P756Thotaxic ultrasound "comet tail" in patients withdiastolic heart failure and pulmonary congestion.


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Abstract

Background: About 1/3 of patients with heart failure (HF) have preserved systolic function. Pulmonary congestion is useful marker of Diastolic Heart Failure (DHF). The aim of this study was to determine the place of thoraxic sonography in diagnosis of DHF.Methods: We studied 280 patients with II-IV NYHA class HF. 185 Patients have Systolic HF (SHF) (I gr), 95 patient - DHF (II gr) and 105 patients Left Ventricular Diastolic Dysfunction but without signs of HF (control, III gr). All patients undergone standard EchoCG examination. Sonographic evaluation of a lung was done in horizontal or vertical positions of patient, from 10 points of thoracic wall which corresponded to the projection of lower, middle and upper lobes of a right lung and upper and lower lobes of left lung.Results: In patients with HF we significantly often found the one of the tips of reverberation phenomenon - "Comet tail Phenomenon" (CTPh). CTPh was registered in 96.2% 90.5% and 40.0% of patients in I, II and III gr respectively (the difference between control an HF groups was significant). The count of points from where the CTPh was registered was 8.8 in SHF group, 6.8 in DHF gr. and 1.9 in control gr. The CTPh was registered from 3 or more points of thoracic wall in 92.4% of patients in Igr, 81.05% - in II gr and only 4,76% in III gr. In HF groups CTPh was prominent and multiple while in the control group it was single and short lasting. There was good correlation between the count of CTPh registration points from the thoracic wall and the heart failure NYHA class (r=0.56), left ventricular systolic (r=0.41) and diastolic (r=0.33) diameters and negative correlation with EF% (r=-0,42).Conclusion: Thoracic US is sensitive and accurate method for evaluation pulmonary congestion in patients Diastolic HF. The US sign of pulmonary congestion in HF is a "Comet tail phenomenon", which is prominent, multiple and registered from larger area of thoracic wall (3 points or more).

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