Assessing pulmonary congestion in patients hospitalized with decompensated chronic heart failure according to lung ultrasound and remote dielectric sensing (ReDS)

Aim . To conduct a comparative assessment of parameters and dynamics of pulmonary congestion according to lung ultrasound and remote dielectric sensing (ReDS) in patients hospitalized with decompensated chronic heart failure (CHF). Materials and methods . The pilot single-center study included patients hospitalized with decompensated CHF. Lung ultrasound and ReDS were simultaneously performed within 24 hours from the moment of hospitalization and at discharge. Eight-zone lung ultrasound was performed with the calculation of the sum of B-lines. Pulmonary congestion was confirmed with the sum of B-lines ≥ 5. ReDS was performed according to the manufacturer’s protocol. Congestion was confirmed at the value of more than 35%. To determine ReDS interoperator variability, each patient was examined by two operators who were blind to each other’s findings with a 20–30-minute interval. Results . Thirty-five patients were included in the study: 40% ( n = 14) men, the average age was 71 (65.5; 78.5) years, the median NT-proBNP was 1,379 (470; 4,277) pg / l. Hydrothorax at admission was observed in 31,4% ( n = 11) of patients. The incidence of pulmonary congestion according to lung ultrasound was 57.1% ( n = 20): 31.4% ( n = 11) of patients had mild congestion, 22.9% ( n = 8) – moderate, and 2.9% ( n = 1) – severe congestion. ReDS data revealed pulmonary congestion in 62.9% ( n = 22) of cases, of which 37,1% ( n = 13) of cases were characterized by mild, 22.9% ( n = 8) – by moderate, and 2.9% ( n = 1) – by severe congestion. A moderate correlation was found between ReDS (%) and lung ultrasound (sum of B-lines) findings at admission (Spearman’s rank correlation coefficient = 0.402; p = 0.017). No correlation between the two methods was found at discharge ( p = 0.613). The frequency of agreement between lung ultrasound and ReDS on signs of congestion at admission was 77.1% ( p = 0.004) with an average Cohen’s Kappa coefficient ( κ = 0.53). The average interoperator variability in ReDS was 9.9%. Conclusion . A moderate correlation was revealed between ReDS (%) and lung ultrasound (sum of B-lines) in detecting pulmonary congestion (Spearman’s rank correlation coefficient = 0.402; p = 0.017). No correlation between the two methods was found at discharge (p = 0.613).