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• Johannessen, Øyvind; Espersen, Caroline; Platz, Elke; Skaarup, Kristoffer Grundtvig; Lassen, Mats Christian Højbjerg & Davidovski, Filip Soeskov [Vis alle 16 forfattere av denne artikkelen] (2025). Predictors of B-line count in hospitalized patients with COVID-19. Frontiers in Cardiovascular Medicine. 12. doi: 10.3389/fcvm.2025.1618919. Fulltekst i vitenarkiv Vis sammendrag

  Background B-lines on lung ultrasound (LUS) are nonspecific signs of increased lung density, which can be secondary to pulmonary congestion, pneumonia, or fibrosis. While its use is recommended in acute heart failure (HF), its value in non-HF populations is less clear. Methods We prospectively analyzed hospitalized non-ICU patients ≥18 years old with confirmed laboratory diagnoses of COVID-19. We aimed to identify associations between 8-zone LUS findings and clinical, laboratory, and echocardiographic data, and 30-day mortality using trend and regression analyses. Results Among 270 patients (mean age 69 ± 14 years, 58% male, and 11% with prior HF) the median time from hospital admission to LUS was 4 days [interquartile range (IQR) 2–8]. In total, 263 (97%) had ≥1 B-line [median B-line number 13 (IQR 9–22)], and the median left ventricular ejection fraction (LVEF) was 59 (IQR 54–63). In adjusted models, having more B-lines was associated with higher levels of C-reactive protein, with an incidence rate ratio (IRR) of 16% (95%CI: 8%–24%) per log-unit increase ( P  < 0.001) and higher Early Warning Score [IRR 5% (95%CI: 2%–8%) per point, P  = 0.003]. Higher tricuspid regurgitation gradient was associated with more B-lines: IRR 2% (95%CI: 1%–3%) per mmHg, P  = 0.001). However, left ventricular function measures and NT-proBNP concentrations showed no significant association with B-lines. Furthermore, B-lines were not associated with 30-day mortality. Conclusions Among patients with COVID-19, B-lines on LUS are associated with markers of infectious disease severity and pulmonary hypertension, but not with markers of left-sided HF.

• Johannessen, Øyvind; Reite, Fride Uthaug; Bhatnagar, Rahul; Øvrebotten, Tarjei; Einvik, Gunnar & Myhre, Peder Langeland (2023). Lung Ultrasound to Assess Pulmonary Congestion in Patients with Acute Exacerbation of COPD. The International Journal of Chronic Obstructive Pulmonary Disease. ISSN 1176-9106. 18, s. 693–703. doi: 10.2147/COPD.S396855. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Heart failure (HF) often coexists with chronic obstructive pulmonary disease (COPD) and is associated with worse outcomes. We aimed to assess the feasibility of detecting vertical artifacts (B-lines) on lung ultrasound (LUS) to identify concurrent HF in patients hospitalized with acute exacerbation of COPD (AECOPD). Second, we wanted to assess the association between B-lines and the risk of rehospitalization for AECOPD or death. Patients and Methods: In a prospective cohort study, 123 patients with AECOPD underwent 8-zone bedside LUS within 24h after admission. A positive LUS was defined by ≥ 3 B-lines in ≥ 2 zones bilaterally. The ability to detect concurrent HF (adjudicated by a cardiologist committee) and association with events were evaluated by logistic- and Cox regression models. Results: Forty-eight of 123 patients with AECOPD (age 75± 9 years, 57[46%] men) had concurrent HF. Sixteen (13%) patients had positive LUS, and the prevalence of positive LUS was similar between patients with and without concurrent HF (8[17%] vs 8[11%], respectively, p=0.34). The number of B-lines was higher in concurrent HF: median 10(IQR 6– 16) vs 7(IQR 5– 12), p=0.03. The sensitivity and specificity for a positive LUS to detect concurrent HF were 17% and 89%, respectively. Positive LUS was not associated with rehospitalization and mortality: Adjusted HR: 0.93(0.49– 1.75), p=0.81. Conclusion: LUS did not detect concurrent HF or predict risk in patients with AECOPD.

• Johannessen, Øyvind; Myhre, Peder Langeland; Claggett, Brian; Lindner, Moritz; Lewis, Eldrin F. & Rivero, Jose [Vis alle 8 forfattere av denne artikkelen] (2022). Left atrial inflow propagation velocity derived by color M-mode Doppler in acute heart failure. The International Journal of Cardiovascular Imaging. ISSN 1569-5794. 38(10), s. 2155–2165. doi: 10.1007/s10554-022-02614-y. Fulltekst i vitenarkiv Vis sammendrag

  Left atrial (LA) inflow propagation velocity from the pulmonary vein (LAIF-PV) has been proposed as a novel measure of LA reservoir function and is associated with pulmonary capillary wedge pressure in critically ill patients. However, data on LAIF-PV in acute heart failure (AHF) are lacking. We sought to examine the feasibility of measuring LAIF-PV and evaluate clinical and echocardiographic correlates of LAIF-PV in AHF. In a prospective cohort study of adults hospitalized for AHF, we used color M-mode Doppler of the pulmonary veins to obtain LAIF-PV in systole. Among 142 patients with appropriate images and no more than moderate mitral regurgitation, LAIF-PV measures were feasible in 76 patients (54%) aged 71 ± 14 years, including 68% men with left ventricular ejection fraction (LVEF) 38% ± 13. Mean LAIF-PV was 24.2 ± 5.9 cm/s. In multivariable regression analysis adjusted for age, sex, systolic blood pressure, heart rate, body mass index, New York Heart Association class, LA volume and LVEF, the only independent echocardiographic predictors of LAIF-PV were right ventricular (RV) S’ [ß 0.46 cm/s per cm/s (95% CI 0.01–0.91), p = 0.045] and tricuspid annular plane systolic excursion (TAPSE) [ß 0.28 cm/s per mm (95% CI 0.02–0.54), p = 0.039]. Notably, LAIF-PV was not significantly correlated with measures of LV function, LA function or E/e’. In conclusion, LAIF-PV was measurable in 54% of patients with AHF, and lower values were associated with measures of impaired RV systolic function but not LV or LA function.

• Johannessen, Øyvind; Claggett, Brian; Lewis, Eldrin F.; Groarke, John D.; Swamy, Varsha & Lindner, Moritz [Vis alle 8 forfattere av denne artikkelen] (2021). A-lines and B-lines in patients with acute heart failure. European Heart Journal: Acute Cardiovascular Care. ISSN 2048-8726. 10(8), s. 909–917. doi: 10.1093/ehjacc/zuab046. Fulltekst i vitenarkiv Vis sammendrag

  Aims Lung ultrasound (LUS) relies on detecting artefacts, including A-lines and B-lines, when assessing dyspnoeic patients. A-lines are horizontal artefacts and characterize normal lung, whereas multiple vertical B-lines are associated with increased lung density. We sought to assess the prevalence of A-lines and B-lines in patients with acute heart failure (AHF) and examine their clinical correlates and their relationship with outcomes. ................................................................................................................................................................................................... Methods and results In a prospective cohort study of adults with AHF, eight-zone LUS and echocardiography were performed early during the hospitalization and pre-discharge at an imaging depth of 18 cm. A- and B-lines were analysed separately off-line, blinded to clinical and outcome data. Of 164 patients [median age 71 years, 61% men, mean ejection fraction (EF) 40%], the sum of A-lines at baseline ranged from 0 to 19 and B-line number from 0 to 36. One hundred and fifty-six patients (95%) had co-existing A-lines and B-lines at baseline. Lower body mass index and lower chest wall thickness were associated with a higher number of A-lines (P trend

• Johannessen, Øyvind; Myhre, Peder Langeland & Omland, Torbjørn (2021). Assessing congestion in acute heart failure using cardiac and lung ultrasound - a review. Expert Review of Cardiovascular Therapy. ISSN 1477-9072. 19(2), s. 165–176. doi: 10.1080/14779072.2021.1865155. Fulltekst i vitenarkiv

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• Moen, Oda Klavestad; Johannessen, Øyvind; Myhre, Peder Langeland; Heck, Siri Lagethon; Corbett, Rebecca Aure & Windstad, Vilde Malo [Vis alle 10 forfattere av denne artikkelen] (2025). Pre-test probability (PTP) for coronary artery disease (CAD) is enhanced by incorporating risk factors and coronary artery calcium (CAC) score. European Society of Cardiology. Fulltekst i vitenarkiv
• Johannessen, Øyvind (2026). Lung Ultrasound in Patients with Acute Dyspnea. A Novel Point-of-Care Imaging Method for Managing Patients with Acute Dyspnea. Universitetet i Oslo. ISSN 9788234807794. Fulltekst i vitenarkiv Vis sammendrag

  Major causes of hospitalization for acute dyspnea include acute heart failure (AHF), acute exacerbations of COPD (AECOPD), and pulmonary infections. Accurate diagnosis of the underlying etiology is essential for timely management. Lung ultrasound is a rapid, non-invasive tool that provides important information about pulmonary congestion by evaluating reverberation imaging artifacts, A-lines, and B-lines. A-lines are horizontal reverberation artifacts indicating air-rich lungs, whereas B-lines are vertical artifacts indicating increased pulmonary tissue density. This thesis aimed to evaluate the feasibility and the diagnostic and prognostic performance of lung ultrasound, focusing on A-lines and B-lines in patients with acute dyspnea and their relationship with markers of cardiac dysfunction and congestion. In three prospective studies, patients with AHF, AECOPD, and COVID-19 were evaluated using a standardized 8-zone lung ultrasound protocol. The sum of artifact counts across the eight lung zones served as the basis for correlations with clinical findings, echocardiography, and laboratory markers. Long-term outcomes were mortality and rehospitalization at 30 days, 90 days, and 12 months. A contextual narrative literature review was also conducted. B-lines were common across all cohorts and correlated with disease severity. In AHF, B-line counts declined from admission to discharge and were prognostically significant. A-lines provided no clinical value and were associated with chest wall characteristics. In AECOPD, patients with known heart failure had more B-lines, but B-lines alone were not diagnostic of concurrent AHF. In COVID-19, B-lines were strongly associated with respiratory distress and inflammatory markers but not with increased mortality or cardiac biomarkers. Overall, the findings support prior evidence on the value of B-lines in assessing congestion in AHF. However, caution is warranted when interpreting LUS findings as indicating intercurrent cardiac disease in patients with pulmonary disease or infections.

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