Landi Irene, Guerritore Ludovica, Iannaccone Andrea, Ricotti Andrea, Rola Philippe, Garrone Marco
Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italia.
Medicina Chirurgia d'accettazione e d'urgenza, Azienda Ospedaliera Ordine Mauriziano, Via Magellano 1, 10128 Torino, Italia.
Eur Heart J Open. 2024 Jul 10;4(5):oeae050. doi: 10.1093/ehjopen/oeae050. eCollection 2024 Sep.
In acute decompensated heart failure (HF), systemic venous congestion contributes to patients' symptoms and hospital admissions. The purpose of our study is to determine if venous congestion, examined using the venous excess ultrasound (VExUS) score, predicts HF-related hospitalization and mortality in patients admitted to the emergency department (ED) with acute decompensated HF.
Fifty patients admitted for acute HF in ED underwent ultrasound (US) assessment according to the VExUS score within the first 24 and 72 h. All patients were followed up with a telephone call at 30 and 60 days after hospital discharge. On admission, 56% had a VExUS score of 3. After 72 h, 32% had no more signs of congestion at the Doppler VExUS examination (inferior vena cava < 2 cm, VExUS score of 0); a similar percentage still exhibited a VExUS score of 3 despite therapy. Eighty per cent of patients were hospitalized after admission to the ED, while six (15%) died in-hospital; all exhibited a first-assessment VExUS score of 3. No patient with a VExUS score < 3 died during the study. During short-term follow-up, 18 patients were readmitted to the ED for acute decompensated HF. Ninety-four per cent of the readmitted patients had a VExUS score of 3 at the Doppler assessment at the first ED admission.
Severe venous congestion, defined as a VExUS score of 3 at the initial assessment of patients with acute decompensated HF, predicts inpatient mortality, HF-related death, and early readmission.
在急性失代偿性心力衰竭（HF）中，体循环静脉淤血会导致患者出现症状并住院治疗。我们研究的目的是确定使用静脉淤血超声（VExUS）评分检查的静脉淤血是否能预测因急性失代偿性HF入住急诊科（ED）的患者发生HF相关住院和死亡的情况。
50例因急性HF入住ED的患者在最初24小时和72小时内根据VExUS评分接受了超声（US）评估。所有患者在出院后30天和60天通过电话进行随访。入院时，56%的患者VExUS评分为3分。72小时后，32%的患者在多普勒VExUS检查中不再有淤血迹象（下腔静脉<2 cm，VExUS评分为0）；尽管进行了治疗，仍有相似比例的患者VExUS评分为3分。80%的患者在入住ED后住院治疗，而6例（15%）在住院期间死亡；所有死亡患者首次评估时VExUS评分均为3分。在研究期间，VExUS评分<3分的患者无死亡情况。在短期随访中，18例患者因急性失代偿性HF再次入住ED。再次入院的患者中94%在首次ED入院时的多普勒评估中VExUS评分为3分。
在急性失代偿性HF患者的初始评估中，定义为VExUS评分为3分的严重静脉淤血可预测住院死亡率、HF相关死亡和早期再次入院。
