Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure
Abstract Background The assessment of left ventricular (LV) diastolic function based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) guidelines requires measurement of several echocardiographic indices. However, these assessments often y...
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BMC
2025-04-01
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| Series: | Cardiovascular Ultrasound |
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| Online Access: | https://doi.org/10.1186/s12947-025-00341-7 |
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| author | Takahiro Sakamoto Toshihiko Asanuma Hiroyuki Sasaki Hiroshi Kawahara Kazuhiko Uchida Akihiro Endo Hiroyuki Yoshitomi Kazuaki Tanabe |
| author_facet | Takahiro Sakamoto Toshihiko Asanuma Hiroyuki Sasaki Hiroshi Kawahara Kazuhiko Uchida Akihiro Endo Hiroyuki Yoshitomi Kazuaki Tanabe |
| author_sort | Takahiro Sakamoto |
| collection | DOAJ |
| description | Abstract Background The assessment of left ventricular (LV) diastolic function based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) guidelines requires measurement of several echocardiographic indices. However, these assessments often yield inconclusive results owing to the absence of measurable parameters. Multiple B-lines on lung ultrasound have been proposed as a method for evaluating pulmonary congestion. We aimed to evaluate the association between B-lines and LV diastolic function and to examine whether B-lines show potential as an alternative to conventional indices for assessing LV diastolic function. Methods This prospective study included 172 patients with pre-heart failure (HF) or HF. We investigated (i) the relationship between B-lines and LV diastolic function using echocardiography, (ii) the diagnostic accuracy of B-lines compared to echocardiography indices for estimating LV filling pressures and (iii) the relationship between B-lines and risk of hospitalisation for HF. Results Among patients for whom the ASE/EACVI guideline algorithm for LV diastolic dysfunction was available (n = 89), the number of B-lines typically increased with the severity of diastolic dysfunction grade. In patients who underwent left heart catheterisation (n = 20), the LV filling pressure was significantly correlated with B-lines (r = 0.690, P < 0.001). The diagnostic accuracy of B-lines for detecting high LV filling pressure was comparable to that of tricuspid regurgitation peak gradient (TRPG). When TRPG was replaced with B-lines to diagnose grade II or III diastolic dysfunction using the ASE/ESCVI algorithm, sensitivity remained comparable (0.80); however, specificity improved (0.80 vs. 0.50). In patients who underwent lung ultrasound while they were hemodynamically stable and were followed up for prognosis (median, 730 days; n = 75), 14 hospitalisations for HF were observed. Kaplan–Meier analysis revealed that the high B-line group had a significantly higher incidence of hospitalisation events for HF (P = 0.036, log-rank test). Conclusion B-lines have shown potential as an alternative to conventional indices for assessing LV diastolic dysfunction. Graphical Abstract |
| format | Article |
| id | doaj-art-731387faa3254f71bdb3dbcdd1021554 |
| institution | OA Journals |
| issn | 1476-7120 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Ultrasound |
| spelling | doaj-art-731387faa3254f71bdb3dbcdd10215542025-08-20T02:17:49ZengBMCCardiovascular Ultrasound1476-71202025-04-0123111110.1186/s12947-025-00341-7Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressureTakahiro Sakamoto0Toshihiko Asanuma1Hiroyuki Sasaki2Hiroshi Kawahara3Kazuhiko Uchida4Akihiro Endo5Hiroyuki Yoshitomi6Kazuaki Tanabe7Division of Cardiology, Shimane University Faculty of MedicineDivision of Cardiology, Shimane University Faculty of MedicineDivision of Cardiology, Shimane University Faculty of MedicineDivision of Cardiology, Shimane University Faculty of MedicineDivision of Cardiology, Masuda Red Cross HospitalDivision of Cardiology, Shimane University Faculty of MedicineDivision of Cardiology, Shimane University Faculty of MedicineDivision of Cardiology, Shimane University Faculty of MedicineAbstract Background The assessment of left ventricular (LV) diastolic function based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) guidelines requires measurement of several echocardiographic indices. However, these assessments often yield inconclusive results owing to the absence of measurable parameters. Multiple B-lines on lung ultrasound have been proposed as a method for evaluating pulmonary congestion. We aimed to evaluate the association between B-lines and LV diastolic function and to examine whether B-lines show potential as an alternative to conventional indices for assessing LV diastolic function. Methods This prospective study included 172 patients with pre-heart failure (HF) or HF. We investigated (i) the relationship between B-lines and LV diastolic function using echocardiography, (ii) the diagnostic accuracy of B-lines compared to echocardiography indices for estimating LV filling pressures and (iii) the relationship between B-lines and risk of hospitalisation for HF. Results Among patients for whom the ASE/EACVI guideline algorithm for LV diastolic dysfunction was available (n = 89), the number of B-lines typically increased with the severity of diastolic dysfunction grade. In patients who underwent left heart catheterisation (n = 20), the LV filling pressure was significantly correlated with B-lines (r = 0.690, P < 0.001). The diagnostic accuracy of B-lines for detecting high LV filling pressure was comparable to that of tricuspid regurgitation peak gradient (TRPG). When TRPG was replaced with B-lines to diagnose grade II or III diastolic dysfunction using the ASE/ESCVI algorithm, sensitivity remained comparable (0.80); however, specificity improved (0.80 vs. 0.50). In patients who underwent lung ultrasound while they were hemodynamically stable and were followed up for prognosis (median, 730 days; n = 75), 14 hospitalisations for HF were observed. Kaplan–Meier analysis revealed that the high B-line group had a significantly higher incidence of hospitalisation events for HF (P = 0.036, log-rank test). Conclusion B-lines have shown potential as an alternative to conventional indices for assessing LV diastolic dysfunction. Graphical Abstracthttps://doi.org/10.1186/s12947-025-00341-7B-linesDiastolic dysfunctionHeart failureLung ultrasound |
| spellingShingle | Takahiro Sakamoto Toshihiko Asanuma Hiroyuki Sasaki Hiroshi Kawahara Kazuhiko Uchida Akihiro Endo Hiroyuki Yoshitomi Kazuaki Tanabe Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure Cardiovascular Ultrasound B-lines Diastolic dysfunction Heart failure Lung ultrasound |
| title | Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure |
| title_full | Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure |
| title_fullStr | Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure |
| title_full_unstemmed | Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure |
| title_short | Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure |
| title_sort | diagnostic value of lung ultrasound b lines for evaluating left ventricular filling pressure |
| topic | B-lines Diastolic dysfunction Heart failure Lung ultrasound |
| url | https://doi.org/10.1186/s12947-025-00341-7 |
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