Abstract 17429: The Usefulness of Ultrasound Lung Comets Evaluated by Using the Newly-Developed Pocket-Sized Transthoracic Echocardiographic Imaging Device in Patients with Suspected Heart Failure

Abstract

Background Ultrasound lung comets (ULCs) assessment is simple, fast and clinically useful for the evaluation of pulmonary congestion in patients with heart failure (HF). The aim of this study is to investigate the feasibility and usefulness of recently-developed pocket-sized transthoracic echocardiographic (pTTE) imaging device for the evaluation of ULCs in patients with HF.

Methods This study consisted of 64 consecutive patients (28 female, 66±15 years) with known or suspected HF. Exclusion criteria included the following: patients with hemodialysis, recent cardiac surgery, known pulmonary diseases. The examination of pTTE was performed with the VSCAN (GE Medical Systems). Immediately after pTTE study including the assessment of ULCs, all patients underwent sTTE and ULCs assessment by another sonographer blinded to the results of pTTE study. We defined ULC score according to the number of ULCs observed in each 4 segments (right upper & lower, left upper & lower) of chest wall as follows; None: 0, Mild (the number of ULCs; 0-5): 1, Moderate (6-10): 2, Severe (11- ): 3. The sum of these scores in each 4 segments is defined as total ULC score (0-12 points).

Results ULCs were observed on pTTE in 44 patients (69%), predominantly in right upper segment (33/44; 75%). There was a highly significant correlation between the total ULC score evaluated by pTTE and sTTE (ρ=0.93; Spearman, p<0.0001). Brain natriuretic peptide (BNP) values were well correlated with ULC score evaluated by pTTE (ρ=0.63; Spearman, p<0.0001). Higher Boston criteria for diagnosing heart failure scores were associated with higher ULC score evaluated by pTTE. Higher ULC score evaluated by pTTE is associated with higher NYHA class and advanced stage of left ventricular diastolic dysfunction. Conclusion; Detection of pulmonary congestion using the newly-developed pTTE imaging device in patients with HF is feasible, accurate and useful in the clinical setting.