TỶ LỆ VÀ ĐẶC ĐIỂM SUNG HUYẾT PHỔI TRÊN SIÊU ÂM PHỔI LÚC XUẤT VIỆN Ở NGƯỜI SUY TIM CẤP

Abstract

Introduction: Pulmonary congestion (PC), a prevalent clinical manifestation of acure heart failure (AHF), can be assessed using B-lines on lung ultrasound (LUS). Understanding the prevalence and characteristics of PC on lung ultrasound at discharge provides essential information for minimizing post discharge death and readmission in patients with AHF. Objective: To determine the prevalence and characteristics of PC at discharge using an eight-zone LUS, based on cut-off value from 2023 European Association of Cardiovascular Imaging (EACVI) clinical consensus statement about LUS in heart failure, in patients with AHF. Methods: This descriptive cross-sectional study was conducted on 100 stable AHF patients preparing for discharge from Department of Cardiology, Nguyen Tri Phuong Hospital, from October 2024 to April 2025. Clinical data, laboratory results, and discharge medications were collected from medical records. Eight-zone LUS was performed concurrently with transthoracic echocardiography on the day of discharge. Results: This study included 100 patients, with median age of 68 years (IQR 58.5–77.2), 50% male. The median left ventricular ejection fraction was 40% (IQR 30–64). The median B-line sum was 14 (IQR 7.25–20), and the median B-line score was 1.5 (IQR 1–6). The prevalence of PC at discharge was 49%. PC was significantly more prevalent in patients with acute decompensated chronic heart failure (ADCHF) compared to “de-novo” AHF, and in those with NYHA class III compared to NYHA class I and II at discharge. Patients with PC at discharge were older, had more rales and leg edema, larger inferior vena cava diameter (IVC), and higher B-line sum, B-line score with statistically significant differences (p<0.05). Conclusion: Nearly 50% of AHF patients exhibited signs of PC on LUS at discharge, with higher prevalence in patients with ADCHF and those classified as NYHA III. Patients with PC were generally older, had more signs of clinical congestion at discharge and greater IVC, as well as higher B-line sum and B-line score.