Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study

Cardiovascular Ultrasound

Research

F. L. Dini¹  M.H. Miglioranza²  F. Frassi³  P. S. Pang⁴  E. Picano⁵  P. Landi⁵  Luna Gargani⁵ 

[1] Cardiac, Vascular and Thoracic Department, Azienda Ospedaliero-Universitaria, Pisa, Italy;Cardiology of Rio Grande do Sul, Porto Alegre, Brazil;Department of Emergency Medicine, Azienda Ospedaliero-Universitaria, Pisa, Italy;Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, USA;National Research Council of Pisa, Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124, Pisa, Italy;

关键词: Lung ultrasound;    B-lines;    Ultrasound lung comets;    Pulmonary congestion;    Prognosis;    Rehospitalization;   

DOI  :  10.1186/s12947-015-0033-4

 received in 2015-07-25, accepted in 2015-08-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundB-lines evaluated by lung ultrasound (LUS) are the sonographic sign of pulmonary congestion, a major predictor of morbidity and mortality in patients with heart failure (HF). Our aim was to assess the prognostic value of B-lines at discharge to predict rehospitalization at 6 months in patients with acute HF (AHF).MethodsA prospective cohort of 100 patients admitted to a Cardiology Department for dyspnea and/or clinical suspicion of AHF were enrolled (mean age 70 ± 11 years). B-lines were evaluated at admission and before discharge. Subjects were followed-up for 6-months after discharge.ResultsMean B-lines at admission was 48 ± 48 with a statistically significant reduction before discharge (20 ± 23, p < .0001). During follow-up, 14 patients were rehospitalized for decompensated HF. The 6-month event-free survival was highest in patients with less B-lines (≤ 15) and lowest in patients with more B-lines (> 15) (log rank χ2 20.5, p < .0001). On multivariable analysis, B-lines > 15 before discharge (hazard ratio [HR] 11.74; 95 % confidence interval [CI] 1.30–106.16) was an independent predictor of events at 6 months.ConclusionsPersistent pulmonary congestion before discharge evaluated by ultrasound strongly predicts rehospitalization for HF at 6-months. Absence or a mild degree of B-lines identify a subgroup at extremely low risk to be readmitted for HF decompensation.

【 授权许可】

CC BY   
© Gargani et al. 2015