title: Lung ultrasound and short-term prognosis in heart failure patients.
abstract: BACKGROUND
  Heart failure (HF) is the leading cause of hospitalization for patients older than 65years, with a 30-day readmission rate of 20-25%. Although several markers have been evaluated to stratify timing of follow-up after an acute decompensation is mostly based on clinical judgment. Lung ultrasound (LUS) has been demonstrated to be a valid tool for the assessment and monitoring of pulmonary congestion. Aim of our study was to evaluate if LUS performed in HF patients at discharge could predict 100-day hospital readmission or death.
  
  
  METHODS
  One-hundred fifty patients were enrolled. The anterolateral chest was scanned to evaluate the presence of B-lines. A sonographic score was calculated attributing 1 to each positive (≥3 B-lines) sector. Clinical, biochemical and echocardiographic data were recorded. A Cox proportional hazard regression analysis was performed to evaluate the association between variables and 100-day events.
  
  
  RESULTS
  Follow-up was obtained in 149 patients. Thirty-four events were recorded. Sonographic score was significantly associated with events (HR 1.19; CI 1.05 to 1.34; p=0.005). On average, the increase of 1 point in the sonographic score was associated with an increase of approximately 24% in the risk of event within 100days. At multivariate analysis NTproBNP remained the only independent prognostic factor.
  
  
  CONCLUSIONS
  We confirmed that B-lines at discharge are a prognostic marker for hospital readmission and death at 100days in HF patients. Nevertheless, further randomized clinical studies are needed to definitely support the routine use of LUS in the clinical management of HF patients, in combination or not with NT-proBNP.
authors.affiliation: Department of Internal Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: chiaracogliati@fastwebnet.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cogliati
authors.affiliation: Department of Biomedical and Clinical Sciences, University of Milan, Italy. Electronic address: giovanni.casazza@unimi.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casazza
authors.affiliation: Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, Department of Health and Community Sciences, University of Milan, Italy. Electronic address: elisa.ceriani@live.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ceriani
authors.affiliation: Department of Internal Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: danielatorzillo@alice.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Torzillo
authors.affiliation: Department of Internal Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: s.furlotti@gmail.com.
authors.forename: Stefano
authors.initials: S
authors.lastname: Furlotti
authors.affiliation: Emergency Medicine, L.Sacco Hospital University of Milan, Italy. Electronic address: ilariaiaia@yahoo.com.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bossi
authors.affiliation: Clinical Endocrinology Laboratory, L.Sacco Hospital University of Milan, Italy. Electronic address: vago.tarcisio@hsacco.it.
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Vago
authors.affiliation: Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, Department of Health and Community Sciences, University of Milan, Italy. Electronic address: giorgio.costantino@unimi.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Costantino
authors.affiliation: Department of Internal Medicine, Ca Granda Foundation IRCCS, Ospedale Maggiore Policlinico, Department of Health and Community Sciences, University of Milan, Italy. Electronic address: nicola.montano@unimi.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010359:Patient Readmission / Q000639:trends; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D013997:Time Factors; D014463:Ultrasonography / Q000639:trends*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Heart failure; Lung ultrasound; Prognosis, B-lines