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Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort

Background and Objectives: Acute heart failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying pulmonary hypertension (PH), a major prognosti...

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Autores principales: Torres-Arrese, Marta, García de Casasola-Sánchez, Gonzalo, Méndez-Bailón, Manuel, Montero-Hernández, Esther, Cobo-Marcos, Marta, Rivas-Lasarte, Mercedes, Caurcel-Díaz, Luis, Rodríguez-Fuertes, Pablo, Villén-Villegas, Tomas, Tung-Chen, Yale
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780545/
https://www.ncbi.nlm.nih.gov/pubmed/35056432
http://dx.doi.org/10.3390/medicina58010124
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author Torres-Arrese, Marta
García de Casasola-Sánchez, Gonzalo
Méndez-Bailón, Manuel
Montero-Hernández, Esther
Cobo-Marcos, Marta
Rivas-Lasarte, Mercedes
Caurcel-Díaz, Luis
Rodríguez-Fuertes, Pablo
Villén-Villegas, Tomas
Tung-Chen, Yale
author_facet Torres-Arrese, Marta
García de Casasola-Sánchez, Gonzalo
Méndez-Bailón, Manuel
Montero-Hernández, Esther
Cobo-Marcos, Marta
Rivas-Lasarte, Mercedes
Caurcel-Díaz, Luis
Rodríguez-Fuertes, Pablo
Villén-Villegas, Tomas
Tung-Chen, Yale
author_sort Torres-Arrese, Marta
collection PubMed
description Background and Objectives: Acute heart failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying pulmonary hypertension (PH), a major prognostic factor in patients admitted due to AHF, and assess whether there are significant changes in the venous excess ultrasonography (VE × US) score or femoral vein Doppler at discharge. Materials and Methods: Patients were evaluated with a standard protocol of lung ultrasound, echocardiography, inferior vena cava (IVC) and hepatic, portal, intra-renal and femoral vein Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation–SD 13.4). Seven patients (23.3%) had a worsening renal function during hospitalization. Regarding ultrasound findings, VE × US score was calculated at admission and at discharge, unexpectedly remaining unchanged or even worsened (21 patients, 70.0%). The area under the curve for the lung score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (16.5 vs. 9.3; p < 0.001), improvement in the hepatic vein Doppler pattern (2.4 vs. 2.1; p = 0.002), improvement in portal vein Doppler pattern (1.7 vs. 1.4; p = 0.023), without significant changes in the intra-renal vein Doppler pattern (1.70 vs. 1.57; p = 0.293), VE × US score (1.3 vs. 1.1; p = 0.501), femoral vein Doppler pattern (2.4 vs. 2.1; p = 0.161) and IVC collapsibility (2.0 vs. 2.1; p = 0.420). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VE × US score, should be further studied before expanding its use in AHF patients.
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spelling pubmed-87805452022-01-22 Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort Torres-Arrese, Marta García de Casasola-Sánchez, Gonzalo Méndez-Bailón, Manuel Montero-Hernández, Esther Cobo-Marcos, Marta Rivas-Lasarte, Mercedes Caurcel-Díaz, Luis Rodríguez-Fuertes, Pablo Villén-Villegas, Tomas Tung-Chen, Yale Medicina (Kaunas) Article Background and Objectives: Acute heart failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying pulmonary hypertension (PH), a major prognostic factor in patients admitted due to AHF, and assess whether there are significant changes in the venous excess ultrasonography (VE × US) score or femoral vein Doppler at discharge. Materials and Methods: Patients were evaluated with a standard protocol of lung ultrasound, echocardiography, inferior vena cava (IVC) and hepatic, portal, intra-renal and femoral vein Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation–SD 13.4). Seven patients (23.3%) had a worsening renal function during hospitalization. Regarding ultrasound findings, VE × US score was calculated at admission and at discharge, unexpectedly remaining unchanged or even worsened (21 patients, 70.0%). The area under the curve for the lung score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (16.5 vs. 9.3; p < 0.001), improvement in the hepatic vein Doppler pattern (2.4 vs. 2.1; p = 0.002), improvement in portal vein Doppler pattern (1.7 vs. 1.4; p = 0.023), without significant changes in the intra-renal vein Doppler pattern (1.70 vs. 1.57; p = 0.293), VE × US score (1.3 vs. 1.1; p = 0.501), femoral vein Doppler pattern (2.4 vs. 2.1; p = 0.161) and IVC collapsibility (2.0 vs. 2.1; p = 0.420). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VE × US score, should be further studied before expanding its use in AHF patients. MDPI 2022-01-14 /pmc/articles/PMC8780545/ /pubmed/35056432 http://dx.doi.org/10.3390/medicina58010124 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Torres-Arrese, Marta
García de Casasola-Sánchez, Gonzalo
Méndez-Bailón, Manuel
Montero-Hernández, Esther
Cobo-Marcos, Marta
Rivas-Lasarte, Mercedes
Caurcel-Díaz, Luis
Rodríguez-Fuertes, Pablo
Villén-Villegas, Tomas
Tung-Chen, Yale
Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort
title Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort
title_full Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort
title_fullStr Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort
title_full_unstemmed Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort
title_short Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort
title_sort usefulness of serial multiorgan point-of-care ultrasound in acute heart failure: results from a prospective observational cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780545/
https://www.ncbi.nlm.nih.gov/pubmed/35056432
http://dx.doi.org/10.3390/medicina58010124
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