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Vol. 147. Issue 1.
Pages 13-15 (July 2016)
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Vol. 147. Issue 1.
Pages 13-15 (July 2016)
Brief report
Use of lung ultrasound as a prognostic tool in outpatients with heart failure
Utilidad pronóstica de la ecografía pulmonar en el seguimiento ambulatorio de pacientes con insuficiencia cardiaca
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María del Carmen Tojo Villanuevaa,b,
Corresponding author
, María Fernández Lópeza,b, Jesús Canora Lebratoa,b, José Ángel Satué Bartoloméa,b,c, Alberto San Martín Pradoa,c, Antonio Zapatero Gaviriaa,b
a Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
b Universidad Rey Juan Carlos, Madrid, Spain
c Unidad de Manejo Integral del Paciente con Insuficiencia Cardiaca (UMIPIC), Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Table 1. Patient characteristics.
Abstract
Objectives

To assess the prognostic value of lung ultrasound for patients with chronic heart failure.

Methods

Prospective observational cohort study, in which a lung ultrasound was performed on 54 patients at a heart failure outpatient consultation. Ultrasonography was classified as positive or negative for ultrasound interstitial syndrome depending on the number of B lines observed. Patients were followed up for six months; considering emergency visits, readmissions and deaths due to heart failure as markers of poor prognosis.

Results

53.7% (29) of the patients had ultrasound interstitial syndrome. Among them, 48.3% (14) were readmitted, compared to 16% (4) of those without the syndrome (p=.012). Considering any of the events previously described as end points (readmissions, emergencies and deaths), we found that in the group of patients with ultrasound interstitial syndrome, 55.2% (16) had at least one of these complications, compared to 20% (5) of participants without the syndrome (p=.008).

Conclusions

Lung ultrasound in the outpatient setting is useful in predicting which patients are at increased risk of heart failure decompensation in the mid-term.

Keywords:
Lung ultrasound
Thoracic ultrasound
Heart failure
Outpatient
Prognosis
Resumen
Objetivo

Valorar la utilidad pronóstica de la ecografía pulmonar en pacientes con insuficiencia cardiaca.

Métodos

Estudio observacional de cohortes prospectivo, en el que se realizó una ecografía pulmonar a 54 pacientes en seguimiento ambulatorio por insuficiencia cardiaca. La ecografía se clasificó como positiva o negativa para síndrome intersticial ecográfico según el número de líneas B observadas. Se realizó un seguimiento durante 6 meses, considerando eventos indicativos de mal pronóstico las visitas a urgencias, reingresos y fallecimientos debidos a insuficiencia cardiaca.

Resultados

El 53,7% (29) de los enfermos presentaban síndrome intersticial ecográfico. De ellos, reingresaron el 48,3% (14) frente al 16% (4) de los que no tenían dicho síndrome (p=0,012). Considerando como variable final conjunta la necesidad de reingreso, las urgencias y fallecimientos por insuficiencia cardiaca, el 55,2% (16) de los pacientes con síndrome intersticial presentaron al menos una de estas complicaciones, frente al 20% (5) de los participantes sin el síndrome (p=0,008).

Conclusiones

La ecografía en el ámbito ambulatorio es útil para predecir qué enfermos tienen mayor riesgo de descompensación de insuficiencia cardiaca a medio plazo.

Palabras clave:
Ecografía pulmonar
Ecografía torácica
Insuficiencia cardiaca
Consulta
Pronóstico

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