Lung ultrasonography derived B-line scores as predictors of left ventricular end-diastolic pressure and pulmonary artery wedge pressure

• Published in: Respiratory medicine 2023-11, Vol.219, p.107415-107415, Article 107415
• Main Authors: Garcia, Marcos V.F., Wiesen, Jonathan, Dugar, Siddharth, Adams, Jacob R., Bott-Silverman, Corinne, Moghekar, Ajit, Tonelli, Adriano R.
• Format: Article
• Language: English
• Subjects: Blood Pressure; Cardiac Catheterization - methods; Heart Diseases; Humans; Left ventricular end-diastolic pressure; Lung - diagnostic imaging; Lung ultrasonography; Pulmonary Artery - diagnostic imaging; Pulmonary artery wedge pressure; Pulmonary Wedge Pressure; Right heart catheterization; Ultrasonography; Ventricular Function, Left
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2023.107415

Non-invasive assessment of elevated left ventricular end-diastolic pressure (LVEDP) and pulmonary artery wedge pressure (PAWP) in patients with heart diseases is challenging. Lung ultrasonography (LUS) is a promising modality for predicting LVEDP and PAWP. Fifty-seven stable ambulatory patients who underwent right and left heart catheterization were included. Following the procedures, LUS was performed in twenty-eight ultrasonographic zones, and the correlation between five different LUS derived B-line scores with LVEDP and PAWP was examined. The B-line index correlated with LVEDP and PAWP, with coefficients of 0.45 (p = 0.006) and 0.30 (p = 0.03), respectively. B-line index showed an AUC of 0.76 for identifying LVEDP > 15 mmHg (p = 0.01) and an AUC of 0.73 for identifying PAWP > 15 mmHg (p = 0.008). Overall, scores performances were similar in predicting LVEDP or PAWP > 15 mmHg. A B-line index ≥ 28 was significantly associated with LVEDP > 15 mmHg (OR: 9.97) and PAWP > 15 mmHg (OR: 6.61), adjusted for age and indication for heart catheterization. LUS derived B-line scores are moderately correlated with PAWP and LVEDP in patients with heart diseases. A B-line index ≥ 28 can be used to predict elevated LVEDP and PAWP with high specificity. •LUS shows promise in assessing left ventricular pressures.•B-line scores correlate with PAWP and LVEDP in heart disease.•B-line index ≥ 28 predicts elevated LVEDP and PAWP with specificity.•Early identification of lung congestion is possible with LUS.•LUS valuable for assessing pulmonary hemodynamics in heart disease.