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Protocol of bedside ultrasound examination for heart failure (ConCOrD – CONgestion, Cardiac and multiORgan Dysfunction)

https://doi.org/10.33667/2078-5631-2022-17-42-49

Abstract

   The purpose of this article is to discuss an algorithm for bedside ultrasound examination in patients with heart failure, which consisting of three blocks: assessment of morphofunctional cardiac pathology, detection of hypertension in the heart chambers, and the presence of congestion. This protocol is based on the point-of-care ultrasound methodology and is designed for use by doctors of clinical non-ultrasound specialties. The protocol is presented in two variations: extended (for expert cardiological assessment) and short for emergency examination. The article provides brief information about the diagnosis, terminology, and classification of heart failure according to modern clinical guidelines.

About the Authors

E. A. Kochmareva
Russian National Research Medical University n. a. N. I. Pirogov; Municipal Clinical Hospital No. 15 n. a. O. M. Filatov; State Clinical Hospital n. a. S. P. Botkin
Russian Federation

Elena A. Kochmareva, PhD Med, head of Educational Laboratory, cardiologist, , teacher

Dept of Hospital Therapy n. a. P. E. Lukomsky

Training and Accreditation Centre (Medical Simulation Centre of the Botkin Hospital)

Moscow



R. Yu. Mikhei
State Clinical Hospital n. a. S. P. Botkin; Ambulance and Emergency Medical Care Station n. a. A. S. Puchkov
Russian Federation

Roman Yu. Mikhey, anesthesiologist-resuscitator, teacher

Training and Accreditation Centre (Medical Simulation Centre of the Botkin Hospital)

Moscow



V. N. Lykhin
State Clinical Hospital n. a. S. P. Botkin
Russian Federation

Vsevolod N. Lykhin, anesthesiologist-resuscitator, teacher

Training and Accreditation Centre (Medical Simulation Centre of the Botkin Hospital)

Moscow



R. E. Filyavin
State Clinical Hospital n. a. S. P. Botkin; Ambulance and Emergency Medical Care Station n. a. A. S. Puchkov
Russian Federation

Roman E. Filyavin, emergency doctor, teacher

Training and Accreditation Centre (Medical Simulation Centre of the Botkin Hospital)

Moscow



V. S. Solov’ev
State Clinical Hospital n. a. S. P. Botkin; Multidisciplinary Medical Centre of the Bank of Russia
Russian Federation

Vadim S. Solovyov,  head of Dept, teacher

Dept of Anesthesiology

Training and Accreditation Centre (Medical Simulation Centre of the Botkin Hospital)

Moscow



References

1. Клинические рекомендации «Хроническая сердечная недостаточность» Министерства Здравоохранения Российской Федерации. – 2022. https://cr.minzdrav.gov.ru/schema/156_1 / Clinical recommendations ‘Chronic Heart Failure’ of the Ministry of Health of the Russian Federation 2022. https://cr.minzdrav.gov.ru/schema/156_1

2. Volkmar Falk, José Ramón González-Juanatey, Veli-Pekka Harjola, Ewa A. Jankowska, Mariell Jessup, Cecilia Linde, Petros Nihoyannopoulos, John T. Parissis, Burkert Pieske, Jillian P. Riley, Giuseppe M. C. Rosano, Luis M. Ruilope, Frank Ruschitzka, Frans H. Rutten, Peter van der Meer, ESC Scientific Document Group, 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 37, Issue 27, 14 July 2016, Pages 2129–2200, https://doi.org/10.1093/eurheartj/ehw128

3. Vexus protocol https://www.pocus101.com/vexus-ultrasound-score-fluid-overload-and-venous-congestion-assessment/

4. FAST protocol. Bloom A. & Gibbons R. C. (2020). Focused Assessment with Sonography for Trauma (FAST). StatPearls, 2020.

5. The BLUE Protocol Daniel A. Lichtenstein, MD, FCCP and Gilbert A. Mezière, MD CHEST July 2008.

6. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography Lawrence G. Rudski, MD, FASE, Chair, Wyman W. Lai, MD, MPH, FASE, Jonathan Afilalo, MD, Msc, Lanqi Hua, RDCS, FASE, Mark D. Handschumacher, BSc, Krishnaswamy Chandrasekaran, MD, FASE, Scott D. Solomon, MD, Eric K. Louie, MD, and Nelson B. Schiller, MD, Montreal, Quebec, Canada; New York, New York; Boston, Massachusetts; Phoenix, Arizona; London, United Kingdom; San Francisco, California (J Am Soc Echocardiogr 2010; 23: 685–713).

7. Luke S. Howard, Julia Grapsa, David Dawson, Michael Bellamy, John B. Chambers, Navroz D. Masani, Petros Nihoyannopoulos and J. Simon R. Gibbs Echocardiographic assessment of pulmonary hypertension: standard operating procedure. Eur Respir Rev 2012; 21: 125, 239–248 DOI: 10.1183/09059180.00003912.

8. Grayburn P., Appleton C., DeMaria A., Greenberg B., Lowes B., Oh J., et al. Echocardiographic predictors of morbidity and mortality in patients with advanced heart failure. The Betablocker Evaluation of Survival Trial (BEST), J Am Coll Cardiol, 2005, vol. 45 (pg. 1064–1071).

9. Nagueh S., Middleton K., Kopelen H., Zoghbi W., Quinones M. Doppler tissue imaging: a non-invasive technique for evaluation of left ventricular relaxation and estimation of filling pressures, J Am Coll Cardiol, 1997, vol. 30 (pg. 1527–1533).

10. Hillis G., Moller J., Pellikka P., Gersh B., Wright R., Ommen S., et al. Non-invasive estimation of left ventricular filling pressure by E/e′ is a powerful predictor of survival after acute myocardial infarction, J Am Coll Cardiol, 2004, vol. 43 (pg. 360–367).

11. Moller J., Pellikka P., Hillis G., Oh J. Prognostic importance of diastolic function and filling pressure in patients with acute myocardial infarction, Circulation, 2006, vol. 114 (pg. 438–444).

12. Рекомендации по диастолической дисфункции АСЕ. / Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging Sherif F. Nagueh, Chair, MD, FASE, Otto A. Smiseth, Co-Chair, MD, PhD, Christopher P. Appleton, MD, Benjamin F. Byrd, III, MD, FASE, Hisham Dokainish, MD, FASE, Thor Edvardsen, MD, PhD, Frank A. Flachskampf, MD, PhD, FESC, Thierry C. Gillebert, MD, PhD, FESC, Allan L. Klein, MD, FASE, Patrizio Lancellotti, MD, PhD, FESC, Paolo Marino, MD, FESC, Jae K. Oh, MD, Bogdan Alexandru Popescu, MD, PhD, FESC, FASE, and Alan D. Waggoner, MHS, RDCS 1, Houston, Texas; Oslo, Norway; Phoenix, Arizona; Nashville, Tennessee; Hamilton, Ontario, Canada; Uppsala, Sweden; Ghent and Liege, Belgium; Cleveland, Ohio; Novara, Italy; Rochester, Minnesota; Bucharest, Romania; and St. Louis, Missouri (J Am Soc Echocardiogr 2016; 29: 277–314).

13. Mozzini C., Cominacini L., Casadei A., et al. Ultrasonography in Heart Failure: A Story that Matters Curr Probl Cardiol. 2019; 44 (4): 116–36. URL: https://pubmed.ncbi.nlm.nih.gov/30172551/

14. Picano E, Pellikka P. A. Ultrasound of extravascular lung water: A new standard for pulmonary congestion. Eur Heart J. 2016: 2097–104. DOI: 10.1093/eurheartj/ehw164.

15. Platz E., Merz A. A., Jhund P. S., et al. Dynamic changes and prognostic value of pulmonary congestion by lung ultrasound in acute and chronic heart failure: a systematic review. Eur J Heart Fail. 2017; 19 (9): 1154–63. DOI: 10.1002/ejhf.839.

16. Platz E., Campbell R. T., Claggett B., et al. Lung Ultrasound in Acute Heart Failure: Prevalence of Pulmonary Congestion and Short- and Long-Term Outcomes. JACC Hear Fail. 2019; 7 (10): 849–58. DOI: 10.1016/j.jchf.2019.07.008.

17. Pellicori P., Shah P., Cuthbert J., et al. Prevalence, pattern and clinical relevance of ultrasound indices of congestion in outpatients with heart failure. Eur J Heart Fail. 2019; 21 (7): 904–916. DOI: 10.1002/ejhf.1383.

18. Кобалава Ж. Д. Статус и перспективы использования ультразвукового исследования легких в оптимизации ведения пациентов с хронической сердечной недостаточностью / Ж. Д. Кобалава [и др.] // Российский кардиологический журнал. – 2020. – 25 (1): 3666. https://doi.org/10.15829/1560–4071–2020–1–3666 / Kobalava Zh. D., Safarova A. F., Kokhan E. V., Islamova M. R. Status and prospects for the use of lung ultrasound in optimizing the management of patients with chronic heart failure. Russian journal of cardiology. 2020; 25 (1): 3666. https://doi.org/10.15829/1560–4071–2020–1–3666


Review

For citations:


Kochmareva E.A., Mikhei R.Yu., Lykhin V.N., Filyavin R.E., Solov’ev V.S. Protocol of bedside ultrasound examination for heart failure (ConCOrD – CONgestion, Cardiac and multiORgan Dysfunction). Medical alphabet. 2022;(17):42-49. (In Russ.) https://doi.org/10.33667/2078-5631-2022-17-42-49

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ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)