B-lines with Lung Ultrasound : The Optimal Scan Technique at Rest and During Stress. / Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography.
In: Ultrasound in Medicine and Biology, Vol. 43, No. 11, 01.11.2017, p. 2558-2566.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - B-lines with Lung Ultrasound
T2 - The Optimal Scan Technique at Rest and During Stress
AU - Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography
AU - Scali, Maria Chiara
AU - Zagatina, Angela
AU - Simova, Iana
AU - Zhuravskaya, Nadezhda
AU - Ciampi, Quirino
AU - Paterni, Marco
AU - Marzilli, Mario
AU - Carpeggiani, Clara
AU - Picano, Eugenio
AU - Citro, Rodolfo
AU - D'Andrea, Antonello
AU - Cortigiani, Lauro
AU - Olivotto, Iacopo
AU - Mori, Fabio
AU - Galderisi, Maurizio
AU - Costantino, Marco Fabio
AU - Pratali, Lorenza
AU - di Salvo, Giovanni
AU - Bossone, Eduardo
AU - Ferrara, Francesco
AU - Kasprszak, Jaroslaw D.
AU - Rigo, Fausto
AU - Gaibazzi, Nicola
AU - Limongelli, Giuseppe
AU - Pacileo, Giuseppe
AU - Severino, Sergio
AU - Pinamonti, Bruno
AU - Massa, Laura
AU - Torres, Marco A.R.
AU - Miglioranza, Marcelo H.
AU - Daros, Clarissa Borguezan
AU - Luis de Castro e Silva Pretto, José
AU - Djordjevic-Dikic, Ana
AU - Dekleva, Milica
AU - Varga, Albert
AU - Agoston, Gergely
AU - Palinkas, Attila
AU - Amor, Miguel
AU - Lowenstein, Jorge
AU - Merlo, Pablo
AU - Celutkiene, Jelena
AU - Perez, Julio E.
AU - Trambaiolo, Paolo
AU - Gregori, Dario
AU - Colonna, Paolo
AU - Andreassi, Maria Grazia
AU - De Nes, Michele
AU - Arystan, Ayana
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Various lung ultrasound (LUS) scanning modalities have been proposed for the detection of B-lines, also referred to as ultrasound lung comets, which are an important indication of extravascular lung water at rest and after exercise stress echo (ESE). The aim of our study was to assess the lung water spatial distribution (comet map) at rest and after ESE. We performed LUS at rest and immediately after semi-supine ESE in 135 patients (45 women, 90 men; age 62 ± 12 y, resting left ventricular ejection fraction = 41 ± 13%) with known or suspected heart failure or coronary artery disease. B-lines were measured by scanning 28 intercostal spaces (ISs) on the antero-lateral chest, 2nd–5th IS, along with the midaxillary (MA), anterior axillary (AA), mid-clavicular (MC) and parasternal (PS) lines. Complete 28-region, 16-region (3rd and 4th IS), 8-region (3rd IS), 4-region (3rd IS, only AA and MA) and 1-region (left 3rd IS, MA) scans were analyzed. In each space, the B-lines were counted from 0 = black lung to 10 = white lung. Interpretable images were obtained in all spaces (feasibility = 100 %). B-lines (>0 in at least 1 space) were present at ESE in 93 patients (69%) and absent in 42. More B-lines were found in the 3rd IS and along AA and MA lines. The B-line cumulative distribution was symmetric at rest (right/left = 1.10) and asymmetric with left lung predominance during stress (right/left = 0.67). The correlation of per-patient B-line number between 28-S and 16-S (R2 = 0.9478), 8-S (R2 = 0.9478) and 4-S scan (R2 = 0.9146) was excellent, but only good with 1-S (R2 = 0.8101). The average imaging and online analysis time were 5 s per space. In conclusion, during ESE, the comet map of lung water accumulation follows a predictable spatial pattern with wet spots preferentially aligned with the third IS and along the AA and MA lines. The time-saving 4-region scan is especially convenient during stress, simply dismissing dry regions and focusing on wet regions alone.
AB - Various lung ultrasound (LUS) scanning modalities have been proposed for the detection of B-lines, also referred to as ultrasound lung comets, which are an important indication of extravascular lung water at rest and after exercise stress echo (ESE). The aim of our study was to assess the lung water spatial distribution (comet map) at rest and after ESE. We performed LUS at rest and immediately after semi-supine ESE in 135 patients (45 women, 90 men; age 62 ± 12 y, resting left ventricular ejection fraction = 41 ± 13%) with known or suspected heart failure or coronary artery disease. B-lines were measured by scanning 28 intercostal spaces (ISs) on the antero-lateral chest, 2nd–5th IS, along with the midaxillary (MA), anterior axillary (AA), mid-clavicular (MC) and parasternal (PS) lines. Complete 28-region, 16-region (3rd and 4th IS), 8-region (3rd IS), 4-region (3rd IS, only AA and MA) and 1-region (left 3rd IS, MA) scans were analyzed. In each space, the B-lines were counted from 0 = black lung to 10 = white lung. Interpretable images were obtained in all spaces (feasibility = 100 %). B-lines (>0 in at least 1 space) were present at ESE in 93 patients (69%) and absent in 42. More B-lines were found in the 3rd IS and along AA and MA lines. The B-line cumulative distribution was symmetric at rest (right/left = 1.10) and asymmetric with left lung predominance during stress (right/left = 0.67). The correlation of per-patient B-line number between 28-S and 16-S (R2 = 0.9478), 8-S (R2 = 0.9478) and 4-S scan (R2 = 0.9146) was excellent, but only good with 1-S (R2 = 0.8101). The average imaging and online analysis time were 5 s per space. In conclusion, during ESE, the comet map of lung water accumulation follows a predictable spatial pattern with wet spots preferentially aligned with the third IS and along the AA and MA lines. The time-saving 4-region scan is especially convenient during stress, simply dismissing dry regions and focusing on wet regions alone.
KW - Exercise
KW - Lung
KW - Stress
KW - Water
UR - http://www.scopus.com/inward/record.url?scp=85028509536&partnerID=8YFLogxK
U2 - 10.1016/j.ultrasmedbio.2017.07.007
DO - 10.1016/j.ultrasmedbio.2017.07.007
M3 - Article
C2 - 28865726
AN - SCOPUS:85028509536
VL - 43
SP - 2558
EP - 2566
JO - Ultrasound in Medicine and Biology
JF - Ultrasound in Medicine and Biology
SN - 0301-5629
IS - 11
ER -
ID: 43612436