Abstract
Objective noninvasive measures of dyspnea in patients with acute heart failure are
lacking. In this review, we describe lung ultrasound as a tool to estimate the degree
of pulmonary congestion in patients presenting with acute heart failure and to monitor
therapeutic efficacy. Serial semiquantitative measures of sonographic B-lines in acute
heart failure patients can be converted to pulmonary edema scores obtained at admission
and hospital discharge. These scores provide prognostic information for short-term
clinical outcomes. Lung ultrasound has the potential to measure changes in pulmonary
edema during acute heart failure management and improve risk stratification.
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References
- Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design.Am Heart J. 2004; 148: 43-51
- Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE).Am Heart J. 2005; 149: 209-216
- Bronchial hyperresponsiveness, word descriptors, and ethnicity: women with mild asthma.J Asthma. 2012; 49: 36-44
- Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial.Lancet. 2013; 381: 29-39
- Assessment of dyspnea early in acute heart failure: patient characteristics and response differences between Likert and visual analog scales.Acad Emerg Med. 2014; 21: 659-666
- The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study.Eur Heart J. 2010; 31: 832-841
- Does this dyspneic patient in the emergency department have congestive heart failure?.JAMA. 2005; 294: 1944-1956
- Diagnosing pulmonary edema: lung ultrasound versus chest radiography.Eur J Emerg Med. 2013; 20: 356-360
- Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis.Acad Emerg Med. 2014; 21: 843-852
- Diagnosing acute heart failure in the emergency department: a systematic review and meta-analysis.Acad Emerg Med. 2016; 23: 223-242
- “Ultrasound comet-tail images”: a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water.Chest. 2005; 127: 1690-1695
- Clinical and echocardiographic determinants of ultrasound lung comets.Eur J Echocardiogr. 2007; 8: 474-479
- Ultrasound lung comets for the differential diagnosis of acute cardiogenic dyspnoea: a comparison with natriuretic peptides.Eur J Heart Fail. 2008; 10: 70-77
- Bedside ultrasound of the lung for the monitoring of acute decompensated heart failure.Am J Emerg Med. 2008; 26: 585-591
- Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study.Cardiovasc Ultrasound. 2015; 13: 40
- Comparison of expert and novice sonographers' performance in focused lung ultrasonography in dyspnea (FLUID) to diagnose patients with acute heart failure syndrome.Acad Emerg Med. 2015; 22: 564-573
- Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water.Am J Cardiol. 2004; 93: 1265-1270
- Ultrasound assessment for extravascular lung water in patients undergoing hemodialysis. Time course for resolution.Chest. 2009; 135: 1433-1439
- The five-point Likert scale for dyspnea can properly assess the degree of pulmonary congestion and predict adverse events in heart failure outpatients.Clinics. 2014; 69: 341-346
- International evidence-based recommendations for point-of-care lung ultrasound.Intensive Care Med. 2012; 38: 577-591
- Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome.Am J Emerg Med. 2006; 24: 689-696
- Impact of patient positioning on lung ultrasound findings in acute heart failure.Eur Heart J Acute Cardiovasc Care. 2015; 4: 326-332
- Usefulness of lung ultrasound in the bedside distinction between pulmonary edema and exacerbation of COPD.Emerg Radiol. 2008; 15: 145-151
- Lung ultrasound and transthoracic impedance for noninvasive evaluation of pulmonary congestion in heart failure.J Cardiovasc Med (Hagerstown). 2015;
- A lung ultrasound sign allowing bedside distinction between pulmonary edema and COPD: the comet-tail artifact.Intensive Care Med. 1998; 24: 1331-1334
- Sonographic interstitial syndrome: the sound of lung water.J Ultrasound Med. 2009; 28: 163-174
- Inter-rater reliability of quantifying pleural B-lines using multiple counting methods.J Ultrasound Med. 2013; 32: 115-120
- Detection of pulmonary congestion by chest ultrasound in dialysis patients.JACC Cardiovasc Imaging. 2010; 3: 586-594
- Lung ultrasound during hemodialysis: the role in the assessment of volume status.Int Urol Nephrol. 2014; 46: 169-174
- Effective and timely evaluation of pulmonary congestion: qualitative comparison between lung ultrasound and thoracic bioelectrical impedance in maintenance hemodialysis patients.Medicine (Baltimore). 2015; 94e473
- Lung ultrasonography for the assessment of rapid extravascular water variation: evidence from hemodialysis patients.Intern Emerg Med. 2013; 8: 409-415
- Prognostic value of residual pulmonary congestion at discharge assessed by lung ultrasound imaging in heart failure.Eur J Heart Fail. 2015; 17: 1172-1181
- Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients†.Eur Heart J. 2016;
- Epidemiology and risk profile of heart failure.Nat Rev Cardiol. 2011; 8: 30-41
- Rehospitalizations among patients in the Medicare fee-for-service program.N Engl J Med. 2009; 360: 1418-1428
Article Info
Publication History
Published online: March 19, 2016
Accepted:
March 17,
2016
Received in revised form:
March 17,
2016
Received:
February 20,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.