C. Granger, L. Legrand, Y. Allali, P. Guedeney, R. Isnard, F. Pousset, J.P. Collet, G. Montalescot, N. Hammoudi
{"title":"保留左心室射血分数患者的肺超声评估运动性肺充血,并参考运动超声心动图排除心肌缺血","authors":"C. Granger, L. Legrand, Y. Allali, P. Guedeney, R. Isnard, F. Pousset, J.P. Collet, G. Montalescot, N. Hammoudi","doi":"10.1016/j.acvdsp.2023.04.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Lung ultrasound (LUS) can detect pulmonary congestion<span> assessed by B-lines in heart failure patients undergoing stress test. Exercise B-lines could help diagnose heart failure with preserved left ventricular ejection fraction (LVEF) at an early stage. This study aimed to assess exercise-induced pulmonary congestion </span></span>in patients<span> with preserved LVEF referred for exercise echocardiography to rule out </span></span>myocardial ischemia.</p></div><div><h3>Method</h3><p><span>Data of stress echocardiography combined with LUS at rest and immediately after exercise in patients with LVEF ≥ 50% referred for investigation of inducible myocardial ischemia in a tertiary center of </span>cardiology were retrospectively analyzed. B-lines were assessed by scanning 2 chest sites. Exercise-induced pulmonary congestion was defined as an increase of B-lines ≥ 2 between baseline and exercise.</p></div><div><h3>Results</h3><p>A total of 1114 patients were included. Mean age was 63 years, 54% of patients had hypertension and 27% had diabetes. Exercise-induced pulmonary congestion was identified in 131 (12%) patients. Age, left atrial volume index (LAVi), resting and 20<!--> <!-->W septal E/e’<!--> <!-->><!--> <span>15 and peak tricuspid regurgitation velocity (TRV) were associated with increased exercise-induced B-lines. At multivariable analysis, LAVi (OR</span> <!-->=<!--> <!-->1.03; 95% confidence interval (CI): 1.01–1.06; <em>P</em> <!-->=<!--> <!-->0.003) and peak TRV (OR<!--> <!-->=<!--> <!-->3.8; 95%CI: 1.4–10.1; <em>P</em> <!-->=<!--> <!-->0.009) were independent predictors of exercise-induced pulmonary congestion.</p></div><div><h3>Conclusion</h3><p>Exercise-induced pulmonary congestion could be diagnosed in patients with preserved LVEF referred to rule out inducible myocardial ischemia. Exercise B-lines are linked with left ventricular diastolic dysfunction indices.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exercise-induced pulmonary congestion assessed by lung ultra sound in patients with preserved left ventricular ejection fraction referred for exercise echocardiography to rule out myocardial ischemia\",\"authors\":\"C. Granger, L. Legrand, Y. Allali, P. Guedeney, R. Isnard, F. Pousset, J.P. Collet, G. Montalescot, N. Hammoudi\",\"doi\":\"10.1016/j.acvdsp.2023.04.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span><span>Lung ultrasound (LUS) can detect pulmonary congestion<span> assessed by B-lines in heart failure patients undergoing stress test. Exercise B-lines could help diagnose heart failure with preserved left ventricular ejection fraction (LVEF) at an early stage. This study aimed to assess exercise-induced pulmonary congestion </span></span>in patients<span> with preserved LVEF referred for exercise echocardiography to rule out </span></span>myocardial ischemia.</p></div><div><h3>Method</h3><p><span>Data of stress echocardiography combined with LUS at rest and immediately after exercise in patients with LVEF ≥ 50% referred for investigation of inducible myocardial ischemia in a tertiary center of </span>cardiology were retrospectively analyzed. B-lines were assessed by scanning 2 chest sites. Exercise-induced pulmonary congestion was defined as an increase of B-lines ≥ 2 between baseline and exercise.</p></div><div><h3>Results</h3><p>A total of 1114 patients were included. Mean age was 63 years, 54% of patients had hypertension and 27% had diabetes. Exercise-induced pulmonary congestion was identified in 131 (12%) patients. Age, left atrial volume index (LAVi), resting and 20<!--> <!-->W septal E/e’<!--> <!-->><!--> <span>15 and peak tricuspid regurgitation velocity (TRV) were associated with increased exercise-induced B-lines. At multivariable analysis, LAVi (OR</span> <!-->=<!--> <!-->1.03; 95% confidence interval (CI): 1.01–1.06; <em>P</em> <!-->=<!--> <!-->0.003) and peak TRV (OR<!--> <!-->=<!--> <!-->3.8; 95%CI: 1.4–10.1; <em>P</em> <!-->=<!--> <!-->0.009) were independent predictors of exercise-induced pulmonary congestion.</p></div><div><h3>Conclusion</h3><p>Exercise-induced pulmonary congestion could be diagnosed in patients with preserved LVEF referred to rule out inducible myocardial ischemia. Exercise B-lines are linked with left ventricular diastolic dysfunction indices.</p></div>\",\"PeriodicalId\":8140,\"journal\":{\"name\":\"Archives of Cardiovascular Diseases Supplements\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":18.0000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Cardiovascular Diseases Supplements\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1878648023001520\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases Supplements","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878648023001520","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Exercise-induced pulmonary congestion assessed by lung ultra sound in patients with preserved left ventricular ejection fraction referred for exercise echocardiography to rule out myocardial ischemia
Introduction
Lung ultrasound (LUS) can detect pulmonary congestion assessed by B-lines in heart failure patients undergoing stress test. Exercise B-lines could help diagnose heart failure with preserved left ventricular ejection fraction (LVEF) at an early stage. This study aimed to assess exercise-induced pulmonary congestion in patients with preserved LVEF referred for exercise echocardiography to rule out myocardial ischemia.
Method
Data of stress echocardiography combined with LUS at rest and immediately after exercise in patients with LVEF ≥ 50% referred for investigation of inducible myocardial ischemia in a tertiary center of cardiology were retrospectively analyzed. B-lines were assessed by scanning 2 chest sites. Exercise-induced pulmonary congestion was defined as an increase of B-lines ≥ 2 between baseline and exercise.
Results
A total of 1114 patients were included. Mean age was 63 years, 54% of patients had hypertension and 27% had diabetes. Exercise-induced pulmonary congestion was identified in 131 (12%) patients. Age, left atrial volume index (LAVi), resting and 20 W septal E/e’ > 15 and peak tricuspid regurgitation velocity (TRV) were associated with increased exercise-induced B-lines. At multivariable analysis, LAVi (OR = 1.03; 95% confidence interval (CI): 1.01–1.06; P = 0.003) and peak TRV (OR = 3.8; 95%CI: 1.4–10.1; P = 0.009) were independent predictors of exercise-induced pulmonary congestion.
Conclusion
Exercise-induced pulmonary congestion could be diagnosed in patients with preserved LVEF referred to rule out inducible myocardial ischemia. Exercise B-lines are linked with left ventricular diastolic dysfunction indices.
期刊介绍:
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.