The application of lung ultrasound in acute decompensated heart failure in heart failure with preserved and reduced ejection fraction

Abstract

Objectives Lung ultrasound detection of B‐lines has become a simple, semiquantitative, noninvasive tool for evaluating pulmonary congestion in heart failure (HF) patients. This study compared the correlation of B‐lines with E/eʹ, NT‐proBNP, and ejection fraction (EF) in acute decompensated heart failure (ADHF). Methods Eighty‐two consecutive patients who were diagnosed with acute decompensated HF were divided into two groups: preserved ejection fraction heart failure (HFpEF, EF≥50%, n=32) and reduced ejection fraction heart failure (HFrEF, EF<50%, n=50). Spearman's correlation was used to evaluate associations of B‐lines with E/eʹ, NT‐proBNP, and EF in the two groups. Receiver operating characteristic (ROC) analysis was performed to compare B‐lines with the E/eʹ ratio. Results Results revealed no significant differences were observed in the B‐lines between the HFpEF and HFrEF groups. However, compared with the control group, B‐lines were significantly increased in the HFpEF and HFrEF groups ( P <.05). The B‐lines were positively correlated with E/eʹ (r=0.742, r=0.52) and NT‐proBNP (r=0.678, r=0.417) but were negatively correlated with EF (r=−0.365, r=−0.337), and the correlation coefficients were higher in the HFpEF group than in the HFrEF group. In ROC analyses, considering E/eʹ ≥14 as a reference, B‐lines yielded a C‐statistic value of 0.94 (sensitivity 92%, specificity 83%) in the HFpEF group and 0.84 (sensitivity 86%, specificity 78%) in the HFrEF group. Conclusions B‐lines were significantly correlated with the more established parameters of ADHF. The correlation between B‐lines and E/eʹ was better, especially in the HFpEF group.