Cor Vasa 2025, 67(3):350-359 | DOI: 10.33678/cor.2025.006

Value of peri-procedural lung ultrasound in predicting heart failure or left ventricular systolic dysfunction within 3 months in STEMI patients undergoing primary PCI

Ahmed Talaat, Mohamed Abou El Ezz, Mohamed Mahmoud Abd El Ghany, Mohamed Abdel Meguid Mahdy, Kareem Mahmoud

Department of Cardiovascular Medicine, Faculty of Medicine Cairo University, Cairo, Egypt

Aim: To see if the detection of subclinical congestion in STEMI patients by lung ultrasound (LUS) could be helpful in predicting the development of future heart failure, systolic dysfunction or diastolic dysfunction.

Methods: 150 patients were included. All patients were successfully revascularized and were not suffering from clinical heart failure on admission. The patients had a 28-point LUS study within the first 24 hours of admission, and B-lines were counted. Patients were divided into two groups: 64 patients into the LUS positive group (with 6 or more B-lines) and 86 into the LUS negative group. They were followed-up after 3 months, looking for heart failure NYHA II or greater, ejection fraction (EF) ≤40%, and global longitudinal strain (GLS) ≤-16%.

Results: More patients from the LUS positive group developed clinical heart failure (17 vs 2 in the LUS negative group, p <0.01), EF ≤40% (34 vs 3, p <0.01), GLS ≤-16% (60 vs 58, p <0.01). Optimal cutoff derived from ROC curves revealed that the best B-line number cutoff to predict clinical heart failure as well as impaired systolic function was 6 or greater (sensitivity = 89.47%, specificity = 64.62% and sensitivity = 91.89%, specificity = 74.11%, respectively). Subgroup analysis by initial diagnosis revealed that the predictive power of LUS was significant only in anterior STEMI.

Conclusions: LUS in STEMI patients, performed within 24 hours of admission, is able to predict the occurrence of clinical heart failure or systolic dysfunction at 3 months, especially in anterior infarctions.

Keywords: Heart failure, Lung ultrasound, Myocardial infarction, ST-segment elevation myocardial infarction

Received: September 20, 2024; Revised: January 5, 2025; Accepted: January 5, 2025; Prepublished online: June 2, 2012; Published: June 20, 2025  Show citation