Abstract
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.
Highlights
Heart failure (HF) afflicts 1–2 % of people in the western world, with an incidence of 5–10 per 1000 persons per year [1]
Pulmonary congestion is a major predictor of morbidity and mortality in heart failure (HF) [5]
Blines is recommended in the pre-hospital and hospital management of acute HF (AHF), as a bedside tool to enable direct visualization of interstitial edema in patients with suspected AHF [21]
Summary
Heart failure (HF) afflicts 1–2 % of people in the western world, with an incidence of 5–10 per 1000 persons per year [1]. Acute heart failure (AHF) is the most common reason for hospitalization in patients aged > 65 years [2, 3]. Despite significant improvement in signs and symptoms during hospitalization, post-discharge outcomes for patients hospitalized for AHF are poor. Pulmonary congestion is a major predictor of morbidity and mortality in HF [5]. It is the single most important contributor to hospitalization, more significant than. B-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)
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