Lung/ultrasonography – ABC CARDIOL

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Is There a Role for Lung Ultrasonography in the Prognosis of Heart Failure Patients?

Mônica Samuel Avila et al. Deborah De Sá Pereira Belfort

Heart failure (HF) hospitalizations are most commonly motivated by systemic and pulmonary congestion, leading to 5–15% of mortality rate and up to 50% of readmission rate in 90 days. Although the usual goal during hospitalization is complete decongestion, 30% of patients have residual congestion at discharge. Signs of congestion, high filling pressures and elevated natriuretic peptides are associated with higher mortality and readmission rates, and residual congestion at discharge is also associated with worse prognosis.^,

Congestion assessment is usually difficult given the low sensitivity and/or specificity of physical examination findings. Chest radiography and natriuretic peptides can improve evaluation, but lung ultrasonography (LUS) has been recently used as a sensitive tool in this scenario. It can estimate right atrial pressure using vena cava diameter and variation and evaluate lung congestion by counting B-lines in chest zones. B-lines are hyperechoic artefacts on LUS which appear as vertical lines from the pleural line to the bottom of the screen and represent thickening of interlobular septa. Recent data report association of B-lines in LUS with higher mortality and hospitalization rates.

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Is There a Role for Lung Ultrasonography in the Prognosis of Heart Failure Patients?

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