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Ecem Gürses1, Mehdi Zoghi2
1Department of Cardiology, University of Bakırçay School of Medicine, İzmir, Türkiye
2Department of Cardiology, Ege University Faculty of Medicine, İzmir, Türkiye
Keywords: Alveolar-capillary membrane, heart failure, thoracic ultrasonography
Objectives: This study aimed to research the effect of the increased B-line count (interstitial fluid accumulation) in patients with congestive heart failure on the diffusion capacity of the alveolar-capillary membrane.
Patients and methods: This prospective study was conducted with 77 inpatients diagnosed with pulmonary edema and decompensated heart failure between January 2018 and December 2018. The B-line counts of the patients were calculated through echocardiography and thoracic ultrasonography within the first 24 h of their admission, and the patients were categorized into two groups based on their B-line counts being <15 (n=26; 18 males, 8 females; mean age: 48.6±3.3 years; range, 21 to 72 years) or >15 (n=51; 36 males, 15 females; mean age: 53.7±2.0 years; range, 20 to 79 years). After sufficient diuretic treatment, the patients who were able to tolerate and pass the tests were then subjected to a respiratory function test, diffusion test [DLCO (diffusing capacity of the lungs for carbon monoxide)], and six-minute walk test (6MWT).
Results: The following results in study were found in the echocardiography of the patients with a B-line number >15: lower right ventricular ejection fraction (p=0.003), lower right ventricular systolic motion (p=0.014), higher systolic pulmonary artery pressure (p<0.0001), higher tricuspid regurgitant velocity (p=0.001), more dilated vena cava inferior radius (p<0.0001), higher left atrium volume (p=0.007), higher early diastolic transmitral flow velocity/early diastolic mitral anullar velocity (E/e´) >15 (p<0.0001), and higher pleural effusion (p=0.014). The following results were found in the respiratory function test, DLCO test, and 6MWT of the patients with a B-line number >15: lower forced vital capacity (p<0.0001), lower forced expiratory volume in 1 sec (p=0.002), lower corrected DLCO (p<0.0001), lower 6MWT (p<0.0001).
Conclusion: B-line counts >15 may be a predictor of a decrease in diffusion capacity, restrictive pattern in respiratory function, decrease
in right ventricular function, and increase in pulmonary vascular resistance.
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