Trial reportCritical care (London, England)2011
Combination of lung ultrasound (a comet-tail sign) and N-terminal pro-brain natriuretic peptide in differentiating acute heart failure from chronic obstructive pulmonary disease and asthma as cause of acute dyspnea in prehospital emergency setting.
Trial report in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT01235182 (Combination of Lung Ultrasound), which is not on this map. Cited by 53 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Combination of Lung Ultrasound(a Comet-tail Sign) and N-terminal Pro-brain Natriuretic Paptide in Differentiating Acute Dyspnea in Prehospital Emergency Setting
Who cites it
53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- Contribution of point-of-care ultrasound in the prehospital management of patients with non-trauma acute dyspnea: a systematic review and meta-analysis.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2025Pooled it
- Recommendations for Lung Ultrasound in Internal Medicine.Diagnostics (Basel, Switzerland) · 2020Guideline
- Pulmonary Ultrasound in Patients with Heart Failure - Systematic Review.Arquivos brasileiros de cardiologia · 2018Pooled it
- The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting.BMJ (Clinical research ed.) · 2015Pooled it
- Use of BNP and NT-proBNP for the diagnosis of heart failure in the emergency department: a systematic review of the evidence.Heart failure reviews · 2014Pooled it
- Trial
- Feasibility and Operator-Reported Utility of Transesophageal Lung Ultrasound As an Adjunct to Resuscitative Transesophageal Echocardiography in the Evaluation of Shock: A Multicenter Observational Study.Critical care medicine · 2026Article
- An Integrated Prehospital Point-of-Care Lung Ultrasound Protocol for Patients With Dyspnea.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Article
- Lung Ultrasound Offers Fast and Reliable Exclusion of Heart Failure in the Emergency Department: A Prospective Diagnostic Study.Diagnostics (Basel, Switzerland) · 2025Article
- Prognostic Utility of HEFESTOS Score and Complementary Lung Ultrasound for Heart Failure Decompensation in Primary Care Outpatients: A Prospective Cohort Study.Journal of cardiovascular development and disease · 2025Article
- Evolving role of point-of-care ultrasound in prehospital emergency care: a narrative review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
- Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2024.Journal of geriatric cardiology : JGC · 2025Article
- Accuracy of Lung Ultrasonography for Diagnosis of Heart Failure; a Systematic Review and Meta-analysis.Archives of academic emergency medicine · 2025Review
- Article
- Prognostic Significance of Lung Ultrasound for Heart Failure Patient Management in Primary Care: A Systematic Review.Journal of clinical medicine · 2024Review
- Lung ultrasound training: how short is too short? observational study on the effects of a focused theoretical training for novice learners.BMC medical education · 2024Observational
- B-lines by lung ultrasound as a predictor of re-intubation in mechanically ventilated patients with heart failure.Frontiers in cardiovascular medicine · 2024Article
- Point-of-Care Ultrasound for the Diagnosis of Frequent Cardiovascular Diseases: A Review.Cureus · 2023Review
- Lung Ultrasound to Assess Pulmonary Congestion in Patients with Acute Exacerbation of COPD.International journal of chronic obstructive pulmonary disease · 2023Article
- Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe studied the diagnostic accuracy of bedside lung ultrasound (the presence of a comet-tail sign), N-terminal pro-brain natriuretic peptide (NT-proBNP) and clinical assessment (according to the modified Boston criteria) in differentiating heart failure (HF)-related acute dyspnea from pulmonary (chronic obstructive pulmonary disease (COPD)/asthma)-related acute dyspnea in the prehospital setting.
methodsOur prospective study was performed at the Center for Emergency Medicine, Maribor, Slovenia, between July 2007 and April 2010. Two groups of patients were compared: a HF-related acute dyspnea group (n = 129) and a pulmonary (asthma/COPD)-related acute dyspnea group (n = 89). All patients underwent lung ultrasound examinations, along with basic laboratory testing, rapid NT-proBNP testing and chest X-rays.
resultsThe ultrasound comet-tail sign has 100% sensitivity, 95% specificity, 100% negative predictive value (NPV) and 96% positive predictive value (PPV) for the diagnosis of HF. NT-proBNP (cutoff point 1,000 pg/mL) has 92% sensitivity, 89% specificity, 86% NPV and 90% PPV. The Boston modified criteria have 85% sensitivity, 86% specificity, 80% NPV and 90% PPV. In comparing the three methods, we found significant differences between ultrasound sign and (1) NT-proBNP (P < 0.05) and (2) Boston modified criteria (P < 0.05). The combination of ultrasound sign and NT-proBNP has 100% sensitivity, 100% specificity, 100% NPV and 100% PPV. With the use of ultrasound, we can exclude HF in patients with pulmonary-related dyspnea who have positive NT-proBNP (> 1,000 pg/mL) and a history of HF.
conclusionsAn ultrasound comet-tail sign alone or in combination with NT-proBNP has high diagnostic accuracy in differentiating acute HF-related from COPD/asthma-related causes of acute dyspnea in the prehospital emergency setting.
trial registrationClinicalTrials.gov NCT01235182.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.