P817 Lung ultrasound in the evaluation of pulmonary congestion in patients with aortic stenosis

Abstract

Abstract Background Aortic stenosis (AS) has a prolonged latent period, as AS worsens, the left ventricular adaptations become inadequate and impaired systolic and/or diastolic dysfunction, may lead to clinical heart failure (HF). The development of HF is an inflexion point in the natural history of AS. Pulmonary congestion is a nearly universal pathophysiological finding in HF, and may precede symptoms. Lung ultrasound (LUS) evaluation of B-lines has been proposed as a simple, non-invasive tool to assess pulmonary interstitial edema. Aim To assess pulmonary interstitial edema with LUS in patients with moderate and severe aortic stenosis, to define performance of LUS compared with clinical assessment and echocardiographic parameters. Methods Sixty-eight consecutive patients (36 women, mean age 74 ± 9 years) with moderate or severe aortic stenosis were enrolled. Exclusion criteria were as follows: moderate or severe aortic regurgitation, moderate or severe mitral regurgitation, cardiomyopathies and pulmonary disease. All patients underwent comprehensive echocardiography examination and LUS according to a previously validated 28 scanning-site assessment. Results we found a significant number of B-lines (≥15) in 79% of patients. B-lines were positively correlated with left atrial volume index (p < 0,05, r = 0,3) and estimated pulmonary pressure ( p < 0,0001, r= 0,62 Figure 1.) The number of B-lines didn’t correlate with the severity of AS (mean gradient vs. B-lines: p = 0,2, valve area vs. B-lines: p = 0,2.), however properly reflects different functional status of the patients (p < 0,0001, Figure 2.) Conclusion Lung ultrasound is a promising tool to detect lung congestion related to AS. The severity of congestion doesn’t correlate with the severity of AS, albeit B-lines better reflect the deteriorating functional status of the patients and the haemodynamic consequences related to AS. Abstract P817 Figure. Correlation PASP vs Blines, NYHA/B-lines