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February 8, 2026European Heart Journal0 citations

Risk stratification with ultrasound markers of congestion in advanced heart failure

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HSH SisakianYerevan State Medical UniversitySSSyuzanna ShahnazaryanYerevan State Medical UniversityNMN MuradyanYerevan State Medical University

Key Result

E/e' >15, >3 B lines on lung ultrasound, and IVC diameter >2.5 cm before discharge predict death and cardiovascular hospitalization in advanced HFrEF.

Key Points

  • To validate ultrasound markers of congestion as predictors of cardiovascular events in advanced heart failure with reduced ejection fraction.
  • Evaluated cardiovascular markers of congestion in 103 patients with advanced HFrEF.
  • Assessed E/e' ratio, B lines on lung ultrasound, and inferior vena cava diameter before discharge.
  • Analyzed the association between ultrasound findings and patient outcomes.
  • E/e' >15, presence of >3 B lines, and inferior vena cava diameter >2.5 cm significantly predicted rehospitalization and mortality.
  • The combination of these markers differentiated patients with <20% survival at 18 months follow-up.

Structured PICO

Do ultrasound markers of congestion before discharge predict death and cardiovascular hospitalization in patients with advanced HFrEF?

P
Population
103 patients with advanced high risk HFrEF before discharge
I
Intervention
Assessment of cardiovascular ultrasound markers of congestion (E/e', lung ultrasound B lines, inferior vena cava diameter) before discharge
O
Outcome
Death and cardiovascular hospitalizationcomposite

Pre-discharge assessment of ultrasound markers of congestion (E/e', lung B lines, IVC diameter) can independently predict rehospitalization and mortality in advanced HFrEF patients.

Abstract

Abstract Aims Ultrasound markers of congestion as predictors of outcomes in heart failure with reduced ejection fraction ( HFrEF ) have not been independently validated. The primary objective was to evaluate the importance of cardiovascular imaging to predict cardiovascular events in patients with advanced HF through assessment of congestion. Methods and Results We assessed the association between cardiovascular markers of congestion and outcomes in 103 patients with advanced high risk HFrEF before discharge . After multiple adjustments , the significant predictors of death and cardiovascular hospitalization were E/e' 15 (Pic 1 ), presence of more than 3 B lines at lung ultrasound ( LUS) at each site and inferior vena cava diameter2,5 cm . The combination of these three parameters differentiated patients with 20 % at 18 months follow up ( (Pic 2). Conclusions Use of three feasible cardiovascular ultrasound markers of congestion - LV filling pressure parameter ,LUS and inferior vena diameter before hospital discharge independently predict rehospitalization and cardiovascular mortality in patients with advanced HF . The data suggest the need of careful cardiovascular ultrasound assessment at pre discharge period in advanced HF.

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Cite This Study

Sisakian et al. (2025) studied this question. E/e' >15, >3 B lines on lung ultrasound, and IVC diameter >2.5 cm before discharge predict death and cardiovascular hospitalization in advanced HFrEF.

synapsesocial.com/papers/698828770fc35cd7a8847f1bhttps://doi.org/10.1093/eurheartj/ehaf784.966
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