Brainin, P. et al. (2020) Body mass index and B-lines on lung ultrasonography in chronic and acute heart failure. ESC Heart Failure, 7(3), pp. 1201-1209. (doi: 10.1002/ehf2.12640) (PMID:32077268) (PMCID:PMC7261588)
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Abstract
Aims: Increased body mass index (BMI) is common in heart failure (HF) patients and is associated with lower levels of N-terminal pro-brain natriuretic peptide (NT-proBNP). We evaluated the influence of BMI on lung ultrasonography (LUS) findings indicative of pulmonary congestion (i.e. B-lines) in patients with chronic and acute HF (AHF). Methods and results: We analysed ambulatory chronic HF (n = 118) and hospitalized AHF (n = 177) patients (mean age 70 years, 64% men, mean BMI 29 kg/m2, mean ejection fraction 42%) undergoing echocardiography and LUS in eight chest zones. B-lines and chest wall thickness (skin to pleura) on ultrasound were quantified offline and blinded to clinical findings. NT-proBNP was available in AHF patients (n = 167). In chronic HF, B-line number decreased by 18% per 5 unit increase in BMI [95% confidence interval (CI) −35% to +5%, P = 0.11]. In AHF, the number of B-lines decreased by 12% per 5 unit increase in BMI (95% CI −19% to −5%, P = 0.001), whereas NT-proBNP concentration decreased by 28% per 5 unit increase in BMI (95% CI −40% to −16%, P < 0.001). For AHF, B-line number declined to a lesser degree than NT-proBNP concentration with increasing BMI (P = 0.020), and >6 B-lines were observed in half of AHF patients with severe obesity. There was an inverse relationship between B-line number and chest wall thickness, and this association varied by chest region. Conclusions: Despite an inverse relationship between B-lines and BMI, B-lines declined to a lesser degree than NT-proBNP with increasing BMI. These data suggest that LUS may be useful in patients with HF despite obesity.
| Item Type: | Articles |
|---|---|
| Keywords: | B-lines, body mass index, heart failure, lung ultrasonography. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McMurray, Professor John |
| Authors: | Brainin, P., Claggett, B., Lewis, E. F., Dwyer, K. H., Merz, A. A., Silverman, M. B., Swamy, V., Biering-Sørensen, T., Rivero, J., Cheng, S., McMurray, J. J.V., Solomon, S. D., and Platz, E. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | ESC Heart Failure |
| Publisher: | Wiley |
| ISSN: | 2055-5822 |
| ISSN (Online): | 2055-5822 |
| Published Online: | 20 February 2020 |
| Copyright Holders: | Copyright © 2020 The Authors |
| First Published: | First published in ESC Heart Failure 7(3): 1201-1209 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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