Lung ultrasound and short-term prognosis in heart failure patients
Lung ultrasound and short-term prognosis in heart failure patients
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DOI：
10.1016/j.ijcard.2016.05.010
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发表时间：
2016-09-01
影响因子：
3.5
通讯作者：
Montano, Nicola
中科院分区：
文献类型：
--
作者：
Cogliati, Chiara;Casazza, Giovanni;Montano, Nicola
背景：心力衰竭（HF）是65岁以上患者住院的主要原因，30天再入院率为20- 25%。虽然已经评估了几个标志物，以分层的时间后，急性失代偿主要是基于临床判断，肺超声（LUS）已被证明是一个有效的工具，用于评估和监测肺充血。我们的研究目的是评估是否LUS在HF患者出院时进行可以预测100天的再入院或death.Methods：一百五十例患者参加。扫描前外侧胸部以评估B线的存在。计算超声评分，每个阳性（>= 3条B线）区段为1。记录临床、生化和超声心动图数据。考克斯比例风险回归分析进行评估变量和100天events.Results之间的关联：随访149例患者。记录了34起事件。超声评分与事件显著相关（HR 1.19; CI 1.05 - 1.34; p = 0.005）。平均而言，超声评分增加1分与100天内事件风险增加约24%相关。在多变量分析NTproBNP仍然是唯一的独立预后factor.Conclusions：我们证实，B-线在出院时是一个预后指标，在100天的HF患者的再入院和死亡。然而，需要进一步的随机临床研究来明确支持LUS在HF患者临床管理中的常规使用，无论是否与NT-proBNP联合使用。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background: Heart failure (HF) is the leading cause of hospitalization for patients older than 65 years, with a 30-day readmission rate of 20-25%. Although several markers have been evaluated to stratify timing of follow-up after an acute decompensation is mostly based on clinical judgment.Lung ultrasound (LUS) has been demonstrated to be a valid tool for the assessment and monitoring of pulmonary congestion. Aim of our study was to evaluate if LUS performed in HF patients at discharge could predict 100-day hospital readmission or death.Methods: One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive (>= 3 B-lines) sector. Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 100-day events.Results: Follow-up was obtained in 149 patients. Thirty-four events were recorded. Sonographic score was significantly associated with events (HR 1.19; CI 1.05 to 1.34; p = 0.005). On average, the increase of 1 point in the sonographic score was associated with an increase of approximately 24% in the risk of event within 100 days. At multivariate analysis NTproBNP remained the only independent prognostic factor.Conclusions: We confirmed that B-lines at discharge are a prognostic marker for hospital readmission and death at 100 days in HF patients. Nevertheless, further randomized clinical studies are needed to definitely support the routine use of LUS in the clinical management of HF patients, in combination or not with NT-proBNP. (C) 2016 Elsevier Ireland Ltd. All rights reserved.