Lung ultrasound score and its correlation with modified Ross score in infants with left to right shunt

Area of Science:

• Pediatric Cardiology
• Diagnostic Imaging
• Critical Care Medicine

Background:

• Lung ultrasound B-lines are established indicators for diagnosing heart failure in adults.
• Congenital heart disease (CHD) in infants can lead to heart failure, necessitating accurate diagnostic tools.
• The utility of lung ultrasound for assessing heart failure severity in infants with CHD requires further investigation.

Purpose of the Study:

• To correlate lung ultrasound scores with heart failure severity in infants diagnosed with CHD.
• To evaluate the effectiveness of lung ultrasound in identifying moderate to severe heart failure in this pediatric population.

Main Methods:

• Fifty infants with left-to-right shunts underwent lung ultrasound scoring, Ross scoring, and NT-proBNP measurement.
• Lung ultrasound scoring involved dividing the lungs into 14 zones, with B-lines categorized into 4 levels (0-3).
• A modified ultrasound score excluded scores of 1, and ROC analysis determined a cut-off for detecting moderate/severe heart failure.

Main Results:

• No significant correlation was found between lung ultrasound scores (total or modified) and modified Ross score or NT-proBNP levels.
• A total lung ultrasound score cut-off of 11 demonstrated 68% accuracy (AUC 0.64) in detecting moderate or severe heart failure.
• These findings indicate a low diagnostic accuracy for lung ultrasound in this context.

Conclusions:

• The current application of lung ultrasound for assessing heart failure severity in infants with left-to-right shunts is limited.
• Low accuracy and the lack of standardized scoring methods restrict the clinical utility of lung ultrasound in this patient group.
• Further research is needed to refine lung ultrasound techniques for pediatric cardiology applications.