The VTI–VExUS ultrasound profiles significantly improved prognostic discrimination in acute heart failure, with 30-day event rates ranging from 11.3% to 69.2% (p<0.001).
Does combined VTI-VExUS ultrasound profiling improve risk stratification compared to standard clinical assessment in adults admitted with acute heart failure?
Combined VTI-VExUS ultrasound profiling significantly improves 30-day prognostic discrimination over standard clinical assessment in patients admitted with acute heart failure.
Absolute Event Rate: 0% vs 0%
Abstract Aims Clinical evaluation of congestion and perfusion in acute heart failure (AHF) has recognized limitations. Ultrasound tools such as the Venous Excess Ultrasound Score (VExUS) and the left ventricular outflow tract velocity–time integral (LVOT VTI) have gained increasing support for bedside haemodynamic profiling. We assessed the incremental prognostic value of a combined VTI–VExUS classification compared with standard clinical assessment. Methods and Results We prospectively enrolled adults admitted with AHF. Within 24 hours of presentation, VExUS (congestion) and LVOT VTI (perfusion) were assessed and integrated into four ultrasound-based profiles. The primary endpoint was a 30-day composite of all-cause mortality, cardiogenic shock, mechanical ventilation, short-term ventricular assist device use, and inotropic/vasopressor therapy. Among 167 patients (mean age 58.2 ± 13.4 years; 72% male), event rates increased across VTI–VExUS profiles (11.3%, 34.6%, 32.4%, and 69.2%, p0.001). Discrimination was superior for the VTI–VExUS model versus clinical assessment alone (AUC 0.74 vs. 0.58, p=0.0016). Integrated discrimination improvement confirmed the added prognostic contribution (IDI 0.157, p=0.004). Ultrasound profiles were independently associated with outcomes. Conclusion VTI–VExUS ultrasound profiling provides significant incremental prognostic information beyond clinical assessment in AHF. These findings support its role as a complementary bedside tool for early risk stratification.
Ruiz-Fuentes et al. (Tue,) reported a other. The VTI–VExUS ultrasound profiles significantly improved prognostic discrimination in acute heart failure, with 30-day event rates ranging from 11.3% to 69.2% (p<0.001).