- For patients with undifferentiated dyspnea in the emergency department (ED), a cardiothoracic point-of-care ultrasound (POCUS) protocol (CaTUS) that combines echocardiography and lung ultrasound accurately detects acute heart failure (AHF).
- CaTUS took operator about 3 minutes.
Why this matters
- The search continues for fast ways to differentiate AHF from other dyspnea.
- 52 patients had AHF.
- CaTUS performance:
- Sensitivity: 100% (95% CI, 91.4%-100%).
- Specificity: 95.8% (84.6%-99.3%).
- Area under the curve: 0.979.
- CaTUS outperformed both lung ultrasound and E/e’ alone.
- Single-ED prospective observational study (n=100).
- Convenience sample of adults with undifferentiated dyspnea underwent immediate bedside CaTUS followed by chest radiography, blood draw for brain natriuretic peptide (BNP), and conventional echocardiography.
- CaTUS was considered positive in the presence of both:
- E/e’ >15 on echocardiography, denoting elevated left atrial filling pressure, and
- Bilateral B-lines or bilateral pleural fluid on lung ultrasound, denoting congestion.
- CaTUS was compared with standard of either:
- BNP >400 ng/L or
- BNP >100 ng/L plus congestion on chest radiography (masked radiologist review) plus structural heart disease on conventional echocardiography.
- Outcome: CaTUS performance in detecting AHF.
- Funding: None disclosed.
- Small study with single experienced operator not fully masked to other patient data.