Purpose: To evaluate the potential confounding effect of concomitant pneumonia (PNM) on lung ultrasound (LUS) B-lines in acute heart failure (AHF).& nbsp;Methods: We enrolled 86 AHF patients with (31 pts, AHF/PNM) and without (55 pts, AHF) concomitant PNM. LUS B-lines were evaluated using a combined antero-lateral (AL) and posterior (POST) approach at admission (T0), after 24 h from T0 (T1), after 48 h from T0 (T2) and before discharge (T3). B-lines score was calculated at each time point on AL and POST chest, dividing the number of B-lines by the number of explorable scanning sites. The decongestion rate (DR) was calculated as the difference between the absolute B-lines number at discharge and admission, divided by the number of days of hospitalization. Patients were followed-up and hospital readmission for AHF was considered as adverse outcome.& nbsp;Results: At admission, AHF/PNM patients showed no difference in AL B-lines score compared with AHF patients [AHF/PNM: 2.00 (IQR: 1.44-2.94) vs. AHF: 1.65 (IQR: 0.50-2.66), p = 0.072], whereas POST B-lines score was higher [AHF/PNM: 3.76 (IQR: 2.70-4.77) vs. AHF = 2.44 (IQR: 1.20-3.60), p < 0.0001]. At discharge, AL B-lines score [HR: 1.907 (1.097-3.313), p = 0.022] and not POST B-lines score was found to predict adverse events (AHF rehospitalization) after a median follow-up of 96 days (IQR: 30-265) in the overall population.& nbsp;Conclusions: Assessing AL B-lines alone is adequate for diagnosis, pulmonary congestion (PC) monitoring and prognostic stratification in AHF patients, despite concomitant PNM.

Diagnostic and Prognostic Value of Lung Ultrasound B-Lines in Acute Heart Failure With Concomitant Pneumonia / Mazzola, M; Pugliese, NR; Zavagli, M; De Biase, N; Bandini, G; Barbarisi, G; D'Angelo, G; Sollazzo, M; Piazzai, C; David, S; Masi, S; Moggi-Pignone, A; Gargani, L. - In: FRONTIERS IN CARDIOVASCULAR MEDICINE. - ISSN 2297-055X. - ELETTRONICO. - 8:(2021), pp. 693912-693912. [10.3389/fcvm.2021.693912]

Diagnostic and Prognostic Value of Lung Ultrasound B-Lines in Acute Heart Failure With Concomitant Pneumonia

Zavagli, M;Bandini, G;Barbarisi, G;D'Angelo, G;Sollazzo, M;Piazzai, C;Moggi-Pignone, A;Gargani, L
2021

Abstract

Purpose: To evaluate the potential confounding effect of concomitant pneumonia (PNM) on lung ultrasound (LUS) B-lines in acute heart failure (AHF).& nbsp;Methods: We enrolled 86 AHF patients with (31 pts, AHF/PNM) and without (55 pts, AHF) concomitant PNM. LUS B-lines were evaluated using a combined antero-lateral (AL) and posterior (POST) approach at admission (T0), after 24 h from T0 (T1), after 48 h from T0 (T2) and before discharge (T3). B-lines score was calculated at each time point on AL and POST chest, dividing the number of B-lines by the number of explorable scanning sites. The decongestion rate (DR) was calculated as the difference between the absolute B-lines number at discharge and admission, divided by the number of days of hospitalization. Patients were followed-up and hospital readmission for AHF was considered as adverse outcome.& nbsp;Results: At admission, AHF/PNM patients showed no difference in AL B-lines score compared with AHF patients [AHF/PNM: 2.00 (IQR: 1.44-2.94) vs. AHF: 1.65 (IQR: 0.50-2.66), p = 0.072], whereas POST B-lines score was higher [AHF/PNM: 3.76 (IQR: 2.70-4.77) vs. AHF = 2.44 (IQR: 1.20-3.60), p < 0.0001]. At discharge, AL B-lines score [HR: 1.907 (1.097-3.313), p = 0.022] and not POST B-lines score was found to predict adverse events (AHF rehospitalization) after a median follow-up of 96 days (IQR: 30-265) in the overall population.& nbsp;Conclusions: Assessing AL B-lines alone is adequate for diagnosis, pulmonary congestion (PC) monitoring and prognostic stratification in AHF patients, despite concomitant PNM.
2021
8
693912
693912
Mazzola, M; Pugliese, NR; Zavagli, M; De Biase, N; Bandini, G; Barbarisi, G; D'Angelo, G; Sollazzo, M; Piazzai, C; David, S; Masi, S; Moggi-Pignone, A...espandi
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1246739
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