• Guilherme Pinheiro Machado, Guilherme Heiden Telo, Gustavo Neves de Araujo, Joao Pedro da Rosa Barbato, Andre Amon, Antônia Martins, Marina Nassif, Wagner Azevedo, da SilveiraAnderson DonelliAD0000-0002-0327-3392Cardiology Department, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350, Porto Alegre, RS, 90035-003, Brazil., Fernando Luis Scolari, Alan Pagnoncelli, Sandro Cadaval Goncalves, Alexander G Truesdell, Rodrigo Wainstein, and Marco Wainstein.
• Cardiology Department, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350, Porto Alegre, RS, 90035-003, Brazil. gpmachado89@gmail.com.
• Intern Emerg Med. 2024 Nov 1; 19 (8): 216721762167-2176.

AbstractDevelopment of ventricular failure and pulmonary edema is associated with a worse prognosis in ST-elevation myocardial infarction (STEMI). We aimed to evaluate the prognostic ability of a novel classification combining lung ultrasound (LUS) and left ventricular outflow tract (LVOT) velocity time integral (VTI) in patients with STEMI. LUS and LVOT-VTI were performed within 24 h of admission in STEMI patients. A LUS combined with LVOT-VTI (LUV) classification was developed based on LUS with < or ≥ 3 positive zone scans, combined with LVOT-VTI > or ≤ 14. Patients were classified as A (< 3zones/ > 14 cm VTI), B (≥ 3zones/ > 14 cm VTI), C (< 3zones/ ≤ 14 cm VTI) and D (≥ 3zones/ ≤ 14 cm VTI). Primary outcome was occurrence of in-hospital mortality. Development of cardiogenic shock (CS) within 24 h was also assessed. A total of 308 patients were included. Overall in-hospital mortality was 8.8%, while mortality for LUV A, B, C, and D was 0%, 3%, 12%, and 45%, respectively. The area under the curve (AUC) for predicting in-hospital mortality was 0.915. Moreover, after exclusion of patients admitted in Killip IV, at each increasing degree of LUV, a higher proportion of patients developed CS within 24 h: LUV A = 0.0%, LUV B 5%, LUV C = 12.5% and LUV D = 30.8% (p < 0.0001). The AUC for predicting CS was 0.908 (p < 0.001). In a cohort of STEMI patients, LUV provided to be an excellent method for prediction of in-hospital mortality and development of CS. LUV classification is a fast, non-invasive and very user-friendly ultrasonographic evaluation method to stratify the risk of mortality and CS.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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