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. 2022 Aug 18;11(16):4846.
doi: 10.3390/jcm11164846.

Speckled Tracking of Pleura-A Novel Tool for Lung Ultrasound; Distinguishing COVID-19 from Acute Heart Failure

Batsheva Tzadok  1 , Yair Blumberg  2   3 , Moti Shubert  2 , Majdi Halabi  2   3 , Eran Tal-Or  1 , Noa Bachner-Hinenzon  4 , Shemy Carasso  1   2
Affiliations

Speckled Tracking of Pleura-A Novel Tool for Lung Ultrasound; Distinguishing COVID-19 from Acute Heart Failure

Batsheva Tzadok et al. J Clin Med. .

Abstract

For the acutely dyspneic patient, discerning bedside between acute decompensated heart failure (ADHF) and COVID-19 is crucial. A lung ultrasound (LUS) is sensitive for detecting these conditions, but not in distinguishing between them; both have bilateral B-lines. The Blue protocol uses pleural sliding to differentiate decreased pneumonia; however, this is not the case in ADHF. Nonetheless, this pleural sliding has never been quantified. Speckled tracking is a technology utilized in the echocardiography field that quantifies the motion of tissues by examining the movement of ultrasound speckles. We conducted a retrospective study of LUS performed in emergency room patients during the COVID-19 pandemic. Speckled tracking of the pleura by applying software to the B-mode of pleura was compared between COVID-19 patients, ADHF patients, and patients with no respiratory complaints. A significant difference was found between the patient groups on speckled tracking both in respect of displacement and velocity. ADHF had the highest displacement, followed by COVID-19, and then non-respiratory patients: 1.63 ± 1.89, 0.59 ± 0.71, and 0.24 ± 0.45, respectively (p < 0.01). A similar trend was seen in velocity with ADHF having the highest velocity 0.34 ± 0.37, followed by COVID-19 0.14 ± 0.71, and non-respiratory patients 0.02 ± 0.09 (p <0.01). Speckled tracking of the pleura is a potential tool for discerning between different causes of dyspnea.

Keywords: B protocol; COVID-19; COVID-19 pneumonia; congestive heart failure; emergency medicine COVID-19; lung ultrasound; point-of-care ultrasound; speckled tracking; viral pneumonia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Speckled tracking applied to the B-mode ultrasound clip of the pleura of an acute decompensated congestive heart failure patient; yellow lines the vector of movement.
Figure 2
Figure 2
Representative measurement of the displacement. ((A)—ADHF (acute decompensated heart failure), (B)—COVID-19, (C)—non-respiratory).
Figure 3
Figure 3
The difference between maximum and minimum displacement (mm) ADHF- (acute decompensated heart failure) (** p < 0.01).
Figure 4
Figure 4
Maximum velocity (Cm/s) (** p < 0.01). ADHF (acute decompensated heart failure).
See this image and copyright information in PMC

References

    1. Jozwiak M., Teboul J.L., Monnet X. Extravascular Lung Water in Critical Care: Recent Advances and Clinical Applications. Ann. Intensive Care. 2015;5:1–13. doi: 10.1186/s13613-015-0081-9. - DOI - PMC - PubMed
    1. Baggish A.L., Lloyd-Jones D.M., Blatt J., Richards A.M., Lainchbury J., O’Donoghue M., Sakhuja R., Chen A.A., Januzzi J.L. A Clinical and Biochemical Score for Mortality Prediction in Patients with Acute Dyspnoea: Derivation, Validation and Incorporation into a Bedside Programme. Heart. 2008;94:1032–1037. doi: 10.1136/hrt.2007.128132. - DOI - PubMed
    1. McManus N.M., Offman R., Oetman J.D. Emergency Department Management of COVID-19: An Evidence-Based Approach. West. J. Emerg. Med. 2020;21:32–44. doi: 10.5811/westjem.2020.8.48288. - DOI - PMC - PubMed
    1. Lichtenstein D., Axler O. Intensive Use of General Ultrasound in the Intensive Care Unit—Prospective Study of 150 Consecutive Patients. Intensive Care Med. 1993;19:353–355. doi: 10.1007/BF01694712. - DOI - PubMed
    1. Lichtenstein D.A., Mezière G.A. Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure the BLUE Protocol. Chest. 2008;134:117–125. doi: 10.1378/chest.07-2800. - DOI - PMC - PubMed

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