{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:55:06Z","timestamp":1787028906996,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"\u015al\u0105ski Uniwersytet Medyczny","doi-asserted-by":"publisher","award":["KNW-1-077\/N\/7\/K"],"award-info":[{"award-number":["KNW-1-077\/N\/7\/K"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objective: Reliable assessment of the fluid status in hemodialysis (HD) patients is often difficult. A lung ultrasound with an assessment of the B-lines (\u201clung comets\u201d (LCs)) number is a novel hydration status measure. However, the occurrence of left ventricular dysfunction may have a significant effect on pulmonary congestion and further modulate the LC number. The aim of this study was to analyze to what extent left ventricular dysfunction, pulmonary hypertension, and hypervolemia affect the occurrence of LC in a cohort of prevalent HD patients. Material and methods: This cross-sectional study included 108 assessments performed in 54 patients who attended thrice weekly outpatient HD. Each patient\u2019s fluid status was evaluated twice, prior to HD sessions, using echocardiography, LC number assessment, measurement of inferior vena cava (IVC) diameters, and bioelectric impedance analysis (BIA). Patients were stratified into three subgroups according to their LC number. Results: There were 76 separate assessments with mild (&lt;14), 16 with moderate (14\u201330), and 16 with severe (&gt;30) LC occurrence. There was a negative correlation between the LC number and left ventricular ejection fraction (LVEF), and positive correlations between the LC number and mitral gradient, and the left and right atrium area and volume, but not with the BIA-derived relative fluid overload. Multivariate linear regression analysis revealed that the LC number was proportionally related to the mitral gradient (\u03b2 = 0.407 (0.247\u20130.567), p &lt; 0.001) and IVC max diameter (\u03b2 = 0.219 (0.060\u20130.378), p &lt; 0.01), and was inversely related to LVEF (\u03b2 = \u22120.431 (\u22120.580 to \u22120.282), p &lt; 0.001). Conclusions: The number of LCs appears to reflect both overhydration and left ventricular dysfunction in our HD patients cohort. Therefore, heart failure must be considered as an important factor limiting the usefulness of LCs number assessment in this population.<\/jats:p>","DOI":"10.3390\/medicina55020045","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T02:49:44Z","timestamp":1550026184000},"page":"45","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Lung Ultrasound B-lines Occurrence in Relation to Left Ventricular Function and Hydration Status in Hemodialysis Patients"],"prefix":"10.3390","volume":"55","author":[{"given":"Agnieszka","family":"Parda\u0142a","sequence":"first","affiliation":[{"name":"Dialysis Centre, Fresenius Nephrocare, 34-600 Limanowa, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariusz","family":"Lupa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, District Hospital, 34-600 Limanowa, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6367-7794","authenticated-orcid":false,"given":"Jerzy","family":"Chudek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, 40-027 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-1872","authenticated-orcid":false,"given":"Aureliusz","family":"Kolonko","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/01.mnh.0000185983.48319.00","article-title":"Bioimpedance, dry weight and blood pressure control: New methods and consequences","volume":"14","author":"Kuhlmann","year":"2005","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1681\/ASN.2005060662","article-title":"Strategies for improving long-term survival in patients with ESRD","volume":"16","author":"Nolan","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1046\/j.1525-1594.2003.07205.x","article-title":"Ultrafiltration and dry weight\u2014What are the cardiovascular consequences?","volume":"27","author":"Stegmayr","year":"2003","journal-title":"Artif. Organs"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1159\/000351008","article-title":"Comparison and reproducibility of techniques for fluid statsu assessment in chronic hemodialysis patients","volume":"3","author":"Basso","year":"2013","journal-title":"Cardiorenal Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1159\/000487702","article-title":"Effects of volume overload and current techniques for the assessment of fluid status in patients with renal disease","volume":"46","author":"Ekinci","year":"2018","journal-title":"Blood Purif."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.amjcard.2004.02.012","article-title":"Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water","volume":"93","author":"Jambrik","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.jcmg.2010.02.005","article-title":"Detection of pulmonary congestion by chest ultrasound in dialysis patients","volume":"3","author":"Mallamaci","year":"2010","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000368973","article-title":"Quantitative lung ultrasound comet measurement: Method and initial clinical results","volume":"39","author":"Weitzel","year":"2015","journal-title":"Blood Purif."},{"key":"ref_9","first-page":"3796","article-title":"Risk factors and impacts on prognosis of ultrasound lung comets in patients undergoing hemodialysis","volume":"97","author":"Wang","year":"2017","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/j.1542-4758.2010.00478.x","article-title":"The long-term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients","volume":"14","author":"Unal","year":"2010","journal-title":"Hemodial. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1177\/112972980901000305","article-title":"Effects of the arteriovenous fistula on pulmonary artery pressure and cardiac output in patients with chronic renal failure","volume":"10","author":"Beigi","year":"2009","journal-title":"J. Vasc. Access"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3296","DOI":"10.1093\/ndt\/gfq851","article-title":"Effects of arteriovenous fistula formation on arterial stiffness and cardiovascular performance and function","volume":"26","author":"Korsheed","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3601","DOI":"10.1093\/ndt\/gfs116","article-title":"Chest ultrasound and hidden lung congestion in peritoneal dialysis patients","volume":"27","author":"Panuccio","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1007\/s00392-018-1221-7","article-title":"Combined use of lung ultrasound, B-type natriuretic peptide, and echocardiography for outcome prediction in patients with acute HFrEF and HFpEF","volume":"107","author":"Palazzuoli","year":"2018","journal-title":"Clin. Res. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1093\/eurheartj\/ehv745","article-title":"Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients","volume":"37","author":"Platz","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13613-015-0100-x","article-title":"Sonographic chest B-lines anticipate elevated B-type natriuretic peptide level, irrespective of ejection fraction","volume":"5","author":"Bitar","year":"2015","journal-title":"Ann. Intensive Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/j.echo.2005.10.005","article-title":"Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography\u2019s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology","volume":"18","author":"Lang","year":"2005","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1161\/01.CIR.55.4.613","article-title":"Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method","volume":"55","author":"Devereux","year":"1977","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1476-7120-9-6","article-title":"Lung ultrasound: A new tool for the cardiologist","volume":"9","author":"Gargani","year":"2011","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Torterue, X., Dehoux, L., Macher, M.-A., Niel, O., Kwon, T., Deschenes, G., and Hogan, J. (2017). Fluid status evaluation by inferior vena cava diameter and bioimpedance spectroscopy in pediatric chronic hemodialysis. BMC Nephrol., 18.","DOI":"10.1186\/s12882-017-0793-1"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1159\/000356085","article-title":"Lung congestion as a risk factor in end-stage renal disease","volume":"36","author":"Zoccali","year":"2013","journal-title":"Blood Purif."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/j.kint.2016.12.008","article-title":"Impact of fluid status and inflammation and their interaction on survival: A study in an international hemodialysis patients cohort","volume":"91","author":"Dekker","year":"2017","journal-title":"Kindey Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1681\/ASN.2016121341","article-title":"Chronic fluid overload and mortality in ESRD","volume":"28","author":"Zoccali","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/MNH.0000000000000409","article-title":"Fluid status assessment in hemodialysis patients and the association with outcome: Review of recent literature","volume":"27","author":"Dekker","year":"2018","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/sdi.12612","article-title":"Interplay of volume, blood pressure, organ ischemia, residual renal function, and diet: Certainties and uncertainties with dialytic management","volume":"30","author":"Ok","year":"2017","journal-title":"Semin. Dial."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1093\/ndt\/gft260","article-title":"Predicting mortality in haemodialysis patients: A comparison between lung ultrasonography, bioimpedance data and echocardiographic parameters","volume":"28","author":"Siriopol","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s11255-011-0022-y","article-title":"Randomized trial of bioelectrical impedance analysis versus clinical criteria for guiding ultrafiltration in hemodialysis patients: Effects on blood pressure, hydration status, and arterial stiffness","volume":"44","author":"Onofriescu","year":"2012","journal-title":"Int. Urol. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s11255-016-1473-y","article-title":"Comparison of multiple fluid status assessment methods in patients on chronic hemodialysis","volume":"49","author":"Alexiadis","year":"2017","journal-title":"Int. Urol. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11255-016-1471-0","article-title":"Dry weight assessment by combined ultrasound and bioimpedance monitoring in low cardiovascular risk hemodialysis patients: A randomized controlled trial","volume":"49","author":"Siriopol","year":"2017","journal-title":"Int. Urol. Nephrol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s10554-015-0768-x","article-title":"Bioimpedance analysis versus lung ultrasonography for optimal risk prediction in hemodialysis patients","volume":"32","author":"Siriopol","year":"2016","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1038\/ki.2014.207","article-title":"A role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessment in dialysis patients","volume":"86","author":"Davies","year":"2014","journal-title":"Kidney Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/2\/45\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:31:21Z","timestamp":1760185881000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/2\/45"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,12]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2]]}},"alternative-id":["medicina55020045"],"URL":"https:\/\/doi.org\/10.3390\/medicina55020045","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,12]]}}}