{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T12:02:51Z","timestamp":1782302571748,"version":"3.54.5"},"reference-count":22,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>For the acutely dyspneic patient, discerning bedside between acute decompensated heart failure (ADHF) and COVID-19 is crucial. A lung ultrasound (LUS) is sensitive for detecting these conditions, but not in distinguishing between them; both have bilateral B-lines. The Blue protocol uses pleural sliding to differentiate decreased pneumonia; however, this is not the case in ADHF. Nonetheless, this pleural sliding has never been quantified. Speckled tracking is a technology utilized in the echocardiography field that quantifies the motion of tissues by examining the movement of ultrasound speckles. We conducted a retrospective study of LUS performed in emergency room patients during the COVID-19 pandemic. Speckled tracking of the pleura by applying software to the B-mode of pleura was compared between COVID-19 patients, ADHF patients, and patients with no respiratory complaints. A significant difference was found between the patient groups on speckled tracking both in respect of displacement and velocity. ADHF had the highest displacement, followed by COVID-19, and then non-respiratory patients: 1.63 \u00b1 1.89, 0.59 \u00b1 0.71, and 0.24 \u00b1 0.45, respectively (p &lt; 0.01). A similar trend was seen in velocity with ADHF having the highest velocity 0.34 \u00b1 0.37, followed by COVID-19 0.14 \u00b1 0.71, and non-respiratory patients 0.02 \u00b1 0.09 (p &lt;0.01). Speckled tracking of the pleura is a potential tool for discerning between different causes of dyspnea.<\/jats:p>","DOI":"10.3390\/jcm11164846","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T23:28:41Z","timestamp":1660865321000},"page":"4846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Speckled Tracking of Pleura\u2014A Novel Tool for Lung Ultrasound; Distinguishing COVID-19 from Acute Heart Failure"],"prefix":"10.3390","volume":"11","author":[{"given":"Batsheva","family":"Tzadok","sequence":"first","affiliation":[{"name":"Baruch Padeh Medical Center, Poriya 1528001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Blumberg","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Zefat 1311502, Israel"},{"name":"Department of Cardiology, Rivka Ziv Medical Center, Zefat 1008, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moti","family":"Shubert","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Zefat 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majdi","family":"Halabi","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Zefat 1311502, Israel"},{"name":"Department of Cardiology, Rivka Ziv Medical Center, Zefat 1008, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8756-9643","authenticated-orcid":false,"given":"Eran","family":"Tal-Or","sequence":"additional","affiliation":[{"name":"Baruch Padeh Medical Center, Poriya 1528001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noa","family":"Bachner-Hinenzon","sequence":"additional","affiliation":[{"name":"Sanolla, Nesher 3688519, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9582-770X","authenticated-orcid":false,"given":"Shemy","family":"Carasso","sequence":"additional","affiliation":[{"name":"Baruch Padeh Medical Center, Poriya 1528001, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Zefat 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13613-015-0081-9","article-title":"Extravascular Lung Water in Critical Care: Recent Advances and Clinical Applications","volume":"5","author":"Jozwiak","year":"2015","journal-title":"Ann. Intensive Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1136\/hrt.2007.128132","article-title":"A Clinical and Biochemical Score for Mortality Prediction in Patients with Acute Dyspnoea: Derivation, Validation and Incorporation into a Bedside Programme","volume":"94","author":"Baggish","year":"2008","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"32","DOI":"10.5811\/westjem.2020.8.48288","article-title":"Emergency Department Management of COVID-19: An Evidence-Based Approach","volume":"21","author":"McManus","year":"2020","journal-title":"West. J. Emerg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/BF01694712","article-title":"Intensive Use of General Ultrasound in the Intensive Care Unit\u2014Prospective Study of 150 Consecutive Patients","volume":"19","author":"Lichtenstein","year":"1993","journal-title":"Intensive Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1378\/chest.07-2800","article-title":"Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure the BLUE Protocol","volume":"134","author":"Lichtenstein","year":"2008","journal-title":"Chest"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.cardfail.2020.04.019","article-title":"Lung Ultrasound for Heart Failure Diagnosis in Primary Care","volume":"26","author":"Conangla","year":"2020","journal-title":"J. Card. Fail."},{"key":"ref_7","first-page":"1","article-title":"Comparing Sensitivity of Ultrasonography and Plain Chest Radiography in Detection of Pneumonia; a Diagnostic Value Study","volume":"7","author":"Karimi","year":"2019","journal-title":"Arch. Acad. Emerg. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1476-7120-6-16","article-title":"Chest Sonography: A Useful Tool to Differentiate Acute Cardiogenic Pulmonary Edema from Acute Respiratory Distress Syndrome","volume":"6","author":"Copetti","year":"2008","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1016\/j.ajem.2019.02.028","article-title":"BLUE Protocol Ultrasonography in Emergency Department Patients Presenting with Acute Dyspnea","volume":"37","author":"Bekgoz","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13089-020-00185-4","article-title":"The \u201cPandemic\u201d Increase in Lung Ultrasound Use in Response to COVID-19: Can We Complement Computed Tomography Findings? A Narrative Review","volume":"12","author":"Vetrugno","year":"2020","journal-title":"Ultrasound J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13089-021-00217-7","article-title":"Diagnostic Accuracy of Lung Ultrasound for SARS-CoV-2: A Retrospective Cohort Study","volume":"13","author":"Brenner","year":"2021","journal-title":"Ultrasound J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.pulmoe.2021.02.004","article-title":"Applicability of Lung Ultrasound in COVID-19 Diagnosis and Evaluation of the Disease Progression: A Systematic Review","volume":"27","author":"Peixoto","year":"2021","journal-title":"Pulmonology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1146\/annurev-pathol-011110-130158","article-title":"The Acute Respiratory Distress Syndrome: Pathogenesis and Treatment","volume":"6","author":"Matthay","year":"2011","journal-title":"Annu. Rev. Pathol. Mech. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1161\/CIRCULATIONAHA.105.571455","article-title":"Novel Speckle-Tracking Radial Strain from Routine Black-and-White Echocardiographic Images to Quantify Dyssynchrony and Predict Response to Cardiac Resynchronization Therapy","volume":"113","author":"Suffoletto","year":"2006","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1007\/s00134-019-05710-1","article-title":"Speckle Tracking Quantification of Lung Sliding for the Diagnosis of Pneumothorax: A Multicentric Observational Study","volume":"45","author":"Duclos","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ajem.2021.05.022","article-title":"Pneumothorax Diagnosis with Lung Sliding Quantification by Speckle Tracking: A Prospective Multicentric Observational Study","volume":"49","author":"Fissore","year":"2021","journal-title":"Am. J. Emerg. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"109344","DOI":"10.1016\/j.ejrad.2020.109344","article-title":"Comparison of Admission Chest Computed Tomography and Lung Ultrasound Performance for Diagnosis of COVID-19 Pneumonia in Populations with Different Disease Prevalence","volume":"133","author":"Colombi","year":"2020","journal-title":"Eur. J. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.jemermed.2020.06.033","article-title":"Best Practice Recommendations for Point-of-Care Lung Ultrasound in Patients with Suspected COVID-19","volume":"59","author":"Duggan","year":"2020","journal-title":"J. Emerg. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1001\/archinte.168.7.741","article-title":"Clinical Uncertainty, Diagnostic Accuracy, and Outcomes in Emergency Department Patients Presenting with Dyspnea","volume":"168","author":"Green","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"158","DOI":"10.4235\/agmr.2017.21.4.158","article-title":"Atypical Clinical Presentation of Geriatric Syndrome in Elderly Patients with Pneumonia or Coronary Artery Disease","volume":"21","author":"Jung","year":"2017","journal-title":"Ann. Geriatr. Med. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1378\/chest.14-1313","article-title":"BLUE-Protocol and FALLS-Protocol: Two Applications of Lung Ultrasound in the Critically Ill","volume":"147","author":"Lichtenstein","year":"2015","journal-title":"Chest"},{"key":"ref_22","first-page":"48","article-title":"The Geriatric Assessment","volume":"83","author":"Elsawy","year":"2011","journal-title":"Am. Fam. Physician"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4846\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:11:48Z","timestamp":1760141508000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,18]]},"references-count":22,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["jcm11164846"],"URL":"https:\/\/doi.org\/10.3390\/jcm11164846","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,18]]}}}