Lung ultrasound in patients with chronic heart failure

Introduction . Currently, attention is being paid to ultrasound examination (ultrasound) of the lungs for the diagnosis of pulmonary congestion in chronic heart failure (CHF). Aim . To determine the presence and frequency of congestive changes in the lungs and pleural cavity in CHF patients based on lung and pleural cavity ultrasound findings. Materials and methods . The study included (n) 342 CHF patients, with a median age of 65 years [55; 71]. Men 52%. The functional class (FC) of CHF: FC II, n = 57; FC III, n = 153; FC IV, n = 132. Left ventricular ejection fraction (LVEF) ≥ 50%, n = 124; LVEF 41–49%, n = 120; LVEF ≤ 40%, n = 118. Stages of CHF: Pre-heart failure, n = 68; stage 1, n = 176; stage 2, n = 98. In addition to general clinical examination, ultrasound of the lungs and pleural cavity was performed. Results . Lung ultrasound revealed interstitial lung changes in 58% of patients, pleurisy in 38%, and a combination of 28%. There was an increase in the incidence of interstitial edema of mild, moderate and severe degrees with an increase in CHF FC. At the same time, the frequency of detection of pleural effusion had no significant differences from FC and LVEF. There was an increase in the incidence of interstitial edema and pleurisy in the CHF stage 1 and 2 groups compared with the group of patients with HF, however, in the HF group there were patients with edema and effusion, in the absence of clinical manifestations of CHF. Interstitial pulmonary edema was detected in 46% of patients with chest X-rays, pleurisy in 54%, and a combination of 24%. Conclusion . The results of this study demonstrate that pulmonary congestion is common in CHF patients, and it is more frequently detected by lung ultrasound than by chest X-ray, which reflects the expediency of lung ultrasound.