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

Luna Gargani, P. S. Pang, F. Frassi, M. H. Miglioranza, F. L. Dini, P. Landi, E. Picano

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Abstract

Background: 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). Methods: A 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. Results: Mean 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 χ<sup>2</sup> 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. Conclusions: Persistent 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.

Original languageEnglish (US)
Article number40
JournalCardiovascular Ultrasound
Volume13
Issue number1
DOIs
StatePublished - Sep 4 2015

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Keywords

  • B-lines
  • Lung ultrasound
  • Prognosis
  • Pulmonary congestion
  • Rehospitalization
  • Ultrasound lung comets

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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