Aims: Studies have demonstrated the reliability of B-lines evaluated by lung ultrasonography to identify pulmonary congestion, but information is lacking about its utility as a prognostic marker of heart failure (HF). We sought to assess the prognostic midterm value of B-lines in ambulatory patients presenting with dyspnoea, as an additive tool for patient management and to avoid acute HF exacerbations.
Methods and results: A total of 93 patients presenting with dyspnoea (New York Heart Association ≥2) were prospectively recruited in an outpatient clinic, and underwent clinical and echocardiographic evaluation, as well as B-line evaluation with lung ultrasonography in eight zones. Primary endpoint was HF hospitalization at 1 year. A total of 88 patients were included, age 72.3 ± 9.6, with left ventricular ejection 47.7 ± 28.6%; E/e' 16.9 ± 10.9, left atrial volume 51.9 ± 22.5 mL/m2 ; peak tricuspid regurgitation velocity 2.6 ± 0.5 m/s, average B-line count 7.7 ± 10. 8 (9%) patients were hospitalized for HF, seven of which had ≥6 B-lines. B-line cut-off ≥6 (specificity = 66.2%; sensitivity = 87.5%) was predictive for HF hospitalization, with an odds ratio at 13.7 for HF hospitalization at 1 year [IC95% (1.6-117.4), P = 0.017].
Conclusions: Ambulatory patients with ≥6 B-lines have a higher risk of HF hospitalization at 1 year. This study highlights the prognostic value of B-lines in evaluating HF risk in dyspnoeic patients.
Keywords: B-line; Dyspnoea; Filling pressure; Heart failure; Prognosis.