Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure

ESC Heart Failure

Tor Biering‐Sørensen¹  Philip Brainin¹  Montane B. Silverman²  Varsha Swamy²  Elke Platz²  Kristin H. Dwyer³  Eldrin F. Lewis⁴  Susan Cheng⁴  Jose Rivero⁴  Scott D. Solomon⁴  Brian Claggett⁴  Allison A. Merz⁵  John J.V. McMurray⁶ 

[1] Department of Cardiology Herlev and Gentofte University Hospital Herlev Denmark;Department of Emergency Medicine Brigham and Women's Hospital 75 Francis Street, Neville House Boston MA 02115 USA;Department of Emergency Medicine Rhode Island Hospital, Warren Alpert Medical School of Brown University Providence RI USA;Division of Cardiovascular Medicine Brigham and Women's Hospital Boston MA USA;Harvard Medical School Boston MA USA;Institute of Cardiovascular and Medical Sciences University of Glasgow Glasgow UK;

关键词: Lung ultrasonography;    B‐lines;    Body mass index;    Heart failure;   

DOI  :  10.1002/ehf2.12640

来源: DOAJ

【 摘 要 】

Abstract Aims Increased body mass index (BMI) is common in heart failure (HF) patients and is associated with lower levels of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP). We evaluated the influence of BMI on lung ultrasonography (LUS) findings indicative of pulmonary congestion (i.e. B‐lines) in patients with chronic and acute HF (AHF). Methods and results We analysed ambulatory chronic HF (n = 118) and hospitalized AHF (n = 177) patients (mean age 70 years, 64% men, mean BMI 29 kg/m2, mean ejection fraction 42%) undergoing echocardiography and LUS in eight chest zones. B‐lines and chest wall thickness (skin to pleura) on ultrasound were quantified offline and blinded to clinical findings. NT‐proBNP was available in AHF patients (n = 167). In chronic HF, B‐line number decreased by 18% per 5 unit increase in BMI [95% confidence interval (CI) −35% to +5%, P = 0.11]. In AHF, the number of B‐lines decreased by 12% per 5 unit increase in BMI (95% CI −19% to −5%, P = 0.001), whereas NT‐proBNP concentration decreased by 28% per 5 unit increase in BMI (95% CI −40% to −16%, P < 0.001). For AHF, B‐line number declined to a lesser degree than NT‐proBNP concentration with increasing BMI (P = 0.020), and >6 B‐lines were observed in half of AHF patients with severe obesity. There was an inverse relationship between B‐line number and chest wall thickness, and this association varied by chest region. Conclusions Despite an inverse relationship between B‐lines and BMI, B‐lines declined to a lesser degree than NT‐proBNP with increasing BMI. These data suggest that LUS may be useful in patients with HF despite obesity.

【 授权许可】

Unknown