Evidence map›Paper›PMID 37210700›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2023

Exercise-induced B-lines for the diagnosis of heart failure with preserved ejection fraction: a two-centre study.

Stefano Coiro, Mathieu Echivard, Dejan Simonovic, Kevin Duarte, Mario Santos, Marina Deljanin-Ilic, Masatake Kobayashi, Giuseppe Ambrosio, Nicolas Girerd

Open access · greenAbstract readControlled Clinical TrialMulticenter Study
PubMed Publisher
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 4 countries.

Stefano Coiro *Cardiology Department, Santa Maria Della Misericordia Hospital, Perugia, Italy.ORCID http://orcid.org/0000-0001-9463-5055
Mathieu Echivard *Département de Cardiologie, CHRU de Nancy, 54500, Vandœuvre-lès-Nancy, France.
Dejan SimonovicInstitute for Treatment and Rehabilitation "Niska Banja", Clinic of Cardiology, University of Nis School of Medicine, Nis, Serbia.
Kevin DuarteUniversité de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France.
Mario SantosCardiology Service, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Marina Deljanin-IlicInstitute for Treatment and Rehabilitation "Niska Banja", Clinic of Cardiology, University of Nis School of Medicine, Nis, Serbia.
Masatake KobayashiUniversité de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France.
Giuseppe AmbrosioDivision of Cardiology, University of Perugia School of Medicine, Perugia, Italy.
Nicolas GirerdUniversité de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France. nicolas_girerd@yahoo.com.
Inserm · FRUniversity of Nis · RSCentre Hospitalier Régional et Universitaire de Nancy · FRUniversidade do Porto · PTUniversity of Perugia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging despite the use of scores/algorithms. This study intended to assess the diagnostic value of exercise lung ultrasound (LUS) for HFpEF diagnosis.

methodsWe studied two independent case-control studies of HFpEF patients and control subjects undergoing different exercise protocols: (i) submaximal exercise stress echocardiography (ESE) with LUS performed by expert cardiologists (N = 116, HFpEF = 65.5%), and (ii) maximal cycle ergometer test (CET) (N = 54, HFpEF = 50%) with LUS performed by unexperienced physicians shortly trained for the study. B-line kinetics (i.e. peak values and their changes from rest) were assessed.

resultsIn the ESE cohort, the C-index (95% CI) of peak B-lines for HFpEF diagnosis was 0.985 (0.968-1.000), whereas the C-index of rest and exercise HFA-PEFF scores (i.e. including stress echo findings) were < 0.90 (CI 0.823-0.949), and that of H2FPEF score was < 0.70 (CI 0.558-0.764). The C-index increase of peak B-lines on top of the above-mentioned scores was significant (C-index increase > 0.090 and P-value < 0.001 for all). Similar results were observed for change B-lines. Peak B-lines > 5 (sensitivity = 93.4%, specificity = 97.5%) and change B-lines > 3 (sensitivity = 94.7%, specificity = 87.5%) were the best cutoffs for HFpEF diagnosis. Adding peak or change B-lines on top of HFpEF scores and BNP significantly improved diagnostic accuracy. Peak B-lines showed a good diagnostic accuracy in the LUS beginner-led CET cohort (C-index = 0.713, 0.588-0.838).

conclusionsExercise LUS showed excellent diagnostic value for HFpEF diagnosis regardless of different exercise protocols/level of expertise, with additive diagnostic accuracy on top of available scores and natriuretic peptides.

Indexed as

Heart FailureEchocardiography, StressExercise TestHumansLungStroke VolumeVentricular Function, LeftB-linesDiagnostic accuracyExercise testHeart failure with preserved ejection factionPulmonary congestion

Identifiers

PMID37210700
OpenAlexW4377195124

What OpenQuestion holds

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Registered trials

None linked

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.