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| The value of bedside lung ultrasound in rapid differential diagnosis of the elderly cardiac dyspnea |
Department of Ultrasound, the Affiliated Hospital of North China University of Science and Technology,
Tangshan Hebei 063000, China |
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Abstract Objective: To observe the emergence of cases with B-line in elderly patients with acute dyspnea, explore the value of the bedside lung ultrasound in the rapid differential diagnosis of senile acute cardiac dyspnea. Methods: Eighty-four elderly patients hospitalized with acute dyspnea, who underwent lung ultrasound(measure B-lines) and echocardiography(measure LVEF and E/E’) before pharmacotherapy were enrolled. The patients were divided into acute left ventricular failure dyspnea group(group Ⅰ) and pulmonary dyspnea group(group Ⅱ) according to the clinical diagnosis. The difference of B-lines, LVEF and E/E’ between the two groups was analyzed, and the relevance of B-lines and NT-proBNP, LVEF, E/E’ was also analyzed. Draw ROC curve, determine the area under the curve(AUC) and determine the diagnostic value of NT-proBNP, B-line. Determine the optimal threshold of the B-line diagnosing acute cardiac dyspnea. Results: B-lines, E/E’ and NT-proBNP of group Ⅰ are higher than group Ⅱ, and EF is lower than group Ⅱ. The difference is statistically significant(P<0.05). The B-line with NT-proBNP(r=0.850, P<0.05), E/E’(r=0.639, P<0.05) and LVEF(r=-0.760, P<0.05) are significantly correlated. NT-proBNP and B-line of AUC and 95% CI are 0.933(0.884～0.981), 0.968(0.937～0.998). When the B-lines is more than 8, diagnostic sensitivity of acute cardiac dyspnea achieves 81%, the specificity achieves 88%. Conclusion: The B-line may assist in clinically diagnosing elderly patients with acute left ventricular failure. The B-lines has high sensitivity and specificity in differentiated diagnosing elderly patients with acute left heart failure and pulmonary dyspnea.
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