Cardiovascular Surgery and Interventions 2024, Vol 11, Num 2 Page(s): 087-094
Evaluation of alveolar-capillary membrane functions by thoracic ultrasonography in heart failure

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.

DOI : 10.5606/e-cvsi.2024.1616