Table 2.
Multimodal assessment (clinical, laboratory, and LUS).
| First Author Year of Publication Country |
Objectives | Methods | Results | |||
|---|---|---|---|---|---|---|
| Design | Participants | Instruments | Outcomes | |||
| Maw AM et al., 2019 [63] (EEUU) |
To compare the accuracy of LUS with the accuracy of chest radiography (CxR) in the diagnosis of HF. | Systematic Review and Meta-analysis Prospective cohorts |
6 studies N = 1827 |
LUS vs. CxR | Detection of cardiogenic pulmonary edema | Sensitivity LUS vs. CxR 0.88 (95% Cl, 0.75–0.95) vs. 0.73 (95% CI, 0.70–0.76) Specificity LUS vs. CxR 0.90 (95% Cl, 0.88–0.92) vs. 0.90 (95% CI, 0.75–0.97). |
| Pivetta E et al., 2019 [67] (Italy) |
To evaluate accuracy of combining [LUS] vs. [CxR + NT-proBNP] | Randomized trial | N = 518 | Either LUS or [CXR/NT + proBNP] | HF diagnosis accuracy | LUS was higher than [CXR/Nt-proBNP] (AUC 0.95 vs. 0.87, p < 0.01). |
| Curbelo et al., 2019 [54] (Spain) |
Comparing the usefulness of inferior vena cava (IVC) ultrasound, lung ultrasound, bioelectrical impedance analysis (BIA), and (NT-proBNP) | Prospective cohort study | N = 99 | LUS IVC BIA NT-proBNP |
Parameters of congestion and mortality | Mortality was associated to significantly lower IVC collapse, and a greater number of lung B-lines; and higher NTproBNP levels. No differences in the BIA parameters. |
| Reddy V et al., 2019 [71] (EEUU) |
To evaluate increases in Extravascular water at rest and during exercise | Observacional | N = 66 | LUS during invasive hemodynamic submaximal exercise testing | B-lines increase during exercise | 54% (n = 33) either developed new B-lines (n = 23, 38%) or developed an increase in the number B-lines (n = 10, 16%) during exercise. |
| Domingo M et al. 2020 [73] (Spain) |
To assess relationship between B-lines assessed by LUS and biomarkers | prospective cohort of ambulatory patients | N = 170 | 12-scan LUS protocol (8 anterolateral areas plus 4 lower posterior thoracic areas) and 11 inflammatory and cardiovascular biomarkers | confirmed HF diagnosis | total B-line sum significantly correlated with NT-proBNP (R = 0.29, p < 0.001), growth/differentiation factor-15 (GDF-15; R = 0.23, p = 0.003), high-sensitive Troponin T (hsTnT; R = 0.36, p < 0.001), soluble interleukin-1 receptor-like 1 (sST2; R = 0.29, p < 0.001), cancer antigen 125 (CA-125; R = 0.17, p = 0.03), high-sensitivity C-reactive protein (hsCRP; R = 0.20, p = 0.009), and interleukin (IL)-6 (R = 0.23, p = 0.003). |
| Rubio-Gracia J et al., 2021 [69] (Spain) |
Evaluate LUS associated to NT-proBNP, cancer antigen 125, relative plasma volume (rPV) estimation. | Retrospective study | N = 203 | LUS CA 125 NT-proBNP rPV |
Parameters of venous congestion and predictors of mortality after one year of follow-up. | Values of NT-proBNP ≥ 3804 pg/mL (HR 2.78 [1.27–6.08]; p = 0.010) and rPV ≥ −4.54% (HR 2.74 [1.18–6.38]; p = 0.019) were independent predictors of all-cause mortality |
| Morvai-Illés B et al., 2021 [70] (Hungary) |
LUS B-lines compared vs. echocardiographic parameters and natriuretic peptide level | prospective cohort study | N = 75 | B-lines LUS NT-proBNP |
The prognostic value of B-lines and other novel ultrasound parameters: global longitudinal strain and left atrial reservoir strain. | ≥15 B-lines lines was associated with a significantly worse event-free survival, and was similar to the predictive value of NT-proBNP (AUC 0.863 vs. 0.859) |
| Burgos et al. 2022 [68] (Argentina) |
To evaluate if inferior vena cava (IVC) and lung ultrasound (CAVAL US)-guided therapy. | CAVAL US-AHF Study- Randomized control trial | N = 58 | Assigned either LUS + IVC (‘intervention group’) or clinical-guided decongestion therapy (‘control group’), B-lines IVC readmission |
Presence ≥ 5 B-lines and/or an increase in the diameter of the IVC, with and without collapsibility. Endpoints: the composite of readmission for HF, unplanned visit for worsening HF, variation of NT-proBNP or death at 90 days. |
Mortality was associated to significantly lower IVC collapse, and a greater number of lung B-lines; and higher NTproBNP levels B-lines at discharge was associated with a significantly increased risk of 30-day readmission |
| Pérez-Herrero S et al., 2022 [65] (Spain) |
To compare the CxR vs. B-lines by LUS and collapsibility of IVC. | Observational cohort study based on data collected in the PROFUND-IC study. | N = 301 | CxR B-lines by LUS IVC |
prediction of 30-day mortality based on the diameter of the IVC | ≥6 B-lines per field and IVC collapsibility ≤ 50% had higher 30-day mortality rates |
| Chiu L et al., 2022 [64] (EEUU) |
LUS diagnostic accuracy vs. a chest X-ray (CxR) | Meta-Analysis | 8 studies N = 2787 | LUS vs. chest radiography | diagnostic accuracy HF | LUS is more sensitive (91.8% vs. 76.5%) and more specific than CxR (92.3% vs. 87.0%) than CXR in detecting pulmonary edema. |
| Coiro S et al., 2023 [72] (France) [72] |
Assess the diagnosis value of exercise lung ultrasound (LUS) for HF with preserved ejection fraction (HFpEF) diagnosis. | Case-control study | N = 116 | B-line kinetics in submaximal exercise | Peak B-lines for HFpEF diagnosis | Peak B-lines > 5 were the best cutoffs for HFpEF diagnosis |
| Xie C et al., 2023 [66] (Xina) | LUS accuracy vs. computerized tomography (CT) vs. echocardiogram | Systematic review and Metanalysis | N = 345 | LUS, (CT), and conventional echocardiogram | predictive value for HF diagnosis | The accuracy of LUS was significantly higher than that of echocardiogram (p = 0.01). |