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Erschienen in:
07.04.2020 | CE-Research Letter to the Editor
Residual congestion and long-term prognosis in acutely decompensated heart failure patients
Erschienen in: Internal and Emergency Medicine | Ausgabe 4/2020
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Aims
Recent studies have established the role of residual congestion evaluated by
lung ultrasound in estimating short-term risk of readmission or death in patients
admitted for heart failure (HF) decompensation. However, if lung ultrasounds maintain
a prognostic role of in long-term survival is still unknown. Aim of our study was to
evaluate if residual congestion could predict all-cause mortality during 4 year follow up
in a cohort of unselected patients admitted for acute decompensated HF.
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 sector (≥ 3 B-lines). Clinical, biochemical
and echocardiographic data were recorded. A Cox proportional hazard regression
analysis was performed to evaluate the association between variables and 4-year
survival.
Results
During the follow-up, 86 patients (58%) died. Univariate analysis showed a
significant correlation between the sonographic score at discharge and events
occurrence at long term follow up (HR 1.21; CI 1.11–1.31; p < 0.001) suggesting that,
on average, the increase of 1 point in the sonographic score was associated with an
increase of approximately 20% in the risk of death.
Conclusions
Our results suggest the role of LUS in the identification of more congested
HF patients, that will be at risk for worse long term outcome.