PMID- 32633473
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 7
IP  - 5
DP  - 2020 Oct
TI  - Prevalence and prognostic impact of subclinical pulmonary congestion at discharge 
      in patients with acute heart failure.
PG  - 2621-2628
LID - 10.1002/ehf2.12842 [doi]
AB  - AIMS: Residual pulmonary congestion at hospital discharge can worsen the outcomes 
      in patients with heart failure (HF) and can be detected by lung ultrasound (LUS). 
      The aim of this study was to analyse the prevalence of subclinical pulmonary 
      congestion at discharge and its impact on prognosis in patients admitted for 
      acute HF. METHODS AND RESULTS: This is a post-hoc analysis of the LUS-HF trial. 
      LUS was performed by the investigators in eight chest zones with a pocket device. 
      Physical exam was subsequently performed by the treating physicians. Primary 
      outcome was a combined endpoint of rehospitalization, unexpected visit for HF 
      worsening or death at 6- month follow-up. Subclinical pulmonary congestion at 
      discharge was defined as the presence of >/=5 B-lines in LUS in absence of rales in 
      the auscultation employing the area under the ROC curve. At discharge, 100 
      patients (81%) did not show clinical signs of pulmonary congestion. Of these, 41 
      had >/=5 B-lines. Independent factors related with the presence of subclinical 
      pulmonary congestion were anaemia, higher New York Heart Association (NYHA) 
      class, and N terminal pro brain natriuretic peptide (NT-proBNP). After adjusting 
      by propensity score analysis including age, renal insufficiency, atrial 
      fibrillation, NYHA class, NT-proBNP levels, clinical congestion, and the trial 
      intervention, the presence of subclinical pulmonary congestion at discharge was a 
      risk factor for the occurrence of the primary outcome (hazard ratio 2.63; 95% 
      confidence interval: 1.08-6.41; P = 0.033). CONCLUSIONS: Up to 40% of patients 
      considered 'dry' according to pulmonary auscultation presents subclinical 
      congestion at hospital discharge that can be detected by LUS and implies a worse 
      prognosis at 6- month follow-up. Comorbidities, high values of natriuretic 
      peptides, and higher NYHA class are the factors related with its presence.
CI  - (c) 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Rivas-Lasarte, Mercedes
AU  - Rivas-Lasarte M
AUID- ORCID: 0000-0002-8704-3104
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Maestro, Alba
AU  - Maestro A
AUID- ORCID: 0000-0003-1785-3125
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Fernandez-Martinez, Juan
AU  - Fernandez-Martinez J
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Lopez-Lopez, Laura
AU  - Lopez-Lopez L
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Sole-Gonzalez, Eduard
AU  - Sole-Gonzalez E
AUID- ORCID: 0000-0002-5727-9925
AD  - Cardiology Department, Hospital del Mar, Barcelona, Spain.
FAU - Vives-Borras, Miquel
AU  - Vives-Borras M
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Montero, Santiago
AU  - Montero S
AUID- ORCID: 0000-0002-0984-3472
AD  - Cardiology Department, Hospital Germans Trias i Pujol, Universitat Autonoma de 
      Barcelona, Barcelona, Spain.
FAU - Mesado, Nuria
AU  - Mesado N
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Pirla, Maria J
AU  - Pirla MJ
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Mirabet, Sonia
AU  - Mirabet S
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Fluvia, Paula
AU  - Fluvia P
AD  - Cardiology Department, Hospital Doctor Josep Trueta, Gerona, Spain.
FAU - Brossa, Vicens
AU  - Brossa V
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Sionis, Alessandro
AU  - Sionis A
AUID- ORCID: 0000-0003-0843-9512
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Roig, Eulalia
AU  - Roig E
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Cinca, Juan
AU  - Cinca J
AUID- ORCID: 0000-0003-4819-4265
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Alvarez-Garcia, Jesus
AU  - Alvarez-Garcia J
AUID- ORCID: 0000-0002-2015-6446
AD  - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIb-SantPau, 
      CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.
LA  - eng
GR  - CM17/00028/Instituto de Salud Carlos III/International
GR  - Fondo Europeo de Desarrollo Regional/International
GR  - CB16/11/00276/Centro de Investigacion Biomedica en Red Enfermedades 
      Cardiovaculares/International
GR  - Spanish Ministerio de Economia y Competitividad/International
GR  - Daniel Bravo Andreu Private Foundation/International
GR  - Spanish Society of Cardiology/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200707
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
SB  - IM
MH  - *Heart Failure/complications/diagnosis/epidemiology
MH  - Humans
MH  - Lung/diagnostic imaging
MH  - *Patient Discharge
MH  - Prevalence
MH  - Prognosis
PMC - PMC7524099
OTO - NOTNLM
OT  - Heart failure
OT  - Lung ultrasound
OT  - Prognosis
OT  - Pulmonary congestion
COIS- None declared.
EDAT- 2020/07/08 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/07/07
CRDT- 2020/07/08 06:00
PHST- 2020/02/14 00:00 [received]
PHST- 2020/04/14 00:00 [revised]
PHST- 2020/05/29 00:00 [accepted]
PHST- 2020/07/08 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/07/08 06:00 [entrez]
PHST- 2020/07/07 00:00 [pmc-release]
AID - EHF212842 [pii]
AID - 10.1002/ehf2.12842 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2020 Oct;7(5):2621-2628. doi: 10.1002/ehf2.12842. Epub 2020 Jul 
      7.