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Meta-Analysis
. 2021 Mar;116(3):383-392.
doi: 10.36660/abc.20190662.

Prognostic Value of Lung Ultrasound for Clinical Outcomes in Heart Failure Patients: A Systematic Review and Meta-Analysis

[Article in English, Portuguese]
Yushu Wang  1 , Di Shi  1 , Fuqiang Liu  1 , Ping Xu  2 , Min Ma  1   3
Affiliations
Meta-Analysis

Prognostic Value of Lung Ultrasound for Clinical Outcomes in Heart Failure Patients: A Systematic Review and Meta-Analysis

[Article in English, Portuguese]
Yushu Wang et al. Arq Bras Cardiol. 2021 Mar.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Arq Bras Cardiol. 2021 Jul;117(1):265. doi: 10.36660/abc.20210556. Arq Bras Cardiol. 2021. PMID: 34320091 Free PMC article. English, Portuguese.

Abstract
in English, Portuguese

Background: There is conflicting information about whether lung ultrasound assessed by B-lines has prognostic value in patients with heart failure (HF).

Objectives: To evaluate the prognostic value of lung ultrasound assessed by B-lines in HF patients.

Methods: Four databases (PubMed, EMBASE, Cochrane Library, and Scopus) were systematically searched to identify relevant articles. We pooled the hazard ratio (HR) and 95% confidence interval (CI) from eligible studies and carried out heterogeneity, quality assessment, and publication bias analyses. Data were pooled using a fixed-effects or random-effect model. A p value < 0.05 was considered to indicate statistical significance.

Results: Nine studies involving 1,212 participants were included in the systematic review. B-lines > 15 and > 30 at discharge were significantly associated with increased risk of combined outcomes of all-cause mortality or HF hospitalization (HR, 3.37, 95% CI, 1.52-7.47; p = 0.003; HR, 4.01, 95% CI, 2.29-7.01; p < 0.001, respectively). A B-line > 30 cutoff at discharge was significantly associated with increased risk of HF hospitalization (HR, 9.01, 95% CI, 2.80-28.93; p < 0.001). Moreover, a B-line > 3 cutoff significantly increased the risk for combined outcomes of all-cause mortality or HF hospitalization in HF outpatients (HR, 3.21, 95% CI, 2.09-4.93; I2 = 10%; p < 0.00001).

Conclusion: B-lines could predict all-cause mortality and HF hospitalizations in patients with HF. Further large randomized controlled trials are needed to explore whether dealing with B-lines would improve the prognosis in clinical settings.

Fundamento: Existem informações conflitantes sobre se a ultrassonografia pulmonar avaliada por linhas B tem valor prognóstico em pacientes com insuficiência cardíaca (ICa).

Objetivos: Avaliar o valor prognóstico da ultrassonografia pulmonar avaliada por linhas B em pacientes com ICa.

Métodos: Quatro bases de dados (PubMed, EMBASE, Cochrane Library e Scopus) foram sistematicamente pesquisadas para identificar artigos relevantes. Reunimos a razão de risco (RR) e o intervalo de confiança de 95% (IC) de estudos elegíveis e realizamos análises de heterogeneidade, avaliação de qualidade e viés de publicação. Os dados foram agrupados usando um modelo de efeitos fixos ou de efeito aleatório. Um valor de p <0,05 foi considerado para indicar significância estatística.

Resultados: Nove estudos envolvendo 1.212 participantes foram incluídos na revisão sistemática. As linhas B > 15 e > 30 na alta hospitalar foram significativamente associadas ao aumento do risco de desfecho combinado de mortalidade por todas as causas ou hospitalização por ICa (RR, 3,37, IC de 95%, 1,52-7,47; p = 0,003; RR, 4,01, IC de 95%, 2,29-7,01; p <0,001, respectivamente). O ponto de corte da linha B > 30 na alta foi significativamente associado ao aumento do risco de hospitalização por ICa (RR, 9,01, IC de 95%, 2,80-28,93; p <0,001). Além disso, o ponto de corte da linha B > 3 aumentou significativamente o risco de desfecho combinado de mortalidade por todas as causas ou hospitalização por ICa em pacientes ambulatoriais com ICa (RR, 3,21, IC de 95%, 2,09-4,93; I2 = 10%; p <0,00001).

Conclusão: As linhas B podem predizer mortalidade por todas as causas e hospitalizações por ICa em pacientes com ICa. Outros grandes ensaios clínicos randomizados são necessários para explorar se lidar com as linhas B melhoraria o prognóstico nos ambientes clínicos. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

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Conflict of interest statement

Potencial conflito de interesses

Declaro não haver conflito de interesses pertinentes.

Figures

Figura 1
Figura 1. – Fluxograma do processo seletivo.
Figura 2
Figura 2. – Gráficos para linhas B de alta hospitalar e desfecho combinado de mortalidade por todas as causas ou hospitalização por ICa.
Figura 3
Figura 3. Análise de subgrupo das linhas B de alta e desfecho combinado de mortalidade por todas as causas ou hospitalização por ICa.
Figura 4
Figura 4. – Gráficos para linhas B e hospitalização por ICa.
Figura 5
Figura 5. – Gráficos para linhas B e desfecho combinado de mortalidade por todas as causas ou hospitalização por ICa em pacientes ambulatoriais com ICa.
Figure 1
Figure 1. – Flow diagram of selection process.
Figure 2
Figure 2. – Forest plots for discharge B-lines and combined outcomes of all-cause mortality or HF hospitalization.
Figure 3
Figure 3. – Subgroup analysis of discharge B-lines and combined outcomes of all-cause mortality or HF hospitalization.
Figure 4
Figure 4. – Forest plots for B-lines and HF hospitalization
Figure 5
Figure 5. – Forest plots for B-lines and combined outcomes of all-cause mortality or HF hospitalization in HF outpatients.
See this image and copyright information in PMC

Comment in

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