus, the total PEs scores were 0 to 8 for each patient [ 15 ] (Fig. 3 ) (Additional files 1–5: Videos 1–5).…”

Section: Methodsmentioning

confidence: 99%

Cardiopulmonary ultrasound correlates of pleural effusions in patients with congestive heart failure

Chen

2022

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background Pleural effusions are common in patients with congestive heart failure. However, there is a need to assess systematically the correlation between effusion volume, extravascular lung water and echocardiographic parameters. We used combined cardiopulmonary ultrasound to evaluate the relationship between effusion volume, extravascular lung water, and echocardiographic parameters in patients with congestive heart failure. Methods Patients who were hospitalized for congestive heart failure underwent combined cardiopulmonary ultrasound. A semiquantitative score of pleural effusions was derived by pulmonary ultrasound and extravascular lung water was estimated by ultrasound lung comets. The measurements were compared with echocardiographic and clinical results. Results Among 168 patients (median age 66 years, 69.6% men), 102 (60.7%) had pleural effusions, 84.3% bilateral, 10.8% right-sided, and 4.9% left-sided. High pleural effusion scores were associated with high ultrasound lung comet scores (P < 0.0001). Compared with patients without pleural effusions, patients with pleural effusions were significantly older and had higher systolic pulmonary artery pressure (SPAP), NT-proBNP, New York Heart Association scale, larger left atrium, larger right ventricle, more severe mitral regurgitation, and worse left and right heart function. Adjusted for age, multiple logistic regression analysis showed that SPAP (OR 5.688, P = 0.006) and E/A (OR 3.941, P = 0.043) were the significant variables and risk factors associated with pleural effusions in heart failure. Conclusion For patients with left heart failure, the degree of pleural effusions was associated with pulmonary congestion. Elevated SPAP and E/A were the main risk factors for the formation of pleural effusions in patients with congestive heart failure.

show abstract

“…If clinically indicated, patients underwent an upright CXR examination on admission. These CXRs were analysed by radiologists for the presence of vascular congestion, interstitial oedema, and alveolar oedema 5 . Only CXR examinations performed within 1 day of admission based on date change were included in this analysis.…”

Section: Methodsmentioning

confidence: 99%

Sex differences in congestive markers in patients hospitalized for acute heart failure

et al. 2021

Self Cite

View full text Add to dashboard Cite

Aims We sought to examine sex differences in congestion in patients hospitalized for acute heart failure (AHF). Understanding congestive patterns in women and men with AHF may provide insights into sex differences in the presentation and prognosis of AHF patients. Methods and results In a prospective, two-site study in adults hospitalized for AHF, four-zone lung ultrasound (LUS) was performed at the time of echocardiography at baseline (LUS1) and, in a subset, pre-discharge (LUS2). B-lines on LUS and echocardiographic images were analysed offline, blinded to clinical information and outcomes. Among 349 patients with LUS1 data (median age 74, 59% male, and 87% White), women had higher left ventricular ejection fraction (mean 43% vs. 36%, P < 0.001), higher tricuspid annular plane systolic excursion (mean 17 vs. 15 mm, P = 0.021), and higher measures of filling pressures (median E/e′ 20 vs. 16, P < 0.001). B-line number on LUS1 (median 6 vs. 6, P = 0.69) and admission N-terminal pro-B-type natriuretic peptide levels (median 3932 vs. 3483 pg/mL, P = 0.77) were similar in women and men. In 121 patients with both LUS1 and LUS2 data, there was a similar and significant decrease in B-lines from baseline to discharge in both women and men. The risk of the composite 90 day outcome increased with higher B-line number on four-zone LUS2: unadjusted hazard ratio for each B-line tertile was 1.86 (95% confidence interval 1.08-3.20, P = 0.025) in women and 1.65 (95% confidence interval 1.03-2.64, P = 0.037) in men (interaction P = 0.72). Conclusions Among patients with AHF, echocardiographic markers differed between women and men at baseline, whereas B-line number on LUS did not. The dynamic changes in B-lines during a hospitalization for AHF were similar in women and men.

show abstract

Quantification of pleural effusions on thoracic ultrasound in acute heart failure

Cited by 22 publications

References 24 publications

Prognostic value of B lines detected with lung ultrasound in acute heart failure. A systematic review

Prognostic value of B lines detected with lung ultrasound in acute heart failure. A systematic review

Cardiopulmonary ultrasound correlates of pleural effusions in patients with congestive heart failure

Sex differences in congestive markers in patients hospitalized for acute heart failure

Contact Info

Product

Resources

About