Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort

Version 1 : Received: 6 December 2021 / Approved: 7 December 2021 / Online: 7 December 2021 (23:46:59 CET)

A peer-reviewed article of this Preprint also exists.

Torres-Arrese, M.; García de Casasola-Sánchez, G.; Méndez-Bailón, M.; Montero-Hernández, E.; Cobo-Marcos, M.; Rivas-Lasarte, M.; Caurcel-Díaz, L.; Rodríguez-Fuertes, P.; Villén-Villegas, T.; Tung-Chen, Y. Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort. Medicina 2022, 58, 124. Torres-Arrese, M.; García de Casasola-Sánchez, G.; Méndez-Bailón, M.; Montero-Hernández, E.; Cobo-Marcos, M.; Rivas-Lasarte, M.; Caurcel-Díaz, L.; Rodríguez-Fuertes, P.; Villén-Villegas, T.; Tung-Chen, Y. Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort. Medicina 2022, 58, 124.

Journal reference: Medicina 2022, 58, 124
DOI: 10.3390/medicina58010124

Abstract

Background and Objectives: Acute Heart Failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying the pulmonary hypertension (PH) in patients admitted due to AHF, predict the evolution of the disease during hospitalization and identify areas of improvement in the care of patients with AHF. Materials and Methods: Patients were evaluated with a standard exam of lung ultrasound, echocardiography, inferior vena cava (IVC) and femoral, renal, hepatic, portal venous Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation – SD 13,4). Seven patients (23.3%) had a renal function worsening. Regarding ultrasound findings, venous excess ultrasonography score (VExUS) score was calculated at admission and at discharge, surprisingly remaining unchanged or even worsened in most of them (21 patients, 70.0%). The area under the curve for the Lung Score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (p <0.001), hepatic vein Doppler (p <0.001), portal vein Doppler (p = 0.030), intra-renal vein Doppler (p = 0.025) and VExUS score (p = 0.023), remaining similar the femoral vein Doppler (p = 0.177) and IVC (p = 0.132). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VExUS score, should be further studied in different populations before expanding its use in AHF patients.

Keywords

acute heart failure (AHF); venous congestion; Point-of-Care Ultrasound (POCUS); VExUS (venous excess ultrasonography score).

Subject

MEDICINE & PHARMACOLOGY, Cardiology

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