3-010 Can screening patients with bilateral lower limb lymphoedema improve heart failure diagnosis?

Le résumé fourni par la source

Introduction Bilateral lower limb lymphoedema is common in clinical practice. Differentiating between lymphoedema and peripheral oedema caused by heart failure on clinical assessment is challenging. This study evaluates whether NT-proBNP screening in patients with bilateral lower limb lymphoedema could improve heart failure diagnosis. Methods Over a six-month period, patients with bilateral lower limb lymphoedema were invited for NT-proBNP testing. Patients were excluded if they had undergone echocardiography, NT-proBNP testing or cardiology review within the past six months. Results Of 62 patients identified, 47 met eligibility criteria, and 32 opted to undergo NT-proBNP testing. Eighteen patients (56%) had NT-proBNP levels < 125 pg/mL, making heart failure unlikely. Fourteen (44%) had NT-proBNP levels > 125 pg/mL, with two deemed ineligible for echocardiography. Among the 12 remaining patients, three (9%) had NT-proBNP > 400 pg/mL (figure 1A). The mean age of these 12 patients was 71.4 years (± 10.9), and 8% were male. One patient (8%) had left ventricular dilation and mildly reduced systolic function in keeping with a diagnosis of heart failure with mildly reduced ejection fraction (HFmrEF). Of the remaining 11 patients, 5 (42%) had evidence of heart failure with preserved ejection fraction (HFpEF), with an HFA-PEFF score of 5 or 6 (figure 1B). Six patients (50%) had an HFA-PEFF score of 3–4, indicating risk of HFpEF that requires further testing (figure 1B). Conclusion NT-proBNP screening identified elevated biomarkers in 44% of patients with bilateral lower limb lymphoedema. Among those who underwent echocardiography, 50% were diagnosed with HFpEF or HFmrEF and referred for specialist care, while others remained at risk. Given these findings, we recommend incorporating NT-proBNP testing into routine assessment for bilateral lower limb lymphoedema to facilitate early heart failure detection and timely cardiology referral.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.