E1253

JACC April 5, 2011

Volume 57, Issue 14

QUALITY OF CARE AND OUTCOMES ASSESSMENT

UTILITY OF RADIOLOGICAL SCORE FOR VERIFICATION OF EVOLVING HEART FAILURE IN THE COURSE

OF ACUTE MYOCARDIAL INFARCTION

ACC Poster ContributionsErnest N. Morial Convention Center, Hall F

Monday, April 04, 2011, 3:30 p.m.-4:45 p.m.

Session Title: Information Technology from Bench to BedsideAbstract Category: 45. Biomedical Computing/Information Technology

Session-Poster Board Number: 1135-138

Authors: Michael Shochat, Avraham Shotan, Ilia Shochat, Mark Kazatsker, Vladimir Gurivich, Aya Asif, Lubov Vasilenko, Elena Naiman, Yaniv Levy, David Blondheim, Simcha Meisel, Hillel Yaffe Heart Institute, Hadera, Israel

Background: Near twenty percents of patients sustaining acute myocardial infarction (AMI) develop acute heart failure (AHF) as a result of

increased lung fluid content (LFC). There is no method to monitor LFC. Lung impedance (LI) that decreases with increasing LFC may be indicator of

LFC, but needs verification. For this we designed radiological score (RS) based on numerical summation lung edema signs.

Aim: To evaluate, in AMI patients developing AHF, the RS by comparison with the clinical stage (CS) of AHF. We assessed RS and LI correlation, in

attempt to validate the pathophysiological significance of LI measurement.

Method: Patients admitted for AMI and without signs of lung edema were monitored by LI device. Absence of lung rales was interpreted as no or

interstitial lung edema (CS0). Detection lung rales signified alveolar edema graded as mild (CS1), moderate (CS2), severe (CS3) according to their

level.

Results: 476 of 622 patients did not develop overt AHF (CS0) during 96 hrs monitoring. Their RS was 1.4±1.3 and LI decreased from initial by

6.3±6.1% (p<0.001). 146 patients developed overt AHF. At CS1RS was 5.1±0.9 (p<0.001) and LI decreased by 21.6±5.2% (p<0.001). At CS2 and 3,

RS were 6.9±1.1 and 9.8±0.5 (p<0.001). LI decreased by 29.5±8.2% and 37.4±7.2%, respectively (p<0.001). An RS of 0-2 characterized patients

with no edema, 3-4 with interstitial edema on chest radiograph, a 5-6 mild edema, and 7-8 and 9-10 signified moderate and severe alveolar edema

(Table). AHF CS correlated with RS (r=0.6, p<0.001) and with LI (r=-0.6, p<0.001). RS correlated with LI (r=-0.85, p<0.001). Changes in RS and LI

strikingly preceded the detection of lung rales.

Conclusions: RS was shown to be a simple and reliable method to assess LFC in patients developing AHF and correlated with the degree of lung

congestion.