Author + information
- Marcelo Haertel Miglioranza,
- Luna Gargani,
- Roberto Sant'Anna,
- Marciane Rover,
- Vitor M. Martins,
- Augusto Mantovani,
- Cristina Weber,
- Maria Antonieta Moraes,
- Carlos Jader Feldman,
- Eugenio Picano,
- Rosa Sicari,
- Renato Kalil and
- Tiago Leiria
Evaluation of pulmonary congestion (PC) is a diagnostic challenge even by highly skilled clinicians. Recently, lung ultrasound (LUS) has been proposed for a reliable, easy evaluation of PC, by assessment of B-lines. Our aim was to test LUS performance as part of the evaluation of heart failure (HF) patient in an outpatient clinic.
97 patients with advanced systolic HF were enrolled. Analyses were performed to compare LUS to NT-proBNP, echocardiography, combined NT-proBNP + echocardiography method (COMB) and to a previously validated clinical congestion score (CCS).
Mean age was 52±9yrs (61% male); 48% had dilated cardiomyopathy HF (mean ejection fraction 28±4%). PC was present in 58% patients when estimated by CCS, 68% by LUS, 53% by NT-proBNP, 65% by E/E'≥15 and 75% by COMB. B-lines number was correlated to NT-proBNP (r=.72; p<.0001), E/E'ratio (r=.68; p<.0001) and CCS (r=.42; p<.0001). LUS and CCS were tested in a multiple ROC analyses (figure). Considering combined method (E/E'≥15 and/or NT-proBNP>1000pg/mL) as reference for PC, ROC analysis yielded a C statistic of .89 for LUS (95% Cl: .82.96), with a cut-off of >15 B-lines to maximize sensitivity (85%) and specificity (83%).
In a HF outpatient clinic, LUS B-lines correlated significantly to more established parameters of decompensation presenting always a high accuracy. Given its accuracy, LUS should be considered a useful tool for a quick and reliable assessment of PC in HF outpatients.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: LV Diastolic Function
Abstract Category: 18. Imaging: Echo
Presentation Number: 1143-359
- 2013 American College of Cardiology Foundation