The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting
Background: Heart failure with preserved ejection fraction (HFpEF) is a growing healthcare burden, and its prevalence is steadily increasing. Lung ultrasound (LUS) is a promising screening and prognostic tool in the heart failure population. However, more information on its value in predicting outco...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:04e894e9c9a74ab18917a52f0aaaf0e62021-12-02T08:12:00ZThe Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting2297-055X10.3389/fcvm.2021.758147https://doaj.org/article/04e894e9c9a74ab18917a52f0aaaf0e62021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.758147/fullhttps://doaj.org/toc/2297-055XBackground: Heart failure with preserved ejection fraction (HFpEF) is a growing healthcare burden, and its prevalence is steadily increasing. Lung ultrasound (LUS) is a promising screening and prognostic tool in the heart failure population. However, more information on its value in predicting outcome is needed.Aims: The aim of our study was to assess the prognostic performance of LUS B-lines compared to traditional and novel clinical and echocardiographic parameters and natriuretic peptide levels in patients with newly diagnosed HFpEF in an ambulatory setting.Methods: In our prospective cohort study, all ambulatory patients with clinical suspicion of HFpEF underwent comprehensive echocardiography, lung ultrasound and NT-proBNP measurement during their first appointment at our cardiology outpatient clinic. Our endpoint was a composite of worsening heart failure symptoms requiring hospitalization or loop diuretic dose escalation and death.Results: We prospectively enrolled 75 consecutive patients with HFpEF who matched our inclusion and exclusion criteria. We detected 11 events on a 26 ± 10-months follow-up. We found that the predictive value of B-lines is similar to the predictive value of NT-proBNP (AUC 0.863 vs. 0.859), with the best cut-off at >15 B-lines. Having more B-lines than 15 significantly increased the likelihood of adverse events with a hazard ratio of 20.956 (p = 0.004). The number of B-lines remained an independent predictor of events at multivariate modeling. Having more than 15 B-lines lines was associated with a significantly worse event-free survival (Log-rank: 16.804, p < 0.001).Conclusion: The number of B-lines seems to be an independent prognostic factor for adverse outcomes in HFpEF. Since it is an easy-to-learn, feasible and radiation-free method, it may add substantial value to the commonly used diagnostic and risk stratification models.Blanka Morvai-IllésNóra Polestyuk-NémethIstván Adorján SzabóMagdolna MonokiLuna GarganiEugenio PicanoAlbert VargaGergely ÁgostonFrontiers Media S.A.articleheart failure with preserved ejection fraction (HFpEF)diagnosislung ultrasonography (LUS)echocardiographyprognosisDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
heart failure with preserved ejection fraction (HFpEF) diagnosis lung ultrasonography (LUS) echocardiography prognosis Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
heart failure with preserved ejection fraction (HFpEF) diagnosis lung ultrasonography (LUS) echocardiography prognosis Diseases of the circulatory (Cardiovascular) system RC666-701 Blanka Morvai-Illés Nóra Polestyuk-Németh István Adorján Szabó Magdolna Monoki Luna Gargani Eugenio Picano Albert Varga Gergely Ágoston The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting |
| description |
Background: Heart failure with preserved ejection fraction (HFpEF) is a growing healthcare burden, and its prevalence is steadily increasing. Lung ultrasound (LUS) is a promising screening and prognostic tool in the heart failure population. However, more information on its value in predicting outcome is needed.Aims: The aim of our study was to assess the prognostic performance of LUS B-lines compared to traditional and novel clinical and echocardiographic parameters and natriuretic peptide levels in patients with newly diagnosed HFpEF in an ambulatory setting.Methods: In our prospective cohort study, all ambulatory patients with clinical suspicion of HFpEF underwent comprehensive echocardiography, lung ultrasound and NT-proBNP measurement during their first appointment at our cardiology outpatient clinic. Our endpoint was a composite of worsening heart failure symptoms requiring hospitalization or loop diuretic dose escalation and death.Results: We prospectively enrolled 75 consecutive patients with HFpEF who matched our inclusion and exclusion criteria. We detected 11 events on a 26 ± 10-months follow-up. We found that the predictive value of B-lines is similar to the predictive value of NT-proBNP (AUC 0.863 vs. 0.859), with the best cut-off at >15 B-lines. Having more B-lines than 15 significantly increased the likelihood of adverse events with a hazard ratio of 20.956 (p = 0.004). The number of B-lines remained an independent predictor of events at multivariate modeling. Having more than 15 B-lines lines was associated with a significantly worse event-free survival (Log-rank: 16.804, p < 0.001).Conclusion: The number of B-lines seems to be an independent prognostic factor for adverse outcomes in HFpEF. Since it is an easy-to-learn, feasible and radiation-free method, it may add substantial value to the commonly used diagnostic and risk stratification models. |
| format |
article |
| author |
Blanka Morvai-Illés Nóra Polestyuk-Németh István Adorján Szabó Magdolna Monoki Luna Gargani Eugenio Picano Albert Varga Gergely Ágoston |
| author_facet |
Blanka Morvai-Illés Nóra Polestyuk-Németh István Adorján Szabó Magdolna Monoki Luna Gargani Eugenio Picano Albert Varga Gergely Ágoston |
| author_sort |
Blanka Morvai-Illés |
| title |
The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting |
| title_short |
The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting |
| title_full |
The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting |
| title_fullStr |
The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting |
| title_full_unstemmed |
The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting |
| title_sort |
prognostic value of lung ultrasound in patients with newly diagnosed heart failure with preserved ejection fraction in the ambulatory setting |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/04e894e9c9a74ab18917a52f0aaaf0e6 |
| work_keys_str_mv |
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