Key result
Pre-discharge E/e', lung B-lines, and dilated IVC predict death and CV hospitalization in advanced HFrEF.
Why the study?
Ultrasound markers of congestion as predictors of outcomes in HFrEF had not been independently validated.
Do ultrasound markers of congestion before discharge predict death and cardiovascular hospitalization in patients with advanced HFrEF?
Do ultrasound markers of congestion before discharge predict death and cardiovascular hospitalization in patients with advanced HFrEF?
Pre-discharge assessment of ultrasound markers of congestion (E/e', lung B lines, IVC diameter) can independently predict rehospitalization and mortality in advanced HFrEF patients.
May support pre-discharge congestion assessment in advanced HFrEF; leaves open prospective validation before guiding therapy.
Aims Ultrasound markers of congestion as predictors of outcomes in heart failure with reduced ejection fraction ( HFrEF ) have not been independently validated. The primary objective was to evaluate the importance of cardiovascular imaging to predict cardiovascular events in patients with advanced HF through assessment of congestion. Methods and Results We assessed the association between cardiovascular markers of congestion and outcomes in 103 patients with advanced high risk HFrEF before discharge . After multiple adjustments , the significant predictors of death and cardiovascular hospitalization were E/e' >15 (Pic 1 ), presence of more than 3 B lines at lung ultrasound ( LUS) at each site and inferior vena cava diameter>2,5 cm . The combination of these three parameters differentiated patients with <20 % at 18 months follow up ( (Pic 2). Conclusions Use of three feasible cardiovascular ultrasound markers of congestion - LV filling pressure parameter ,LUS and inferior vena diameter before hospital discharge independently predict rehospitalization and cardiovascular mortality in patients with advanced HF . The data suggest the need of careful cardiovascular ultrasound assessment at pre discharge period in advanced HF.
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Sisakian et al. (2025) studied this question. E/e' >15, >3 B lines on lung ultrasound, and IVC diameter >2.5 cm before discharge predict death and cardiovascular hospitalization in advanced HFrEF.
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