Department of Ultrasound, Shanxi Provincial People's Hospital, Taiyuan 030012, China.
Department of Echocardiography, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Biomed Res Int. 2018 Jan 2;2018:8474839. doi: 10.1155/2018/8474839. eCollection 2018.
Ultrasound lung comets (ULCs) are a nonionizing bedside approach to assess extravascular lung water. We evaluated a protocol for grading ULC score to estimate pulmonary congestion in heart failure patients and investigated clinical and echocardiographic correlates of the ULC score. Ninety-three patients with congestive heart failure, admitted to the emergency department, underwent pulmonary ultrasound and echocardiography. A ULC score was obtained by summing the ULC scores of 7 zones of anterolateral chest scans. The results of ULC score were compared with echocardiographic results, the New York Heart Association (NYHA) functional classification, radiologic score, and N-terminal pro-b-type natriuretic peptide (NT-proBNP). Positive linear correlations were found between the 7-zone ULC score and the following: /', systolic pulmonary artery pressure, severity of mitral regurgitation, left ventricular global longitudinal strain, NYHA functional classification, radiologic score, and NT-proBNP. However, there was no significant correlation between ULC score and left ventricular ejection fraction, left ventricle diameter, left ventricular volume, or left atrial volume. A multivariate analysis identified the /', systolic pulmonary artery pressure, and radiologic score as the only independent variables associated with ULC score increase. The simplified 7-zone ULC score is a rapid and noninvasive method to assess lung congestion. Diastolic rather than systolic performance may be the most important determinant of the degree of lung congestion in patients with heart failure.
超声肺彗星征（ULC）是一种非电离床边方法，用于评估血管外肺水。我们评估了 ULC 评分分级方案，以评估心力衰竭患者的肺淤血，并研究了 ULC 评分与临床和超声心动图的相关性。93 例充血性心力衰竭患者在急诊科接受了肺部超声和超声心动图检查。通过对前外侧胸部扫描的 7 个区域的 ULC 评分进行求和，获得 ULC 评分。将 ULC 评分的结果与超声心动图结果、纽约心脏协会（NYHA）功能分类、放射评分和 N 端脑利钠肽前体（NT-proBNP）进行比较。7 区 ULC 评分与以下因素呈正线性相关：/', 肺动脉收缩压、二尖瓣反流严重程度、左心室整体纵向应变、NYHA 功能分类、放射评分和 NT-proBNP。然而，ULC 评分与左心室射血分数、左心室直径、左心室容积或左心房容积之间无显著相关性。多变量分析确定了/', 肺动脉收缩压和放射评分是与 ULC 评分增加相关的唯一独立变量。简化的 7 区 ULC 评分是一种快速、非侵入性的方法，用于评估肺淤血。在心力衰竭患者中，舒张功能而不是收缩功能可能是肺淤血程度的最重要决定因素。
