Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure
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‐line...
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12640 |
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| author | Philip Brainin Brian Claggett Eldrin F. Lewis Kristin H. Dwyer Allison A. Merz Montane B. Silverman Varsha Swamy Tor Biering‐Sørensen Jose Rivero Susan Cheng John J.V. McMurray Scott D. Solomon Elke Platz |
| author_facet | Philip Brainin Brian Claggett Eldrin F. Lewis Kristin H. Dwyer Allison A. Merz Montane B. Silverman Varsha Swamy Tor Biering‐Sørensen Jose Rivero Susan Cheng John J.V. McMurray Scott D. Solomon Elke Platz |
| author_sort | Philip Brainin |
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| description | 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. |
| format | Article |
| id | doaj-art-ca634d5d380e4200997d5a3be85e3946 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-ca634d5d380e4200997d5a3be85e39462025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-01731201120910.1002/ehf2.12640Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failurePhilip Brainin0Brian Claggett1Eldrin F. Lewis2Kristin H. Dwyer3Allison A. Merz4Montane B. Silverman5Varsha Swamy6Tor Biering‐Sørensen7Jose Rivero8Susan Cheng9John J.V. McMurray10Scott D. Solomon11Elke Platz12Department of Cardiology Herlev and Gentofte University Hospital Herlev DenmarkDivision of Cardiovascular Medicine Brigham and Women's Hospital Boston MA USADivision of Cardiovascular Medicine Brigham and Women's Hospital Boston MA USADepartment of Emergency Medicine Rhode Island Hospital, Warren Alpert Medical School of Brown University Providence RI USAHarvard Medical School Boston MA USADepartment of Emergency Medicine Brigham and Women's Hospital 75 Francis Street, Neville House Boston MA 02115 USADepartment of Emergency Medicine Brigham and Women's Hospital 75 Francis Street, Neville House Boston MA 02115 USADepartment of Cardiology Herlev and Gentofte University Hospital Herlev DenmarkDivision of Cardiovascular Medicine Brigham and Women's Hospital Boston MA USADivision of Cardiovascular Medicine Brigham and Women's Hospital Boston MA USAInstitute of Cardiovascular and Medical Sciences University of Glasgow Glasgow UKDivision of Cardiovascular Medicine Brigham and Women's Hospital Boston MA USADepartment of Emergency Medicine Brigham and Women's Hospital 75 Francis Street, Neville House Boston MA 02115 USAAbstract 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.https://doi.org/10.1002/ehf2.12640Lung ultrasonographyB‐linesBody mass indexHeart failure |
| spellingShingle | Philip Brainin Brian Claggett Eldrin F. Lewis Kristin H. Dwyer Allison A. Merz Montane B. Silverman Varsha Swamy Tor Biering‐Sørensen Jose Rivero Susan Cheng John J.V. McMurray Scott D. Solomon Elke Platz Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure ESC Heart Failure Lung ultrasonography B‐lines Body mass index Heart failure |
| title | Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure |
| title_full | Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure |
| title_fullStr | Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure |
| title_full_unstemmed | Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure |
| title_short | Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure |
| title_sort | body mass index and b lines on lung ultrasonography in chronic and acute heart failure |
| topic | Lung ultrasonography B‐lines Body mass index Heart failure |
| url | https://doi.org/10.1002/ehf2.12640 |
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