RESULTS: We pooled data on patients hospitalized for HF or followed up in outpatient clinics from international cohorts. We enrolled 1947 patients at admission (n = 578), discharge (n = 389), and in outpatient clinics (n = 980). The total LUS B-line count was calculated for the eight-zone scanning protocol. The primary outcome was a composite of rehospitalization for HF and all-cause death. Compared with those in the lower tertiles of B lines, patients in the highest tertiles were older, more likely to have signs of HF and had higher N-terminal pro b-type natriuretic peptide (NT-proBNP) levels. A higher number of B lines was associated with increased risk of primary outcome at discharge [Tertile 3 vs. Tertile 1: adjusted hazard ratio (HR): 5.74 (3.26-10.12), P < 0.0001] and in outpatients [Tertile 3 vs. Tertile 1: adjusted HR: 2.66 (1.08-6.54), P = 0.033]. Age and LVEF did not influence the prognostic capacity of LUS in different clinical settings. Adding B-line count to the MAGGIC and AHEAD scores improved net reclassification significantly in all three clinical settings.
CONCLUSIONS: A higher number of B lines in patients with HF was associated with an increased risk of morbidity and mortality, regardless of the clinical setting.
结果:我们汇集了国际队列中HF住院患者或门诊随访患者的数据。我们招募了1,947名患者,在入学时(n=578),出院(n=389)和门诊(n=980)。计算8区扫描方案的总LUSB线计数。主要结局是心力衰竭再住院和全因死亡的复合结果。与B线较低的三分位数相比,最高三分位数的患者年龄较大,更有可能有HF的迹象和更高的NT-proBNP水平。B线数量增加与出院时主要结局风险增加相关(Tertile3vsTertile1:adjustedHR=5.74(3.26-10.12),p<0.0001)和门诊患者(Tertile3vsTertile1:adjustedHR=2.66(1.08-6.54),p=0.033)。年龄和LVEF不影响LUS在不同临床情况下的预后能力。在所有三种临床设置中,将B线计数添加到MAGGIC和AHEAD评分显着改善了净重新分类。
结论:HF患者的B线数量增加与发病率和死亡率风险增加相关,无论临床环境如何。