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This study aimed to examine the association between patient-reported symptoms and the extent of pulmonary congestion in acute heart failure (AHF). The study results showed that among 322 patients with AHF, the median KCCQ-TSS score was 33. Worse KCCQ-TSS was associated with worse New York Heart Association class, dyspnoea at rest and on exertion, and peripheral oedema. However, KCCQ-TSS was not associated with the extent of pulmonary congestion, as assessed by the number of B-lines on LUS, or findings on CXR, or physical examination. Similarly, KCCQ-TSS was not significantly associated with echocardiographic markers of left ventricular filling pressure, pulmonary pressure or with N-terminal pro-B-type natriuretic peptide level. In conclusion, among patients hospitalized for AHF, at baseline, KCCQ-TSS was not associated with pulmonary congestion assessed by LUS, CXR, or physical examination. These findings suggest that the profound reduction in KCCQ-TSS in patients with AHF may not be solely explained by pulmonary congestion.
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