- In a proof-of-concept study, outpatients recently hospitalised with heart failure (HF) had better follow-up outcomes if doctors based treatment decisions on lung ultrasound (LUS).
- Large clinical trials are needed.
Why this matters
- Pulmonary congestion is the most important reason these patients land in the hospital, yet it is hard to assess clinically.
- LUS vs standard group:
- Primary outcome: 23% (n=14) vs 40% (n=25; P=.045).
- Primary outcome: HR, 0.518 (95% CI, 0.268-0.998; P=.049).
- Number needed to treat to avoid an event: 5 (95% CI, 3-62).
- Difference attributable mainly to fewer urgent visits for worsening heart failure in LUS-guided group.
- Similar between-group levels of NT-proBNP and QoL.
- LUS-guided group received more loop diuretics and had greater improvement in the 6-minute walking test.
- Single-blind 6-month clinical LUS-HF trial of adults hospitalised for HF (n=123).
- After discharge, participants were randomly assigned to LUS-guided vs standard follow-up.
- They were seen at 14, 30, 90, and 180 days postdischarge.
- For LUS group, physicians were encouraged to make diuretic decisions based on B-lines.
- Outcomes: composite of urgent visit, hospitalisation for worsening HF, and all-cause mortality.
- Funding: Spanish governmental, nonprofit funders.
- Single-centre study.
- Wide confidence ratios and low fragility index.