A Simplified Ultrasound Comet Tail Grading Scoring to Assess Pulmonary Congestion in Patients with Heart Failure

<table class="fixed-width table-group" id="tab2"><tr><td><table class="table"><colgroup><col style="width:14.99em"/><col style="width:12.00em"/></colgroup><tr><td class="thead-hr" colspan="2"><hr/></td></tr><tr class="thead"><td class="align_left">Variables</td><td class="align_center">Mean ± SD or number (%)</td></tr><tr><td class="thead-hr" colspan="2"><hr/></td></tr><tr><td class="align_left">Subjects, <svg height="6.1673pt" id="M4" style="vertical-align:-0.2063904pt" version="1.1" viewbox="-0.0498162 -5.96091 6.6501 6.1673" width="6.6501pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z" id="g113-111"></path></g></svg></td><td class="align_center">93</td></tr><tr><td class="align_left">Age, y</td><td class="align_center"> <svg height="8.69875pt" id="M5" style="vertical-align:-0.3499298pt" version="1.1" viewbox="-0.0498162 -8.34882 38.6238 8.69875" width="38.6238pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z" id="g113-55"></path></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z" id="g113-56"></path></g><g transform="matrix(.013,0,0,-0.013,15.388,0)"><path d="M535 290V340H323V533H265V340H52V290H265V84H323V290H535ZM535 -22V28H52V-22H535Z" id="g117-37"></path></g><g transform="matrix(.013,0,0,-0.013,25.924,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,32.164,0)"><path d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z" id="g113-53"></path></g></svg></td></tr><tr><td class="align_left">Gender, female/male</td><td class="align_center">32/61</td></tr><tr><td class="align_left">Body surface area, m<sup>2</sup></td><td class="align_center"> <svg height="8.69875pt" id="M6" style="vertical-align:-0.3499298pt" version="1.1" viewbox="-0.0498162 -8.34882 44.574 8.69875" width="44.574pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z" id="g113-47"></path></g><g transform="matrix(.013,0,0,-0.013,9.204,0)"><path d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z" id="g113-57"></path></g><g transform="matrix(.013,0,0,-0.013,18.35,0)"><path d="M535 290V340H323V533H265V340H52V290H265V84H323V290H535ZM535 -22V28H52V-22H535Z" id="g117-37"></path></g><g transform="matrix(.013,0,0,-0.013,28.886,0)"><path d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" id="g113-49"></path></g><g transform="matrix(.013,0,0,-0.013,35.126,0)"><path d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z" id="g113-47"></path></g><g transform="matrix(.013,0,0,-0.013,38.09,0)"><path d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z" id="g113-51"></path></g></svg></td></tr><tr><td class="align_left">Hypercholesterolemia</td><td class="align_center">40 (43)</td></tr><tr><td class="align_left">Diabetes</td><td class="align_center">20 (22)</td></tr><tr><td class="align_left">Previous MI<svg height="9.93771pt" id="M7" style="vertical-align:-0.04981995pt" version="1.1" viewbox="-0.0498162 -9.88789 4.69898 9.93771" width="4.69898pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M442 39L431 68C420 63 406 57 394 57C377 57 359 71 359 118V301C359 353 349 393 314 424C291 443 261 451 230 451C171 438 107 401 79 381C59 366 46 355 46 340C46 316 72 295 91 295C106 295 117 303 122 319C131 350 139 371 152 384C163 397 178 404 197 404C246 404 281 365 281 293V278C260 262 186 232 124 213C69 194 41 161 41 112C41 47 92 -12 163 -12C195 -12 243 25 283 51C288 35 293 22 308 7C319 -4 339 -12 354 -12L442 39ZM281 87C262 68 226 51 199 51C169 51 129 74 129 126C129 162 151 181 190 198C211 208 259 229 281 240V87Z" id="g58-95"></path></g></svg></td><td class="align_center">16 (17)</td></tr><tr><td class="align_left">PCI<svg height="12.2075pt" id="M8" style="vertical-align:-0.04980087pt" version="1.1" viewbox="-0.0498162 -12.1577 5.32009 12.2075" width="5.32009pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M156 406V710C117 695 54 682 9 675V647C73 642 75 635 75 573V25C131 -2 180 -12 223 -12C359 -12 478 92 478 240C478 357 387 451 278 451C265 451 251 447 236 440L156 406ZM156 373C175 384 208 392 235 392C315 392 387 328 387 214C387 97 332 30 251 31C197 31 170 66 162 84C158 93 156 104 156 118V373Z" id="g58-96"></path></g></svg></td><td class="align_center">10 (11)</td></tr><tr><td class="align_left">CABG<svg height="9.93771pt" id="M9" style="vertical-align:-0.04981995pt" version="1.1" viewbox="-0.0498162 -9.88789 4.54369 9.93771" width="4.54369pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M396 114C349 71 317 59 274 59C216 59 123 104 123 241C123 342 180 400 246 400C283 400 317 386 348 359C355 352 361 348 366 348C378 348 401 371 402 394C402 405 398 413 385 424C369 437 337 451 294 451H293C254 451 193 434 141 394C73 342 39 277 39 198C39 90 114 -12 243 -12C303 -12 371 31 415 90L396 114Z" id="g58-97"></path></g></svg></td><td class="align_center">4 (4)</td></tr><tr><td class="align_left">NT-proBNP, pg/ml</td><td class="align_center"> <svg height="8.69875pt" id="M10" style="vertical-align:-0.3499298pt" version="1.1" viewbox="-0.0498162 -8.34882 76.2041 8.69875" width="76.2041pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,12.48,0)"><path d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z" id="g113-55"></path></g><g transform="matrix(.013,0,0,-0.013,18.72,0)"><path d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z" id="g113-53"></path></g><g transform="matrix(.013,0,0,-0.013,24.96,0)"><path d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z" id="g113-54"></path></g><g transform="matrix(.013,0,0,-0.013,34.106,0)"><path d="M535 290V340H323V533H265V340H52V290H265V84H323V290H535ZM535 -22V28H52V-22H535Z" id="g117-37"></path></g><g transform="matrix(.013,0,0,-0.013,44.643,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,50.883,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,57.123,0)"><path d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" id="g113-49"></path></g><g transform="matrix(.013,0,0,-0.013,63.363,0)"><path d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z" id="g113-56"></path></g><g transform="matrix(.013,0,0,-0.013,69.605,0)"><path d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" id="g113-49"></path></g></svg></td></tr><tr><td class="align_left">Radiologic score</td><td class="align_center"> <svg height="8.69875pt" id="M11" style="vertical-align:-0.3499298pt" version="1.1" viewbox="-0.0498162 -8.34882 32.3604 8.69875" width="32.3604pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z" id="g113-52"></path></g><g transform="matrix(.013,0,0,-0.013,15.386,0)"><path d="M535 290V340H323V533H265V340H52V290H265V84H323V290H535ZM535 -22V28H52V-22H535Z" id="g117-37"></path></g><g transform="matrix(.013,0,0,-0.013,25.922,0)"><path d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z" id="g113-56"></path></g></svg></td></tr><tr><td class="align_left">NYHA functional class</td><td class="align_center"> </td></tr><tr><td class="align_left"> II</td><td class="align_center">28 (30)</td></tr><tr><td class="align_left"> III</td><td class="align_center">56 (60)</td></tr><tr><td class="align_left"> IV</td><td class="align_center">9 (10)</td></tr><tr><td class="align_left">Cause of heart failure</td><td class="align_center"> </td></tr><tr><td class="align_left"> Coronary artery disease</td><td class="align_center">64 (69)</td></tr><tr><td class="align_left"> Hypertension</td><td class="align_center">14 (15)</td></tr><tr><td class="align_left"> Dilated cardiomyopathy</td><td class="align_center">7 (8)</td></tr><tr><td class="align_left"> Myocarditis</td><td class="align_center">4 (4)</td></tr><tr><td class="align_left"> Perinatal cardiomyopathy</td><td class="align_center">1 (1)</td></tr><tr><td class="align_left"> Autoimmunity cardiomyopathy</td><td class="align_center">1 (1)</td></tr><tr><td class="align_left"> Alcoholic cardiomyopathy</td><td class="align_center">2 (2)</td></tr><tr class="table-tr"><td colspan="2"><hr class="tbody-hr"/></td></tr></table></td></tr><tr class="table-fn"><td><div><span class="nowrap"><svg height="13.7218pt" id="M12" style="vertical-align:-3.83391pt" version="1.1" viewbox="-0.0498162 -9.88789 20.775 13.7218" width="20.775pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M442 39L431 68C420 63 406 57 394 57C377 57 359 71 359 118V301C359 353 349 393 314 424C291 443 261 451 230 451C171 438 107 401 79 381C59 366 46 355 46 340C46 316 72 295 91 295C106 295 117 303 122 319C131 350 139 371 152 384C163 397 178 404 197 404C246 404 281 365 281 293V278C260 262 186 232 124 213C69 194 41 161 41 112C41 47 92 -12 163 -12C195 -12 243 25 283 51C288 35 293 22 308 7C319 -4 339 -12 354 -12L442 39ZM281 87C262 68 226 51 199 51C169 51 129 74 129 126C129 162 151 181 190 198C211 208 259 229 281 240V87Z" id="g58-95"></path></g><g transform="matrix(.013,0,0,-0.013,4.599,0)"><path d="M861 0V28C774 35 771 41 768 147L759 509C756 612 762 614 851 622V650H681L449 149L221 650H57V622C148 613 153 609 144 479L130 271C123 166 117 123 111 88C104 46 85 34 26 28V0H259V28C192 35 169 42 167 90C166 130 166 173 170 256L185 541H187L411 7H431L675 555H679L683 147C683 41 680 35 598 28V0H861Z" id="g121-75"></path></g><g transform="matrix(.013,0,0,-0.013,16.182,0)"><path d="M303 0V28C221 34 213 39 213 125V525C213 610 221 616 303 622V650H38V622C120 616 128 610 128 525V125C128 40 120 34 38 28V0H303Z" id="g121-71"></path></g></svg>:</span> myocardial infarction; <span class="nowrap"><svg height="15.9917pt" id="M13" style="vertical-align:-3.834001pt" version="1.1" viewbox="-0.0498162 -12.1577 25.7936 15.9917" width="25.7936pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M156 406V710C117 695 54 682 9 675V647C73 642 75 635 75 573V25C131 -2 180 -12 223 -12C359 -12 478 92 478 240C478 357 387 451 278 451C265 451 251 447 236 440L156 406ZM156 373C175 384 208 392 235 392C315 392 387 328 387 214C387 97 332 30 251 31C197 31 170 66 162 84C158 93 156 104 156 118V373Z" id="g58-96"></path></g><g transform="matrix(.013,0,0,-0.013,5.22,0)"><path d="M46 650V622C120 617 128 613 128 525V125C128 42 120 34 40 28V0H311V28C221 34 212 39 212 124V281L286 262C297 261 316 261 331 263C429 275 526 338 526 468C526 533 501 579 462 609C422 638 364 650 293 650H46ZM212 559C212 588 215 600 223 606C230 613 251 618 279 618C361 618 430 572 430 464C430 337 350 302 285 302C252 302 225 309 212 314V559Z" id="g121-78"></path></g><g transform="matrix(.013,0,0,-0.013,12.54,0)"><path d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z" id="g121-65"></path></g><g transform="matrix(.013,0,0,-0.013,21.184,0)"><path d="M303 0V28C221 34 213 39 213 125V525C213 610 221 616 303 622V650H38V622C120 616 128 610 128 525V125C128 40 120 34 38 28V0H303Z" id="g121-71"></path></g></svg>:</span> percutaneous coronary intervention; <span class="nowrap"><svg height="13.7218pt" id="M14" style="vertical-align:-3.83391pt" version="1.1" viewbox="-0.0498162 -9.88789 39.5013 13.7218" width="39.5013pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M396 114C349 71 317 59 274 59C216 59 123 104 123 241C123 342 180 400 246 400C283 400 317 386 348 359C355 352 361 348 366 348C378 348 401 371 402 394C402 405 398 413 385 424C369 437 337 451 294 451H293C254 451 193 434 141 394C73 342 39 277 39 198C39 90 114 -12 243 -12C303 -12 371 31 415 90L396 114Z" id="g58-97"></path></g><g transform="matrix(.013,0,0,-0.013,4.444,0)"><path d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z" id="g121-65"></path></g><g transform="matrix(.013,0,0,-0.013,13.089,0)"><path d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z" id="g121-63"></path></g><g transform="matrix(.013,0,0,-0.013,22.072,0)"><path d="M372 352C427 368 507 407 507 502C507 548 486 592 451 616C420 638 376 650 301 650H44V622C124 616 128 610 128 527V123C128 40 122 34 36 28V0H257C336 0 402 12 453 40C512 72 548 124 548 191C548 291 471 335 372 350V352ZM213 362V558C213 591 216 602 226 608C235 614 258 618 282 618C377 618 415 558 415 490C415 406 369 362 260 362H213ZM213 328H258C380 328 450 283 450 181C450 76 377 35 296 34C231 34 213 53 213 125V328Z" id="g121-64"></path></g><g transform="matrix(.013,0,0,-0.013,29.977,0)"><path d="M692 302H438V274C537 267 543 260 543 188V103C543 61 531 48 511 37C489 26 458 20 424 20C231 20 146 188 146 333C146 517 258 630 411 630C507 630 582 597 606 474L634 480C627 546 622 601 619 636C586 643 510 665 426 665C230 665 44 552 44 321C44 122 191 -15 411 -15C491 -15 573 7 635 21C629 49 628 81 628 116V202C628 261 632 266 692 274V302Z" id="g121-69"></path></g></svg>:</span> coronary artery bypass grafting.<br/></div></td></tr></table>

<div>Patients’ clinical characteristics.</div>

BioMed Research International

tab2

Table 2

Table 2: A Simplified Ultrasound Comet Tail Grading Scoring to Assess Pulmonary Congestion in Patients with Heart Failure 