Lung ultrasound in outpatients with heart failure : the wet-to-dry HF study
Domingo, Mar (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Lupón, Josep (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Girerd, Nicolás (Centre d'Investigations Cliniques Plurithématique 1433. INSERM DCAC. CHRU de Nancy. F-CRIN INI-CRCT. Université de Lorraine)
Conangla, Laura (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
de Antonio Ferrer, Marta (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Moliner, Pedro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Santiago-Vacas, Evelyn (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Codina, Pau (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Spitaleri, Giosafat (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
González, Beatriz (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Díaz, Violeta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rivas Jiménez, Carmen (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Velayos, Patricia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Núñez, Julio (Universitat de València. Departament de Medicina)
Bayés-Genís, Antoni (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	Aims: In ambulatory patients with chronic heart failure (HF), congestion and decongestion assessment may be challenging. The aim of this study is to assess the value of lung ultrasound (LUS) in outpatients with HF in characterizing decompensation and recompensation, and in outcomes prediction. Methods and results: Heart failure outpatients attended to establish HF decompensation were included. LUS was blindly performed at baseline (LUS1) and at clinical recompensation (LUS2). B-lines were counted in eight scanned areas. Diagnosis of no HF decompensation vs. right-sided, left-sided, or global HF decompensation, and patients' management were performed by physicians blinded to LUS1. Outcome was the composite of all-cause death or HF-related hospitalization. Two hundred and thirty-three suspicions of HF decompensation were included in 187 patients (71. 4 ± 11. 3 years, 66. 8% men). Mean B-line (LUS1) was 17. 6 ± 11. 2 vs. 3. 7 ± 4. 5 for episodes with and without HF decompensation, respectively (P < 0. 001). Global HF decompensation showed the highest number of B-lines (20. 6 ± 11), followed by left-sided (19. 7 ± 11. 6) and right-sided (13. 5 ± 9. 8). B-lines declined to 6. 9 ± 6. 7 (LUS2) (P < 0. 001 vs. LUS1) after treatment, within a mean time of 24. 2 ± 23. 7 days [median 13. 5 days (interquartile range 6-40)]. B-lines were significantly associated with the composite endpoint at 30 days (hazard ratio [HR] 1. 04 [95% confidence interval 1. 01-1. 07], P = 0. 02), but not at 60 (P = 0. 22) or 180 days (P = 0. 54). In multivariable analysis, B-line number remained as an independent predictor of the composite endpoint at 30 days, [HR 1. 04 (1. 01-1. 07), P = 0. 014], with a 4% increase risk per B-line added. B-lines correlated significantly with CA125 (R = 0. 30, P = 0. 001). Conclusions: Lung ultrasound supports the diagnostic work-up of congestion and decongestion in chronic HF outpatients and identifies patients at high risk of short-term events.
Ajuts:	Fundació la Marató de TV3 PI201510.10
Nota:	The Nancy team is supported by the RHU Fight-HF, a public grant overseen by the French National Research Agency (ANR) as part of the second 'Investissements d'Avenir' programme (reference: ANR-15-RHUS-0004), by the French PIA project 'Lorraine Université d'Excellence' (reference: ANR-15-IDEX-04-LUE), the ANR FOCUS-MR (reference: ANR-15-CE14-0032-01), ERA-CVD EXPERT (reference: ANR-16-ECVD-0002-02), the Contrat de Plan Etat Lorraine IT2MP, and FEDER Lorraine.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Female ; Heart Failure ; Humans ; Lung ; Male ; Outpatients ; Prognosis ; Ultrasonography
Publicat a:	ESC Heart Failure, Vol. 8 Núm. 6 (december 2021) , p. 4506-4516, ISSN 2055-5822

DOI: 10.1002/ehf2.13660
PMID: 34725962

11 p, 7.3 MB

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