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Prognostic Role of Ultrasound Diagnostic Methods in Patients With Acute Decompensated Heart Failure Publisher



Kobalava ZD1 ; Vladimirovna TV1 ; Kanatbekovich SB2 ; Aslanova RS1 ; Alekseevich LA1 ; Sergeevich NI1 ; Pavlovich SI1 ; Vatsikgorodetskaya MV3 ; Tabatabaei GA4 ; Alzakwani I5, 6 ; Al Jarallah M7 ; Baca GL8 ; Brady PA9 ; Rajan R7 Show All Authors
Authors
  1. Kobalava ZD1
  2. Vladimirovna TV1
  3. Kanatbekovich SB2
  4. Aslanova RS1
  5. Alekseevich LA1
  6. Sergeevich NI1
  7. Pavlovich SI1
  8. Vatsikgorodetskaya MV3
  9. Tabatabaei GA4
  10. Alzakwani I5, 6
  11. Al Jarallah M7
  12. Baca GL8
  13. Brady PA9
  14. Rajan R7
  15. Talera B10
Show Affiliations
Authors Affiliations
  1. 1. Department of Internal Diseases with Courses of Cardiology and Functional Diagnostics, Peoples’ Friendship, University of Russia, Moscow, Russian Federation
  2. 2. Department of Therapeutic Disciplines, Salymbekov Medical University, Bishkek, Kyrgyzstan
  3. 3. Department of Anesthesiology and Rehabilitation, Vinogradov City Clinical Hospital, Moscow, Russian Federation
  4. 4. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  6. 6. Gulf Health Research, Muscat, Oman
  7. 7. Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait
  8. 8. Department of Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, United States
  9. 9. Department of Cardiology, Illinois Masonic Medical Center, Chicago, United States
  10. 10. Department of Internal Medicine, Ivy Superspecialty Hospital, Chandigarh, India

Source: Oman Medical Journal Published:2024


Abstract

Objectives:To evaluate the prognostic value (total mortality + repeated hospitalization for heart failure (HF)) of ultrasound diagnostic methods in patients with acute decompensated HF (ADHF). Methods: The subjects were patients with chronic HF, who were hospitalized for ADHF. Using ultrasound methods—lung ultrasound, ultrasound assessment of hepatic venous congestion as per the venous excess ultrasound (VExUS) protocol, and indirect elastometry—we assessed the number of B-lines, hepatic venous congestion, and liver density of the patients. Clinical outcomes were assessed using a structured telephone survey method at 1, 3, 6, and 12 months after discharge. Combined overall mortality and readmission rates associated with HF were assessed. Threshold values for different methods for detecting congestion were set as follows: the number of B-lines in ultrasound data > 5; liver density > 6.2 kPa. Results: The subjects were 207 patients (54.1% male; mean age = 70.7 ± 12.8 years). A total of 63 (30.4%) endpoints and 23 (11.1%) deaths were detected within 364 days (IQR = 197–365). Liver density > 6.2 kPa had a hazard ratio (HR) of 1.9 (95% CI: 1.0–3.3; p = 0.029). Hepatic venous congestion (VExUS protocol) had HR of 2.8 (95%CI: 1.3–5.7; p = 0.004). There was a significant increase in the risk of overall prognostic value in the presence of congestion, identified by liver fibroelastometry + lung ultrasound (HR = 10.5, 95% CI: 2.3–46.2; p = 0.002). The ultrasound assessment of hepatic venous congestion (VExUS + lung ultrasound protocol) yielded HR of 16.7 (95% CI: 3.9–70.7; p < 0.001). For all three methods combined, the overall HR was 40.1 (95% CI: 6.6–243.1; p <0.001). Conclusions: A combination of ultrasound diagnostic methods that include the number of B-lines, presence of hepatic venous congestion according to the VExUS protocol, and liver density according to indirect elastometry at discharge may have an independent prognostic value for patients with ADHF. © 2024, Oman Medical Journal.
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