Clinical Report: Assessment of Lung Ultrasound B-Lines and NT-proBNP Levels

Overview

This study evaluates the combined use of lung ultrasound B-lines, NT-proBNP levels, and left atrial volume index (LAVI) for identifying acute heart failure with preserved ejection fraction (HFpEF). The findings suggest that this combination can moderately distinguish HFpEF from non-HFpEF in hospitalized patients.

Background

Heart failure with preserved ejection fraction (HFpEF) is a prevalent condition that poses significant diagnostic challenges due to its heterogeneous nature. Accurate identification of HFpEF is crucial for appropriate management, as it often coexists with other comorbidities and may not present with overt symptoms. Current diagnostic methods lack specificity, highlighting the need for integrated approaches that combine clinical, biochemical, and imaging modalities.

Data Highlights

Key Findings

• The study included 220 patients, of whom 57 had HFpEF and 163 had non-HFpEF.
• Individual markers (B-line score, NT-proBNP, LAVI) showed limited-to-moderate discriminatory ability.
• The three-marker model achieved an AUC of 0.737, indicating moderate diagnostic performance.
• Decision curve analysis indicated that combined models provided greater net benefit than treat-all and treat-none strategies.
• This approach should be viewed as a tool for bedside phenotype characterization rather than a definitive diagnostic model.

Clinical Implications

The combination of lung ultrasound B-lines, NT-proBNP, and LAVI may enhance the bedside identification of HFpEF, allowing for more accurate patient management. Clinicians should consider integrating these parameters into their assessment protocols for patients presenting with acute heart failure symptoms.

Conclusion

The study demonstrates that a combination of lung ultrasound B-lines, NT-proBNP, and LAVI can moderately improve the identification of HFpEF in acute heart failure settings. Further validation is necessary to establish its utility as a diagnostic tool.

Related Resources & Content

1. Author(s)/Org, Source, Year -- Title
2. Author(s)/Org, Source, Year -- Title
3. Author(s)/Org, Source, Year -- Title
4. Frontiers in Cardiovascular Medicine, 2026 -- Integrated biomarkers and cardiac phenotypes associated with atrial fibrillation: evidence from real-world hospital data
5. American Society of Echocardiography, 2025 -- Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis
6. The role of POCUS in diagnosing acute heart failure in the emergency department: A meta-analysis
7. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis