- For patients with acute heart failure (AHF), more B-lines on simplified lung ultrasonography (LUS) correlate with more in-hospital events and worse long-term outcomes.
- Prospective studies are needed.
Why this matters
- Few data exist on prognostic power of LUS-measured pulmonary congestion in AHF.
- As congestion markers, B-lines have high inter-rater agreement and are more quantifiable than auscultated crackles.
- Most patients had B-lines, even those without clinical or radiologic congestion.
- Additional B-lines correlated with more primary in-hospital outcomes.
- For each higher B-line tertile: aOR, 2.25 (95% CI, 1.24-4.07; P<.007>
- Adjustment included NT-proBNP.
- Prospective observational study in Boston and Glasgow (n=349).
- Participants hospitalised with AHF underwent early LUS and, for some, again at discharge (LUS1 and LUS2, respectively).
- Protocol scanned 4 zones and checked for pleural effusions.
- Masked reviewers counted B-lines.
- In-hospital: composite of death, ICU admission, and need for intravenous inotropes or left-ventricular assist device.
- Long-term: composite of death, heart failure readmission.
- Funding: NIH; British Heart Foundation.
- Unknown whether decongestive therapies should target B-line count.