The value of cardiopulmonary ultrasound in diagnosing cardiogenic pulmonary edema in patients with heart failure.

Abstract

Objective: Heart failure (HF) is generally complicated with cardiogenic pulmonary edema (CPE), the early diagnosis and treatment is essential. We aimed to evaluate the effects of cardiopulmonary ultrasound (CPUS) in the diagnosis of CPE in HF patients, to provide reference for the management of HF.

Methods: HF patients entering The People's Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences intensive care unit (ICU) between March 2025 and July 2026 were included. All patients underwent CPUS and chest computed tomography (CT), and comparison of the detection rates of cardiogenic pulmonary edema between CPUS and CT.

Results: A total of 117 patients with HF were enrolled in this study. Of the 117 HF patients, 46 were diagnosed with CPE, and 43 were correctly diagnosed by CT, with a diagnostic accuracy of 94.9%, the positive predictive value (PPV) was 93.5%, the negative predictive value (NPV) was 95.8%, the sensitivity was 93.5%, the specificity was 95.8%, the positive likelihood ratio (PLR) was 22, and the negative likelihood ratio (NLR) was 0.07. While 41 were correctly diagnosed by CPUS, with a diagnostic accuracy of 92.3%, the PPV was 91.1%, NPV was 93.1%, the sensitivity was 89.1%, the specificity was 94.3%, the PLR was 16, and the NLR was 0.12. Comparison of CT and CPUS in the diagnosis of CPE, there was no statistically significant difference between the two methods (X ² = 0.111, P > 0.05). And The Cohen's kappa for the diagnosis of CPE by CT and CPUS is 0.873 (95% CI was 0.782-0.963, P < 0.001).

Conclusions: In conclusion, the present study suggests that CPUS is feasible for identifying cardiogenic pulmonary edema in ICU patients with heart failure. Based on diagnostic agreement analysis, CPUS demonstrates promising performance for CPE detection in this critically-ill cohort.