title: A novel radiological score to assess lung fluid content during evolving acute heart failure in the course of acute myocardial infarction.
abstract: BACKGROUND
  Monitoring of lung fluid content (LFC) in order to predict acute heart failure (AHF) during acute myocardial infarction (AMI) is an unmet challenge.
  
  
  OBJECTIVE
  To evaluate in AMI patients the ability of proposed radiological score (RS), which is the sum of selected radiological signs of congestion, to reflect correctly LFC, as assessed with repeat physical examinations and lung impedance (LI) measurements.
  
  
  METHODS
  Chest X-rays were taken at baseline, when rales were detected, whenever indicated, and at conclusion of monitoring. RS grading for LFC assessment was: RS = 0-1 for normal X-ray, RS = 2-4 for interstitial congestion, and RS values of 5-6, 7-8 and 9-10 signified mild, moderate and severe alveolar edema, respectively.
  
  
  RESULTS
  624 AMI patients without AHF at baseline were monitored (94 ± 42 h). 476 patients (76%) with baseline RS of 0.3 ± 0.5 did not develop AHF. Overt AHF developed in 148 patients (24%) during monitoring; baseline RS (0.6 ± 0.8) reached 5.4 ± 0.7, 7.0 ± 0.8, and 9.8 ± 0.5 at the stages of mild, moderate, and severe alveolar edema, respectively. AHF resolved with treatment. RS decreased to 1.5 ± 1.3 (P < 0.01) and correlated with physical examination (r = 0.6, P < 0.01) and LI (r = -0.9, P < 0.01).
  
  
  CONCLUSIONS
  RS correlated well with findings on physical examination during AHF and closely correlated with LI.
authors.affiliation: Heart Institute, Hillel Yaffe Medical Center, Hadera, Israel. shochat1@yahoo.com
authors.forename: Michael
authors.initials: M
authors.lastname: Shochat
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
authors.forename: Victoria
authors.initials: V
authors.lastname: Trachtengerts
authors.forename: David S
authors.initials: DS
authors.lastname: Blondheim
authors.forename: Mark
authors.initials: M
authors.lastname: Kazatsker
authors.forename: Vladimir
authors.initials: V
authors.lastname: Gurovich
authors.forename: Aya
authors.initials: A
authors.lastname: Asif
authors.forename: Ilia
authors.initials: I
authors.lastname: Shochat
authors.forename: Yoseph
authors.initials: Y
authors.lastname: Rozenman
authors.forename: Simcha R
authors.initials: SR
authors.lastname: Meisel
mesh_terms: D000208:Acute Disease; D000368:Aged; D002307:Cardiography, Impedance; D015633:Extravascular Lung Water / Q000000981:diagnostic imaging*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000175:diagnosis*; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D012720:Severity of Illness Index