EVALUATION OF ALVEOLAR-CAPILLARY MEMBRANE FUNCTIONS BY THORACIC
ULTRASONOGRAPHY IN HEART FAILURE
Abstract
Objective This study aims to research the effect of the
increased interstitial fluid accumulation in patients with congestive
heart failure on the diffusion capacity of the alveolar-capillary
membrane. Methods This prospective study is conducted on 77 in-patients
diagnosed with pulmonary edema and decompansated heart failure. The
B-line counts of the patients are calculated through echocardiography
and thoracic ultrasonography within the first 24 hours of their
admission and the patients are categorized into two groups based on
their B-line counts being higher or lower than 15. After sufficient
diuretic treatment, the patients are subjected to respiratory function
test, diffusion test(DLCO) and 6 minute walk test. Results The following
results in study have been found in the echocardiography of the patients
in the higher-than-15 B-line group: lower RVEF (p=0,003), lower RVSm
(p=0,014), higher SPAP (p<0,0001), higher TRV (p=0,001), more
dilated VCI radius (p<0,0001), higher LA volume(p=0,007),
higher E/e’>15 (p<0,0001), higher pleural
effusıon (p=0,014). The following results have been found in the
respiratory function test, DLCO and 6 minute walk test of the patients
in the higher-than-15 B-line group: lower FVC (p
<0,0001),lower FEV1 (p=0,002), lower corrected DLCO
(p<0,0001), lower 6 minute walk test (p<0,0001).16
of the 77 patients have undergone right heart catheterization during
their stay in the hospital and higher PVR (p=0,039) has been found in
the higher-than-15 B-line group. Conclusion B-line counts of higher than
15 may be predictor of decrease in diffusion capacity, restrictive
patern in respiratory function, decrease in right ventricular function
and increase in pulmonary vascular resistance.