The following is a summary of “Lung ultrasonography derived B-line scores as predictors of left ventricular end-diastolic pressure and pulmonary artery wedge pressure,” published in the NOVEMBER 2023 issue of Pulmonology by Garcia, et al.
The non-invasive assessment of elevated left ventricular end-diastolic pressure (LVEDP) and pulmonary artery wedge pressure (PAWP) in patients with heart diseases poses a significant challenge. Lung ultrasonography (LUS) is an emerging diagnostic tool that showed promise for predicting LVEDP and PAWP.
The study enrolled 57 stable ambulatory patients undergoing right and left heart catheterization procedures. Following these cardiac procedures, LUS was employed to examine 28 different ultrasonographic zones, specifically focusing on the correlation between five distinct LUS-derived B-line scores and both LVEDP and PAWP.
The B-line index demonstrated notable correlations with LVEDP and PAWP, supported by coefficients of 0.45 (P = 0.006) and 0.30 (P = 0.03), respectively. In assessing LVEDP > 15 mmHg, the B-line index yielded an AUC of 0.76 (P = 0.01), while for identifying PAWP > 15 mmHg, the AUC was 0.73 (P = 0.008). Overall, the performance of the scores in predicting either LVEDP or PAWP > 15 mmHg was comparable. It was determined that a B-line index value equal to or greater than 28 had a significant association with LVEDP > 15 mmHg (OR: 9.97) and PAWP > 15 mmHg (OR: 6.61), even after adjusting for age and the indication for heart catheterization.
The study revealed that LUS-derived B-line scores exhibited moderate correlations with PAWP and LVEDP in patients with heart diseases. Specifically, a B-line index of 28 or higher can serve as a useful indicator for predicting elevated LVEDP and PAWP, offering a high level of specificity in the clinical context.