Copyright © 2007, The European Society of Cardiology
Clinical and echocardiographic determinants of ultrasound lung comets
aInstitute of Clinical Physiology, Via Moruzzi 1, Pisa 56010, Italy
bClinica Cardiologica "Montevergine", Mercogliano, Italy
cFF, LG and SG performed the data acquisition; QC was mainly responsible for the data analysis; GM contributed to data acquisition and study protocol design; EP proposed the study and contributed to data discussion. All authors critically reviewed the manuscript.
dSG is recipient of a training fellowship of European Society of Cardiology for the year 2005.
eQC is a visiting scientist to Pisa CNR Echo lab from the Division of Cardiology, Fatebenefratelli Hospital, Benevento.
Received 17 May 2006; received in revised form 15 September 2006; accepted after revision 30 September 2006.
* Corresponding author. Tel.: +39 050 315 2400; fax: +39 050 315 2374. picano{at}ifc.cnr.it
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Abstract |
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Background: Ultrasound lung comets (ULCs) are an echographic sign of extravascular lung water, that originate from water-thickened interlobular septa.
Aim: To establish the echocardiographic correlates of ULCs.
Methods 340 in-hospital patients (68±12years, 115 females) admitted to adult cardiology department underwent upon admission a separate evaluation of chest ULCs and a comprehensive 2D and Doppler echocardiography assessment, including the degree of left ventricular diastolic dysfunction (from 0=normal to 3=restrictive pattern). A patient ULC score has been obtained by summing the number of ULCs from each of the scanning spaces in the anterior right and left chest, from second to fifth intercostal space.
Results: Multivariate linear regression analysis identified New York Heart Association (NYHA) class (OR=2.1, CI=1.4–2.9), ejection fraction (OR 0.954, CI=0.928–0.981) and degree of diastolic dysfunction (OR=2.438, CI=1.418–4.190) as the only parameters independently associated to the number of ULCs.
Conclusion: ULCs are a simple echographic sign of extravascular lung water, more frequently associated with left ventricular diastolic and/or systolic dysfunction. ULCs can usefully integrate the clinical and pathophysiological information provided by conventional 2D and Doppler echocardiography, in patients with known or suspected heart failure and dyspnoea as a presenting symptom.
Keywords: Dyspnoea; Ultrasound lung comets; Echocardiography
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