Experience in using ultrasonography to detect pulmonary extravascular fluid in patients with heart failure

Abstract

Aim. To study the possibilities of ultrasonography to detect abundant pulmonary fluid accumulation, by recording the ultrasound lung comets (ULCs). Subjects and methods. One hundred and forty coronary heart disease patients (aged 68.6 ± 15.7 years) with signs of heart failure: acute left ventricular heart failure (acute left ventricular heart failure (ALVHF) in 19 patients and chronic heart failure (CHF) in 121, were examined. EchoCG, lung X-ray study and ultrasonography (USG) were performed to reveal ULCs on admission and over time. Results. On admission, lung USG recorded multiple ULCs in all patients (n = 15) in the ALVHF group. Repeated lung USG showed a decrease in the amount of ULCs in response to diuretic therapy. In the group of patients with Functional Classes (FC) III-IV CHF (n = 19), primary lung USG indicated multiple and single ULCs in 11 (57.9%). Repeated lung USG demonstrated a decrease in the amount of ULCs in response to diuretic therapy. In the FC I-II CHF (n = 106), primary lung ULCs identified multiple and single ULCs in 12 (11.3%). In the group of 19 apparently healthy individuals, single ULCs were revealed in 3 (15.8%) cases. Conclusion. The decreased number of ULCs in patients with CHF shows a high correlation with the efficiency of diuretic therapy. In patients with CHF, the detection rate of ULCs depends on the severity of CHF.

Keywords

• lung ultrasonography
• lung comets
• diagnosis
• echocardiography