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Body mass index and B-lines on lung ultrasonography in chronic and acute heart failure

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  • Philip Brainin
  • Brian Claggett
  • Eldrin F Lewis
  • Kristin H Dwyer
  • Allison A Merz
  • Montane B Silverman
  • Varsha Swamy
  • Tor Biering-Sørensen
  • Jose Rivero
  • Susan Cheng
  • John J V McMurray
  • Scott D Solomon
  • Elke Platz
Vis graf over relationer

AIMS: Increased body mass index (BMI) is common in heart failure (HF) patients and is associated with lower levels of N-terminal pro-brain natriuretic peptide (NT-proBNP). We evaluated the influence of BMI on lung ultrasonography (LUS) findings indicative of pulmonary congestion (i.e. B-lines) in patients with chronic and acute HF (AHF).

METHODS AND RESULTS: We analysed ambulatory chronic HF (n = 118) and hospitalized AHF (n = 177) patients (mean age 70 years, 64% men, mean BMI 29 kg/m2 , mean ejection fraction 42%) undergoing echocardiography and LUS in eight chest zones. B-lines and chest wall thickness (skin to pleura) on ultrasound were quantified offline and blinded to clinical findings. NT-proBNP was available in AHF patients (n = 167). In chronic HF, B-line number decreased by 18% per 5 unit increase in BMI [95% confidence interval (CI) -35% to +5%, P = 0.11]. In AHF, the number of B-lines decreased by 12% per 5 unit increase in BMI (95% CI -19% to -5%, P = 0.001), whereas NT-proBNP concentration decreased by 28% per 5 unit increase in BMI (95% CI -40% to -16%, P < 0.001). For AHF, B-line number declined to a lesser degree than NT-proBNP concentration with increasing BMI (P = 0.020), and >6 B-lines were observed in half of AHF patients with severe obesity. There was an inverse relationship between B-line number and chest wall thickness, and this association varied by chest region.

CONCLUSIONS: Despite an inverse relationship between B-lines and BMI, B-lines declined to a lesser degree than NT-proBNP with increasing BMI. These data suggest that LUS may be useful in patients with HF despite obesity.

OriginalsprogEngelsk
TidsskriftESC Heart Failure
Vol/bind7
Udgave nummer3
Sider (fra-til)1201-1209
Antal sider9
ISSN2055-5822
DOI
StatusUdgivet - jun. 2020

Bibliografisk note

© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

ID: 61290996