Residual congestion and long-term prognosis in acutely decompensated heart failure patients

Aims: Recent studies have established the role of residual congestion evaluated bylung ultrasound in estimating short-term risk of readmission or death in patientsadmitted for heart failure (HF) decompensation. However, if lung ultrasounds maintaina prognostic role of in long-term survival is still unknown. Aim of our study was toevaluate if residual congestion could predict all-cause mortality during 4 year follow upin a cohort of unselected patients admitted for acute decompensated HF. Methods: One-hundred fifty patients were enrolled. The anterolateral chest wasscanned to evaluate the presence of B-lines. A sonographic score was calculatedattributing 1 to each positive sector (≥ 3 B-lines). Clinical, biochemicaland echocardiographic data were recorded. A Cox proportional hazard regressionanalysis was performed to evaluate the association between variables and 4-yearsurvival. Results: During the follow-up, 86 patients (58%) died. Univariate analysis showed asignificant correlation between the sonographic score at discharge and eventsoccurrence at long term follow up (HR 1.21; CI 1.11–1.31; p < 0.001) suggesting that,on average, the increase of 1 point in the sonographic score was associated with anincrease of approximately 20% in the risk of death. Conclusions: Our results suggest the role of LUS in the identification of more congestedHF patients, that will be at risk for worse long term outcome.