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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Elsevier
2025-07-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483225000975 |
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| author | Kevin Fernando Suhardi Agung Prasetyo Rahadian Malik Pauliana Aqsha Tiara Viazelda |
| author_facet | Kevin Fernando Suhardi Agung Prasetyo Rahadian Malik Pauliana Aqsha Tiara Viazelda |
| author_sort | Kevin Fernando Suhardi |
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| description | 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. |
| format | Article |
| id | doaj-art-5b66ba2d99744a74ac367b61925d99bc |
| institution | Kabale University |
| issn | 0019-4832 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
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| series | Indian Heart Journal |
| spelling | doaj-art-5b66ba2d99744a74ac367b61925d99bc2025-08-20T03:31:37ZengElsevierIndian Heart Journal0019-48322025-07-0177425826610.1016/j.ihj.2025.05.003Quantification 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 analysisKevin Fernando Suhardi0Agung Prasetyo1Rahadian Malik2 Pauliana3Aqsha Tiara Viazelda4M.Th Djaman Sanggau Regional General Hospital, West Kalimantan, Indonesia; Corresponding author.M.Th Djaman Sanggau Regional General Hospital, West Kalimantan, IndonesiaFaculty of Medicine Universitas Pembangunan Nasional Veteran Jakarta, IndonesiaRS Fatima Ketapang, West Kalimantan, IndonesiaM.Th Djaman Sanggau Regional General Hospital, West Kalimantan, IndonesiaBackground: 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.http://www.sciencedirect.com/science/article/pii/S0019483225000975Acute heart failureLung ultrasoundB-linesPrognosis |
| spellingShingle | Kevin Fernando Suhardi Agung Prasetyo Rahadian Malik Pauliana Aqsha Tiara Viazelda 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 Indian Heart Journal Acute heart failure Lung ultrasound B-lines Prognosis |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Acute heart failure Lung ultrasound B-lines Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S0019483225000975 |
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