{"id":"46ab69c42932","type":"article","url":"https://hartvaat.nl/2022/08/01/b-lijnen-geleide-hartfalenbehandeling-verbetert-uitkomsten-na-ontslag/","title":"B-lijnen-geleide hartfalenbehandeling verbetert uitkomsten na ontslag","title_en":"Impact of B-lines-guided intensive heart failure management on outcome of discharged heart failure patients with residual B-lines.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","bloeddrukbehandeling","nt-probnp"],"journal":"ESC heart failure","doi":"10.1002/ehf2.13988","source_url":"https://doi.org/10.1002/ehf2.13988","authors":["Yunlong Zhu","Na Li","Mingxing Wu","Zhiliu Peng","Haobo Huang","Wenjiao Zhao","Liqing Yi","Min Liao","Zhican Liu","Yiqun Peng","Yuying Zhou","Jinxin Lu","Guohua Li","Jianping Zeng"],"significance":6,"published":"2022-08-01","source_date":"2022-08-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/harttransplantatie-indicaties/","https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"This study showed that B-lines-guided intensive heart failure management using lung ultrasound improves outcomes in discharged HF patients with residual pulmonary congestion, supporting imaging-guided decongestion monitoring.","created":"2026-07-03T10:29:51Z","updated":"2026-07-03T18:38:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie toonde dat intensieve hartfalenbehandeling gestuurd door longechografie B-lijnen de uitkomsten verbeterde bij patiënten met residuale pulmonale congestie na ontslag. B-lijnen-monitoring kan de ambulante titratiestrategieën verbeteren.","abstract_original":"AIMS: Pulmonary congestion (PC) expressed by residual lung ultrasound B-lines (LUS-BL) could exist in some discharged heart failure (HF) patients, which is a known determinant of poor outcomes. Detection efficacy for PC is suboptimal with widely used imaging modalities, like X-ray or echocardiography, while lung ultrasound (LUS) can sufficiently detect PC by visualizing LUS-BL. In this trial, we sought to evaluate the impact LUS-BL-guided intensive HF management post-discharge on outcome of HF patients discharged with residual LUS-BL up to 1 year after discharge. IMP-OUTCOME is a prospective, single-centre, single-blinded, randomized cohort study, which is designed to investigate if LUS-BL-guided intensive HF management post-discharge in patients with residual LUS-BL could improve the clinical outcome up to 1 year after discharge or not. METHODS AND RESULTS: After receiving the standardized treatment of HF according to current guidelines, 318 patients with ≥3 LUS-BL assessed by LUS within 48 h before discharge will be randomly divided into the conventional HF management group and the LUS-BL-guided intensive HF management group at 1:1 ratio. Patient-related basic clinical data including sex, age, blood chemistry, imaging examination, and drug utilization will be obtained and analysed. LUS-BL will be assessed at 2 month interval post-discharge in both groups, but LUS-BL results will be enveloped in the conventional HF management group, and diuretics will be adjusted based on symptom and physical examination results with or without knowing the LUS-BL results. Echocardiography examination will be performed for all patients at 12 month post-discharge. The primary endpoint is consisted of the composite of readmission for worsening HF and all-cause death during follow up as indicated. The secondary endpoints consisted of the change in the New York Heart Association classification, Duke Activity Status Index, N terminal pro brain natriuretic peptide value, malignant arrhythmia event and 6 min walk distance at each designed follow up, echocardiography-derived left ventricular ejection fraction, and number of LUS-BL at 12 month post-discharge. Safety profile will be recorded and managed accordingly for all patients. CONCLUSIONS: This trial will explore the impact of LUS-BL-guided intensive HF management on the outcome of discharged HF patients with residual LUS-BL up to 1 year after discharge in the era of sodium-glucose cotransporter-2 inhibitors and angiotensin receptor blocker-neprilysin inhibitor. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05035459."}