Lung ultrasound and biomarkers in primary care: Partners for a better management of patients with heart failure?

Authors

  • Mar Domingo Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona and Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona - Spain
  • Laura Conangla Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona and Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona - Spain
  • Josep Lupon Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona and CIBERCV, Instituto de Salud Carlos III, Madrid - Spain
  • Asunción Wilke Primary Care Service Barcelonès Nord i Maresme, Catalan Health Institute, Badalona and Department of Medicine, Universitat Autònoma de Barcelona, Barcelona - Spain
  • Gladys Juncà Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona - Spain
  • Elena Revuelta-López Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, CIBERCV, Instituto de Salud Carlos III, Madrid and ICREC Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Badalona - Spain
  • Xavier Tejedor Biochemistry Service, Hospital Universitari Germans Trias i Pujol, Badalona - Spain
  • Antoni Bayes-Genis Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona and CIBERCV, Instituto de Salud Carlos III, Madrid - Spain

DOI:

https://doi.org/10.33393/jcb.2020.2164

Keywords:

Biomarkers, Congestion, Diagnosis, Heart failure, Lung ultrasound, Primary care

Abstract

Introduction: The association of pulmonary congestion assessed by lung ultrasound (LUS) and biomarkers—other than N-terminal pro-brain natriuretic peptide (NT-proBNP)—is uncertain.

Methods: We investigated the relationship between total B-line count by LUS and several biomarkers in outpatients with suspicion of heart failure (HF). Primary care patients with suspected new-onset nonacute HF were evaluated both with a 12-scan LUS protocol (8 anterolateral areas plus 4 lower posterior thoracic areas) and 11 inflammatory and cardiovascular biomarkers. A cardiologist blinded to LUS and biomarkers except NT-proBNP confirmed HF diagnosis. After log-transformation of biomarkers’ concentrations, unadjusted and adjusted correlations were performed.

Results: A total of 170 patients were included (age 76 ± 10 years, 67.6% women). HF diagnosis was confirmed in 38 (22.4%) patients. After adjustment by age, sex, body mass index, and renal function, total B-line sum significantly correlated with NT-proBNP (R = 0.29, p < 0.001), growth/differentiation factor-15 (GDF-15; R = 0.23, p = 0.003), high-sensitive Troponin T (hsTnT; R = 0.36, p < 0.001), soluble interleukin-1 receptor-like 1 (sST2; R = 0.29, p < 0.001), cancer antigen 125 (CA-125; R = 0.17, p = 0.03), high-sensitivity C-reactive protein (hsCRP; R = 0.20, p = 0.009), and interleukin (IL)-6 (R = 0.23, p = 0.003). In contrast, IL-33 (R = −0.01, p = 0.93), IL-1β (R = −0.10, p = 0.20), soluble neprilysin (sNEP; R = 0.09, p = 0.24), tumor necrosis factor-alpha (TNF-α; R = 0.07, p = 0.39), and TNF-α receptor superfamily member 1A (TNFRSF1A; R = 0.14, p = 0.07) did not.

Conclusions: Total B-line sum correlated significantly, although moderately, with congestion and several inflammation biomarkers. Unexpectedly, the highest correlation found was with hsTnT.

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References

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Published

2020-10-16

How to Cite

Domingo, M., Conangla, L., Lupon, J., Wilke, A., Juncà, G., Revuelta-López, E., Tejedor, X., & Bayes-Genis, A. (2020). Lung ultrasound and biomarkers in primary care: Partners for a better management of patients with heart failure?. Journal of Circulating Biomarkers, 9(1), 8–12. https://doi.org/10.33393/jcb.2020.2164

Issue

Section

Original research article
Received 2020-06-11
Accepted 2020-09-02
Published 2020-10-16

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