Quantification of residual pulmonary congestion defined by B-line findings on lung ultrasound to predict cardiovascular events in acute heart failure: A systematic review and meta analysis
Background: Pulmonary congestion detected by lung ultrasound (LUS) has emerged as a valuable prognostic marker in acute heart failure (AHF). This systematic review and meta-analysis aimed to evaluate the prognostic significance of residual B-lines identified by LUS before hospital discharge. Methods...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
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| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483225000975 |
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| Summary: | Background: Pulmonary congestion detected by lung ultrasound (LUS) has emerged as a valuable prognostic marker in acute heart failure (AHF). This systematic review and meta-analysis aimed to evaluate the prognostic significance of residual B-lines identified by LUS before hospital discharge. Methods: A comprehensive literature search of PubMed, Cochrane Library, ScienceDirect, and ClinicalTrials.gov was conducted up to October 4, 2024. Studies assessing the association between residual B-lines and adverse clinical outcomes in hospitalized AHF patients were included, while studies involving ambulatory assessments were excluded. The primary outcome was a composite of all-cause mortality and heart failure (HF) rehospitalization. Secondary outcomes included all-cause mortality and HF rehospitalization individually. Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated. Results: Fifteen studies were included. Residual B-lines were significantly associated with an increased risk of composite outcomes (HR: 2.32; 95 % CI: 1.91–2.82), all-cause mortality (HR: 3.01; 95 % CI: 1.91–4.73), and HF readmission or cardiovascular events (HR: 4.01; 95 % CI: 2.22–7.24). Risk increased with greater B-line burden. Prognostic impact was stronger in short-term follow-up (<6 months; HR: 3.57) than in longer-term follow-up (≥6 months; HR: 1.96). Conclusions: Residual pulmonary congestion assessed by LUS at discharge is a strong independent predictor of adverse outcomes and may guide therapy decisions in AHF management. |
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| ISSN: | 0019-4832 |