Valor pronóstico de la ecografía de pulmón en pacientes ambulatorios con insuficiencia cardiaca crónica estable

Translated title of the contribution: Prognostic value of lung ultrasound in chronic stable ambulatory heart failure patients

Mar Domingo, Laura Conangla, Josep Lupón, Marta de Antonio, Pedro Moliner, Evelyn Santiago-Vacas, Pau Codina, Elisabet Zamora, Germán Cediel, Beatriz González, Violeta Díaz, Carmen Rivas, Patricia Velayos, Javier Santesmases, Ana Pulido, Eva Crespo, Antoni Bayés-Genís*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction and objectives: The role of lung ultrasound (LUS) in acute heart failure (HF) has been widely studied, but little is known about its usefulness in chronic HF. This study assessed the prognostic value of LUS in a cohort of chronic HF stable ambulatory patients. Methods: We included consecutive outpatients who attended a scheduled follow-up visit in a HF clinic. LUS was performed in situ. The operators were blinded to clinical data and examined 8 thoracic areas. The sum of B-lines across all lung zones and the quartiles of this addition were used for the analyses. Linear regression and Cox regression analyses were performed. The main clinical outcomes were a composite of all-cause death or hospitalization for HF and mortality from any cause. Results: A total of 577 individuals were included (72% men; 69 ± 12 years). The mean number of B-lines was 5 ± 6. During a mean follow-up of 31 ± 7 months, 157 patients experienced the main clinical outcome and 111 died. Having ≥ 8 B-lines (Q4) doubled the risk of experiencing the composite primary event (P < .001) and increased the risk of death from any cause by 2.6-fold (P < .001). On multivariate analysis, the total sum of B-lines remained independent predictive factor of the composite endpoint (HR, 1.04; 95%CI, 1.02-1.06; P = .002) and of all-cause death (HR, 1.04; 95%CI, 1.02-1.07; P = .001), independently of whether or not N-terminal pro-B-type natriuretic peptide (NT-proBNP) was included in the model (P = .01 and P = .008, respectively), with a 3% to 4% increased risk for each 1-line addition. Conclusions: LUS identified patients with stable chronic HF at high risk of death or HF hospitalization.

Translated title of the contributionPrognostic value of lung ultrasound in chronic stable ambulatory heart failure patients
Original languageSpanish
JournalRevista Espanola de Cardiologia
DOIs
Publication statusAccepted in press - 2020

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