Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure.

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Ultrasound Pub Date : 2025-04-14 DOI:10.1186/s12947-025-00341-7

Takahiro Sakamoto, Toshihiko Asanuma, Hiroyuki Sasaki, Hiroshi Kawahara, Kazuhiko Uchida, Akihiro Endo, Hiroyuki Yoshitomi, Kazuaki Tanabe

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引用次数: 0

Abstract

Background: The assessment of left ventricular (LV) diastolic function based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) guidelines requires measurement of several echocardiographic indices. However, these assessments often yield inconclusive results owing to the absence of measurable parameters. Multiple B-lines on lung ultrasound have been proposed as a method for evaluating pulmonary congestion. We aimed to evaluate the association between B-lines and LV diastolic function and to examine whether B-lines show potential as an alternative to conventional indices for assessing LV diastolic function.

Methods: This prospective study included 172 patients with pre-heart failure (HF) or HF. We investigated (i) the relationship between B-lines and LV diastolic function using echocardiography, (ii) the diagnostic accuracy of B-lines compared to echocardiography indices for estimating LV filling pressures and (iii) the relationship between B-lines and risk of hospitalisation for HF.

Results: Among patients for whom the ASE/EACVI guideline algorithm for LV diastolic dysfunction was available (n = 89), the number of B-lines typically increased with the severity of diastolic dysfunction grade. In patients who underwent left heart catheterisation (n = 20), the LV filling pressure was significantly correlated with B-lines (r = 0.690, P < 0.001). The diagnostic accuracy of B-lines for detecting high LV filling pressure was comparable to that of tricuspid regurgitation peak gradient (TRPG). When TRPG was replaced with B-lines to diagnose grade II or III diastolic dysfunction using the ASE/ESCVI algorithm, sensitivity remained comparable (0.80); however, specificity improved (0.80 vs. 0.50). In patients who underwent lung ultrasound while they were hemodynamically stable and were followed up for prognosis (median, 730 days; n = 75), 14 hospitalisations for HF were observed. Kaplan-Meier analysis revealed that the high B-line group had a significantly higher incidence of hospitalisation events for HF (P = 0.036, log-rank test).

Conclusion: B-lines have shown potential as an alternative to conventional indices for assessing LV diastolic dysfunction.

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肺超声b线对左心室充盈压力的诊断价值。

背景：根据美国超声心动图学会和欧洲心血管成像协会（ASE/EACVI）指南评估左室（LV）舒张功能需要测量几个超声心动图指标。然而，由于缺乏可测量的参数，这些评估往往产生不确定的结果。肺超声上的多条b线已被提出作为评估肺充血的方法。我们的目的是评估b线与左室舒张功能之间的关系，并检查b线是否有潜力作为评估左室舒张功能的传统指标的替代品。方法：本前瞻性研究纳入172例心衰前期（HF）或HF患者。我们研究了(i)超声心动图中b线与左室舒张功能之间的关系，（ii）与超声心动图指标相比，b线在估计左室充盈压力方面的诊断准确性，以及（iii） b线与心衰住院风险之间的关系。结果：在可获得ASE/EACVI左室舒张功能障碍指南算法的患者中（n = 89）， b线数量通常随着舒张功能障碍等级的严重程度而增加。在接受左心导管插管的患者（n = 20）中，左室充血压力与b线显著相关（r = 0.690， P）。结论：b线显示出作为评估左室舒张功能障碍的常规指标的替代方案的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Ultrasound CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cardiovascular Ultrasound is an online journal, publishing peer-reviewed: original research; authoritative reviews; case reports on challenging and/or unusual diagnostic aspects; and expert opinions on new techniques and technologies. We are particularly interested in articles that include relevant images or video files, which provide an additional dimension to published articles and enhance understanding. As an open access journal, Cardiovascular Ultrasound ensures high visibility for authors in addition to providing an up-to-date and freely available resource for the community. The journal welcomes discussion, and provides a forum for publishing opinion and debate ranging from biology to engineering to clinical echocardiography, with both speed and versatility.