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Utility of pulmonary echography with a handheld ultrasound device in patients with acute coronary syndrome

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Abstract

The objectives of this study are to establish the usefulness of lung ultrasound with a handheld device to predict the risk of developing heart failure with the need for mechanical ventilation (MV) in acute coronary syndrome (ACS). This is a prospective study of consecutive patients admitted because of ACS-type myocardial infarction, without data of HF at admission in a tertiary hospital, between February 2017 and February 2018. Lung ultrasounds were performed with a handheld cardiologic device in the first 24 h, and defined as echo-positive (PE+) when exams revealed 3 or more B-lines in 2 or more bilateral quadrants. We related this finding to the need for MV during admission. We included 119 patients (65.1 ± 12.8 year; 75.6% male, 24.4% female; 87.4% in Killip class I, 12.6% in Killip class II). Pulmonary echography was positive (PE+) in 21 patients (17.6%). The sensitivity of PE+ to predict MV was 93.3%, the specificity 93.3%, and the area under the curve 0.93. In Cox regression analysis adjusted by CRUSADE score and Killip class, PE+ patients had a hazard ratio of 64.55 (CI 7.87; 529.25, p < 0.001) of needing MV. PE+ was associated with more frequent use of inotropes and mortality. Pulmonary ultrasonography with a handheld echocardiograph was predictive of severe heart failure and the need for mechanical ventilation in ACS with high specificity and sensitivity.

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Authors and Affiliations

  1. Servicio de Cardiología, Hospital Virgen Macarena, Avenida Dr Fedriani sn, 41009, Seville, Spain

    María José Cristo Ropero, Francisco Javier Rivera Rabanal, Tania Seoane García, Luis Madrona Jiménez, Álvaro Izquierdo Bajo, Rafael Hidalgo Urbano & Juan Carlos Garcia-Rubira

  2. Departamento de Medicina Preventiva y Salud Pública de La Universidad de Sevilla, Plaza del Dr Barraquer 1, 41009, Seville, Spain

    Angel Vilches Arenas

  3. Unidad Coronaria, Hospital Virgen Macarena, Avenida Dr Fedriani sn, 41009, Seville, Spain

    Juan Carlos Garcia-Rubira

Authors
  1. María José Cristo Ropero
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  2. Francisco Javier Rivera Rabanal
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  3. Tania Seoane García
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Correspondence to Juan Carlos Garcia-Rubira.

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This work was performed in accordance with the ethical standards of the 1964 Helsinki Declaration and was approved by the Ethics Commity of the Hospital.

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This work has been previously published as an abstract in ESC Congress 2020-The Digital Experience 29 August–1 September.

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Cristo Ropero, M.J., Rivera Rabanal, F.J., Seoane García, T. et al. Utility of pulmonary echography with a handheld ultrasound device in patients with acute coronary syndrome. Intern Emerg Med 18, 249–255 (2023). https://doi.org/10.1007/s11739-022-03113-7

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