Potential of modern investigations for detecting and monitoring asymptomatic congestion in patients with heart failure

Abstract

Congestion associated with pressure and/or volume overload plays a central role in the pathophysiology, manifestations and prognosis of heart failure, being one of the important aims of its therapy. The current methods for congestion diagnosis, mainly clinical, have low sensitivity and specificity, which can lead to a delay in diagnosis and initiation of treatment.Over the past decades, novel, more sensitive and specific ultrasound techniques have been developed to detect increased intracardiac pressure and/or volume overload, providing early and accurate diagnosis and facilitating treatment strategies. The review discusses the role of modern investigations for detecting and quantifying congestion, including visualization of the lungs (B-lines), kidneys (intrarenal venous flow) and the venous system (diameter of the inferior vena cava and internal jugular veins), and transient elastography.

Keywords

• congestion
• heart failure
• b-lines
• inferior vena cava
• intrarenal venous flow
• transient elastography