The Use of Single-Beat TE-e' in Evaluation of Left Atrial Pressure in Critically Ill Patients: The TELAP-ICU Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Correlation between novel (single-beat) and conventional (two-beat) TE-e' values
研究概览
简要总结
This study evaluates a new single-beat echocardiographic technique (TE-e', the time difference between the onset of the mitral inflow E wave and the septal e' wave on tissue Doppler imaging) for estimating left atrial pressure (LAP) in critically ill patients, comparing it against the standard two-beat method. The goal is to determine whether the faster, single-beat method gives results as reliable as the conventional method, and whether it can help identify patients with elevated left atrial pressure without an invasive procedure.
详细描述
Left atrial pressure (LAP) is an important measure in the care of critically ill patients but usually requires an invasive catheter to assess directly. Echocardiography offers a non-invasive alternative. One promising marker, TE-e' (the time difference between the onset of the mitral inflow E wave and the septal e' wave on tissue Doppler imaging), was recently incorporated into the 2025 American Society of Echocardiography (ASE) diastolic function guidelines. The conventional method for calculating TE-e' requires measurements from two separate heartbeats, introducing potential error from beat-to-beat heart rate variability - a common issue in the critically ill patients. This study assesses a novel single-beat method, in which both waveforms are captured on the same Doppler display within one cardiac cycle, eliminating that source of variability. Patients undergoing clinically indicated transthoracic echocardiography (TTE) in the Adult Intensive Care Unit of Queen Mary Hospital, Hong Kong will have TE-e' measured by both methods, along with other echocardiographic parameters associated with LAP, to evaluate correlation between the two methods and their relationship with clinically assessed LAP.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients ≥18 years admitted to the QMH Adult Intensive Care Unit (AICU)
- •Requiring a transthoracic echocardiogram (TTE) as part of routine clinical care
- •TE-e' obtainable by both the conventional and the novel method
排除标准
- •Patients <18 years of age
- •Patients in atrial fibrillation
- •Patients with a poor TTE acoustic window
- •Patients in whom TE-e' is technically difficult to obtain or interpret by either method
研究组 & 干预措施
Single cohort
each patient serves as their own comparison - conventional vs. novel method measured within the same transthoracic echocardiography study
干预措施: Echocardiography (Diagnostic Test)
结局指标
主要结局
Correlation between novel (single-beat) and conventional (two-beat) TE-e' values
时间窗: At the time of index TTE (single time point for each patient) during the course of ICU stay (from day 1 of ICU admission till ICU discharge, up to 1 month)
次要结局
- Correlation between novel and conventional methods in obtaining septal e' and s' velocities - At time of index TTE(At the time of index TTE (single time point for each patient) during the course of ICU stay (from day 1 of ICU admission till ICU discharge, up to 1 month))
- Correlation between clinical evaluation of LAP and TE-e' value(At the time of index TTE (single time point for each patient) during the course of ICU stay (from day 1 of ICU admission till ICU discharge, up to 1 month))
- Correlation between other echocardiographic parameters of LAP (E/A ratio, LAVi, TR Vmax, lung ultrasound 6-point protocol) and TE-e' value(At the time of index TTE (single time point for each patient) during the course of ICU stay (from day 1 of ICU admission till ICU discharge, up to 1 month))
研究者
Wincy Wing-Sze Ng
Associate Consultant
Queen Mary Hospital, Hong Kong