Abstract：Objective To analyze the ultrasound lung comets (ULCs) in patients with cardiac inadequacy and evaluate its clinical value. Methods 167 patients with acute dyspnea were recruited randomly, and divided into acute left heart failure group (ALHF) and non-ALHF group (NALHF). Both groups were studied by lung ultrosonography to count ultrasound lung comets (ULCs). Left atrial diameter (LAD), left ventricular diastolic diameter end (LVEDD), the ratio of early diastolic mitral inflow velocity to early diastolic velocity of the mitral annulus (E/Ea) and left ventricular ejection fraction (EF) were measured by transthoracic echocardiography examination. The ROC curve was drawn to find the maximum Younden index as the optimal diagnosis boundary point and calculated the area under the curve. Results The median of ULCs, LAD, LVEDD and E/Ea in group ALHF were significantly higher than that in group NALHF(P<0.05). However, the median of EF in group ALHF was significantly lower than that in group NALHF(P<0.05). The area under the ROC was 0.946 (P<0.01). When B-lines>5, the sensitivity and specificity of ultrasound comet-tail sign was 92.7% (95% CI 79.2%-95.3%), and 79.6% (95% CI 66.5%-92.8%), respectively. And the positive and negative predictive values were 90.67% (95% CI 68.29%-96.17%), and 79.3% (95% CI 65.1%-86.9%), respectively for the diagnosing heart failure related acute dyspnea. The accuracy was 82.9% (155/187). Conclusions Transthoracic ultrasound comet-tail sign is a simple and accurate tool for the assessment of cardiac function which can be included in routine screening for patients with acute dyspnea.
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LI Mei, XUE Ailing, and ZHANG Xiaorong. Clinical value of ultrasound lung comets in Patients with acute left heart failure. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(1): 61-64.
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