| Objective: The purpose of this study is to investigate the clinical characteristics of lung ultrasound in the evaluation of different ejection fraction classification of heart failure in patients with acute exacerbation of chronic heart failure,as well as the correlation between lung ultrasound,Echocardiography,and laboratory examination results,so as to provide an effective basis for evaluating the diagnosis of acute exacerbation of chronic heart failure.Methods: This is a prospective,single-center,observational study.The patients with acute exacerbation of chronic heart failure who meet the inclusion and exclusion criteria were continuously collected and treated in accordance with the “Chinese Heart Failure Diagnosis and Treatment Guidelines 2018” after admission.Heart and lung ultrasound examinations were performed within 2 hours of the patient’s admission.Two cardiologists who have received professional training and passed the assessment will perform transthoracic heart color ultrasonography and lung ultrasound examinations without knowing the patient’s condition.Calculate the B-line score according to the method of Professor Enghard.According to the classification of left ventricular ejection fraction,they were divided into three groups: heart failure with preserved ejection fraction(HFpEF),heart failure with Midrange ejection fraction(HFmrEF),and heart failure with reduced ejection fraction(HFrEF).Admission to the hospital to complete laboratory tests such as troponin T,blood routine,electrolytes,renal function,amino-terminal B-type natriuretic peptide precursor,lactic acid,and C-reactive protein.Collect patients’ general clinical data including age,gender,body mass index,heart failure symptoms,heart failure signs,etc.,and finally perform relevant statistical analysis.Results: From December 2020 to February 2021,112 patients with acute exacerbation of chronic heart failure in the Department of Cardiology,Xiangtan Central Hospital were continuously collected for cardiac ultrasound and lung ultrasound.According to the inclusion and exclusion criteria,81 patients with acute exacerbation of chronic heart failure were finally included.Compare the clinical data of patients with acute exacerbation of chronic heart failure HFpEF group,HFmrEF group and HFrEF group.The lung B-line score of 18.00(15.00,28.50)in the HFpEF group was lower than 33.00(18.00,41.00)in the HFrEF group,the difference was statistically significant(P<0.05);There was no statistical difference between 26.00(22.00,34.50)in the HFmrEF group.The NT-proBNP concentration of 12533.00(5300.00,22789.00)pg/ml in the HFrEF group was higher than 7141.00(2616.50,10496.50)pg/ml in the HFpEF group,and the difference was statistically significant(P<0.05).The left ventricular end-diastolic diameter(5.39±0.76)cm in the HFrEF group was higher than that in the HFpEF group(4.55±0.75)cm and the HFmrEF group(4.70±0.68)cm,and the difference was statistically significant(P<0.05).The left ventricular end-systolic diameter(4.59±0.75)cm in the HFrEF group was higher than that in the HFpEF group(3.16±0.77)cm and the HFmrEF group(3.49±0.74)cm,and the difference was statistically significant(P<0.05).The lung B-line score was significantly positively correlated with NT-proBNP(r=0.789,P<0.001).The lung B-line score was significantly positively correlated with E/e’(r=0.601,P<0.001).The lung B-line score was markedly negatively correlated with LVEF(r=-0.386,P<0.001).Conclusion:(1)Lung ultrasound B-line score is a reliable indicator of the severity of heart failure in patients with acute exacerbation of chronic heart failure.(2)The lung ultrasound B-line score has a good correlation with NT-proBNP,E/e’,and LVEF. |
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