Lung Ultrasound for Heart Failure Diagnosis in Primary Care.

Journal of Cardiac Failure
Laura ConanglaAntoni Bayés-Genís

Abstract

Lung ultrasound (LUS) is useful for diagnosing pulmonary congestion, but its value in primary care remains unclear. We investigated whether LUS improved diagnostic accuracy in outpatients with heart failure (HF) suspicion. LUS was performed on 2 anterior (A), 2 lateral (L), and 2 posterior (P) areas per hemithorax. An area was positive when ≥3 B-lines were observed. Two diagnostic criteria were used: for LUS-C1, 2 positive areas of 4 (A-L) on each hemithorax; and for LUS-C2, 2 positive areas of 6 (A-L-P) on each hemithorax. A cardiologist blinded to LUS validated HF diagnosis. 162 patients were included (age 75.6 ± 9.4 years, 70.4% women). Both LUS criteria, alone and combined with other HF diagnostic criteria, were accurate for identifying HF. LUS-C2 outperformed LUS-C1, showing remarkable specificity (0.99) and positive predictive value (0.92). LUS-C2, together with Framingham criteria, N-terminal pro-B-type natriuretic peptide, and electrocardiogram, added diagnostic value (area under the receiver operating characteristic curves 0.90 with LUS-C2 vs 0.84 without; P = .006). In the absence of N-terminal pro-B-type natriuretic peptide, LUS-C2 significantly reclassified one-third of patients above Framingham criteria and electro...Continue Reading

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Citations

Nov 21, 2020·European Journal of Heart Failure·Erwan DonalLeyla Elif Sade
Mar 16, 2021·Journal of Circulating Biomarkers·Mar DomingoAntoni Bayes-Genis
Aug 28, 2021·Diagnostics·Filippo PirrottaAlberto Palazzuoli
Nov 3, 2021·ESC Heart Failure·Mar DomingoAntoni Bayes-Genís

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