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Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea
AIMS: Dyspnoea is common in heart failure (HF) but non‐specific. Lung ultrasound (LUS) could represent a non‐invasive tool to detect subclinical pulmonary congestion in patients with undifferentiated dyspnoea. METHODS AND RESULTS: We assessed the feasibility of an abbreviated LUS protocol (eight and...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352886/ https://www.ncbi.nlm.nih.gov/pubmed/30474936 http://dx.doi.org/10.1002/ehf2.12381 |
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author | Platz, Elke Merz, Allison Silverman, Montane Lewis, Eldrin Groarke, John D. Waxman, Aaron Systrom, David |
author_facet | Platz, Elke Merz, Allison Silverman, Montane Lewis, Eldrin Groarke, John D. Waxman, Aaron Systrom, David |
author_sort | Platz, Elke |
collection | PubMed |
description | AIMS: Dyspnoea is common in heart failure (HF) but non‐specific. Lung ultrasound (LUS) could represent a non‐invasive tool to detect subclinical pulmonary congestion in patients with undifferentiated dyspnoea. METHODS AND RESULTS: We assessed the feasibility of an abbreviated LUS protocol (eight and two zones) in a prospective pilot study of 25 ambulatory patients with undifferentiated dyspnoea undergoing clinically indicated invasive cardiopulmonary exercise testing (iCPET) at rest (LUS 1) and after peak exercise (LUS 2). We also related LUS findings (B‐lines) to invasive haemodynamics stratified by supine pulmonary capillary wedge pressure (PCWP) (Congestion, >15 mmHg; Control, ≤15 mmHg). All enrolled patients (median age 68, 60% women, 32% prior HF, median ejection fraction 59%) had interpretable LUS 1 images in eight zones, and 20 (80%) had adequate LUS 2 images. LUS images were adequate in two posterior zones in 24 patients (96%) for LUS 1 and 18 (72%) for LUS 2. Although B‐line number was numerically higher in the Congestion group at rest and after peak exercise, this difference did not reach statistical significance. In the entire cohort, there was an association between B‐lines and rest systolic pulmonary artery pressure (r = 0.46, P = 0.02) and PCWP (r = 0.54, P = 0.005). There was an inverse relationship between B‐lines and peak VO(2) (r = −0.65, P = 0.002). CONCLUSIONS: Among ambulatory patients with undifferentiated dyspnoea, an abbreviated LUS protocol before and after iCPET is feasible in the majority of patients. B‐line number at rest was associated with invasively measured markers of haemodynamic congestion and was inversely related with peak VO(2). |
format | Online Article Text |
id | pubmed-6352886 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63528862019-02-06 Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea Platz, Elke Merz, Allison Silverman, Montane Lewis, Eldrin Groarke, John D. Waxman, Aaron Systrom, David ESC Heart Fail Short Communication AIMS: Dyspnoea is common in heart failure (HF) but non‐specific. Lung ultrasound (LUS) could represent a non‐invasive tool to detect subclinical pulmonary congestion in patients with undifferentiated dyspnoea. METHODS AND RESULTS: We assessed the feasibility of an abbreviated LUS protocol (eight and two zones) in a prospective pilot study of 25 ambulatory patients with undifferentiated dyspnoea undergoing clinically indicated invasive cardiopulmonary exercise testing (iCPET) at rest (LUS 1) and after peak exercise (LUS 2). We also related LUS findings (B‐lines) to invasive haemodynamics stratified by supine pulmonary capillary wedge pressure (PCWP) (Congestion, >15 mmHg; Control, ≤15 mmHg). All enrolled patients (median age 68, 60% women, 32% prior HF, median ejection fraction 59%) had interpretable LUS 1 images in eight zones, and 20 (80%) had adequate LUS 2 images. LUS images were adequate in two posterior zones in 24 patients (96%) for LUS 1 and 18 (72%) for LUS 2. Although B‐line number was numerically higher in the Congestion group at rest and after peak exercise, this difference did not reach statistical significance. In the entire cohort, there was an association between B‐lines and rest systolic pulmonary artery pressure (r = 0.46, P = 0.02) and PCWP (r = 0.54, P = 0.005). There was an inverse relationship between B‐lines and peak VO(2) (r = −0.65, P = 0.002). CONCLUSIONS: Among ambulatory patients with undifferentiated dyspnoea, an abbreviated LUS protocol before and after iCPET is feasible in the majority of patients. B‐line number at rest was associated with invasively measured markers of haemodynamic congestion and was inversely related with peak VO(2). John Wiley and Sons Inc. 2018-11-26 /pmc/articles/PMC6352886/ /pubmed/30474936 http://dx.doi.org/10.1002/ehf2.12381 Text en © 2018 The Authors ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Short Communication Platz, Elke Merz, Allison Silverman, Montane Lewis, Eldrin Groarke, John D. Waxman, Aaron Systrom, David Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
title | Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
title_full | Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
title_fullStr | Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
title_full_unstemmed | Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
title_short | Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
title_sort | association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352886/ https://www.ncbi.nlm.nih.gov/pubmed/30474936 http://dx.doi.org/10.1002/ehf2.12381 |
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