Table 5 Open in new tab Gaps in current...

Setting

Trials/studies needed

Main questions to be addressed

Acute heart failure

Additional randomized trials assessing whether LUS can improve the diagnosis and characterization of patients with AHF beyond traditional approaches.

Can the use of LUS facilitate the classification of AHF phenotypes that may benefit from specific therapeutic interventions?
Can LUS imaging be used to improve management decisions in patients with AHF, e.g. hospital admission vs. early discharge from the Emergency Department?
Is the use of LUS imaging effective and safe as part of a strategy to improve congestion relief in AHF, including intensification/de-intensification of diuretic therapy?
Can the use of LUS improve post-discharge outcomes in patients with AHF?

Chronic heart failure

Development and validation of diagnostic protocols assessing the utility of LUS at rest or during exercise in the diagnosis of HFpEF.

Can the use of LUS improve the clinical course of patients with chronic HF (HFrEF and/or HFpEF)?
Can the use of LUS facilitate the identification of subsets of patients with chronic HF that can benefit from specific therapeutic interventions?
Is the use of LUS in the management of patients with chronic HF cost-effective?
Can the use of LUS improve the clinical course of specific HF phenotypes (myocarditis, cardiotoxicity, inherited cardiomyopathies, post-partum cardiomyopathy, and cardiac amyloidosis)?

Acute coronary syndromes

Additional randomized trials assessing whether LUS can improve the diagnosis of the aetiology of chest pain beyond traditional approaches.

Can the use of LUS facilitate the identification of subsets of patients with ACS that may benefit from specific therapeutic interventions?

Table 5

Open in new tab

Gaps in current evidence

Setting	Trials/studies needed	Main questions to be addressed
Acute heart failure	Additional randomized trials assessing whether LUS can improve the diagnosis and characterization of patients with AHF beyond traditional approaches.	Can the use of LUS facilitate the classification of AHF phenotypes that may benefit from specific therapeutic interventions? Can LUS imaging be used to improve management decisions in patients with AHF, e.g. hospital admission vs. early discharge from the Emergency Department? Is the use of LUS imaging effective and safe as part of a strategy to improve congestion relief in AHF, including intensification/de-intensification of diuretic therapy? Can the use of LUS improve post-discharge outcomes in patients with AHF?
Chronic heart failure	Development and validation of diagnostic protocols assessing the utility of LUS at rest or during exercise in the diagnosis of HFpEF.	Can the use of LUS improve the clinical course of patients with chronic HF (HFrEF and/or HFpEF)? Can the use of LUS facilitate the identification of subsets of patients with chronic HF that can benefit from specific therapeutic interventions? Is the use of LUS in the management of patients with chronic HF cost-effective? Can the use of LUS improve the clinical course of specific HF phenotypes (myocarditis, cardiotoxicity, inherited cardiomyopathies, post-partum cardiomyopathy, and cardiac amyloidosis)?
Acute coronary syndromes	Additional randomized trials assessing whether LUS can improve the diagnosis of the aetiology of chest pain beyond traditional approaches.	Can the use of LUS facilitate the identification of subsets of patients with ACS that may benefit from specific therapeutic interventions?

Setting	Trials/studies needed	Main questions to be addressed
Acute heart failure	Additional randomized trials assessing whether LUS can improve the diagnosis and characterization of patients with AHF beyond traditional approaches.	Can the use of LUS facilitate the classification of AHF phenotypes that may benefit from specific therapeutic interventions? Can LUS imaging be used to improve management decisions in patients with AHF, e.g. hospital admission vs. early discharge from the Emergency Department? Is the use of LUS imaging effective and safe as part of a strategy to improve congestion relief in AHF, including intensification/de-intensification of diuretic therapy? Can the use of LUS improve post-discharge outcomes in patients with AHF?
Chronic heart failure	Development and validation of diagnostic protocols assessing the utility of LUS at rest or during exercise in the diagnosis of HFpEF.	Can the use of LUS improve the clinical course of patients with chronic HF (HFrEF and/or HFpEF)? Can the use of LUS facilitate the identification of subsets of patients with chronic HF that can benefit from specific therapeutic interventions? Is the use of LUS in the management of patients with chronic HF cost-effective? Can the use of LUS improve the clinical course of specific HF phenotypes (myocarditis, cardiotoxicity, inherited cardiomyopathies, post-partum cardiomyopathy, and cardiac amyloidosis)?
Acute coronary syndromes	Additional randomized trials assessing whether LUS can improve the diagnosis of the aetiology of chest pain beyond traditional approaches.	Can the use of LUS facilitate the identification of subsets of patients with ACS that may benefit from specific therapeutic interventions?

AHF, acute heart failure; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; HFpEF, heart failure with preserved ejection fraction; LUS, lung ultrasound.

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