Lung ultrasound evaluation of diabetic patients with acute onset dyspnea and its relationship with established markers of heart failure

Abstract

Objective: The aim of the study was to assess the interrelation between sonographic pleural B-Line, left ventricular function and Naturetic Peptides in type 2 Diabetics with acute onset class III-IV dyspnea. There is dearth of data in this subset of patients in Asian population. Methods: Subjects (n = 73) were divided into those with pleural B line (Group A, n = 41) and those without (Group B) and their serum B type Naturetic Peptide (BNP) and Echocardiography evaluated. Results: The serum BNP was significantly higher and mean Left Ventricular Ejection Fraction (LVEF) lower in Group A compared to Group B (p < 0.001). There was a significant negative correlation between LVEF and BNP and positive correlation between E/E’ and BNP. Among patients with LVEF 40% and above (n = 36), patients with B line had significantly higher BNP and E/E’ compared to those without. Group A had significantly more patients on insulin therapy and troponin positivity than Group B (p < 0.01). On auscultation though crepitations was found more frequently in group A but it was present in only 50% of the subset. Conclusion: Pleural B-Lines, LVEF and mitral inflow E/septal E’ can be used to rule in heart failure in the above population. Keywords: Sonographic B line, Diabetes mellitus, Heart failure