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肺部超声扫描在不同心力衰竭情形中的作用:当前应用及证据不足

The Role of Lung Ultrasound Scan in Different Heart Failure Scenarios: Current Applications and Lacks of Evidences.

作者信息

Campora Alessandro, Beltrami Matteo, Di Renzo Anita, Petrini Alessia, Palazzuoli Alberto

机构信息

Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Bracci 1, 53100 Siena, Italy.

Arrhythmia and Electrophysiology Unit, Careggi University Hospital, 50134 Florence, Italy.

出版信息

Diagnostics (Basel). 2024 Dec 28;15(1):45. doi: 10.3390/diagnostics15010045.

Abstract

Pulmonary congestion is a critical factor influencing the clinical presentation, therapeutic decisions, and outcomes of heart failure (HF) patients. Lung ultrasound (LUS) offers a simple, rapid, and accurate method for assessing pulmonary congestion, surpassing the diagnostic capabilities of traditional clinical evaluation and chest radiography. Due to the wide availability of ultrasound equipment, congestion can be evaluated in multiple settings, ranging from emergency departments to intensive care units, including outpatient settings. A combined cardiopulmonary imaging approach, integrating LUS with other imaging modalities, enhances congestion assessment in both acute and chronic HF. This comprehensive approach provides valuable insights for HF management and risk stratification. However, optimizing the utilization of LUS remains a challenge, as standardized imaging protocols and B-line thresholds may vary across different clinical scenarios and HF phenotypes. Despite the widespread use of LUS in various HF settings, physician adoption and interpretation of LUS findings remain suboptimal. This review aims to provide a practical and clinical overview of LUS in HF, guiding clinicians towards the correct application and interpretation of this valuable tool in diverse HF contexts.

摘要

肺淤血是影响心力衰竭(HF)患者临床表现、治疗决策和预后的关键因素。肺部超声(LUS)为评估肺淤血提供了一种简单、快速且准确的方法,其诊断能力超过了传统临床评估和胸部X线检查。由于超声设备广泛可得,在从急诊科到重症监护病房等多种环境中,包括门诊环境,都可以对肺淤血进行评估。将LUS与其他成像方式相结合的心肺成像综合方法,可增强对急性和慢性HF患者肺淤血的评估。这种全面的方法为HF管理和风险分层提供了有价值的见解。然而,优化LUS的使用仍然是一项挑战,因为标准化成像方案和B线阈值可能因不同临床场景和HF表型而异。尽管LUS在各种HF环境中广泛使用,但医生对LUS检查结果的接受程度和解读能力仍不尽人意。本综述旨在提供LUS在HF中的实用临床概述,指导临床医生在不同HF背景下正确应用和解读这一有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5c9/11719622/94896821c42a/diagnostics-15-00045-g001.jpg

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