Comparative study in left heart failure patients with or without pulmonary edema by integrative cardiopulmonary ultrasound / 中华超声影像学杂志

ABSTRACT

Objective To compare the clinical and echocardiographic parameters in left heart failure patients with or without pulmonary edema by cardiopulmonary ultrasound.Methods All patients underwent transthoracic lung ultrasonography and echocardiography examination.The following echocardiographic parameters were determinedleft ventricular end-diastolic and end-systolic diameters (LVEDD and LVESD),left ventricular end-diastolic and end-systolic volumes (LVEDV and LVESV),left ventricular ejection fraction (LVEF),left atrial volume index (LAVindex),systolic pulmonary artery pressure (SPAP) and the degree of mitral regurgitation,the peak Doppler velocities of early (E) and late (A) diastolic flow,early (e') diastolic velocity of the mitral annulus,and the average E/e'ratio was calculated.The NYHA functional classification and N-terminal pro B-type natriuretic peptide (NT-proBNP) were also recorded.Results A total of 113 heart failure patients,included 72 patients (63.7％) combined with pulmonary edema revealed by lung ultrasonography.Compared with patients without pulmonary edema,those with pulmonary edema were with higher plasma concentrations of NT-proBNP,NYHA functional class,left ventricular diastolic function classification,SPAP and E/e',larger LVEDD and the diameter of right ventricle,more severe mitral regurgitation,and lower LVEF(all P ＜0.05).By multivariate logistic regression analysis,E/e',SPAP and NT-proBNP were independent echocardiographic predictors of pulmonary edema in patients with heart failure.Conclusions Cardiopulmonary ultrasound can evaluate heart and pulmonary condition in patients with heart failure.Left ventricular diastolic function is an important determinant of pulmonary edema in patients with left heart failure.