Prognostic value of rest B-lines with the simplified 4-site scan for predicting survival: incremental value over transthoracic echocardiography

Abstract Background Lung ultrasound (LUS) detects pulmonary congestion as B-lines at rest. Methods After preliminary exclusion of 154 patients lost to follow-up, we analyzed transthoracic echocardiography (TTE) plus LUS (4-site simplified scan) data in 5165 subjects (age 64±11 years) referred 19 certified centers 9 countries for known or suspected coronary artery disease (n=3891, 75%), dyspnea (n=591, 12%), screening asymptomatic with risk factors (n=667, 13%). We the anterior and lateral hemi-thoraces, scanning from mid-axillary mid-clavicular lines on third intercostal space. score ranged 0 (normal) 40 (severely abnormal). By selection, follow-up information was available all. All-cause death predetermined end-point. Results Feasibility 100% all subjects. (median) were 0.1 [0–1]. Rest (≥2) present 863 (16.7%). Ejection fraction 61±10%. a median 690 (Interquartile range 420–1065) days, 96 all-cause deaths occurred. Two-year mortality 3.6% 1.5% without (p<0.001) increased progressively increasing number B-lines, 2.4% mild (2–4, n=630), 5.0% moderate (5–9, n=160) 8.2% severe (≥10, n=73) (see figure). At multivariable analysis, rest B (HR 1.812, 95% CI: 1.165–2.916, p=0.008) ejection 0.987, 0.976–0.998, p=0.020) independent predictors death, addition age 1.045, 1.023–01.067, p<0.001) diabetes 1.643, 1.079–2.503, p=0.021). Conclusion In all-comers TTE, resting assessed by focused 4-site scan are detected 1 out 4 symptos associated worse survival. The severity predicts outcomes. prognostic value is additive over standard clinical TTE such fraction. Focused can easily be incorporated examination. Funding Acknowledgement Type funding sources: None.