Potential Role for Echocardiography in Adult Patients With Community-Acquired Pneumonia

Completed

• Conditions: Community-acquired Pneumonia
• Interventions: Device: echocardiography

• Registration Number: NCT02441855
• Lead Sponsor: Muğla Sıtkı Koçman University

Brief Summary

Despite the efficacy of modern treatment, community-acquired pneumonia (CAP) is the the leading cause of death. Prognostic scores have been developed to estimate the risk of adverse outcome. Several serum biomarkers have been also investigated in patients with CAP. A growing number of echocardiographic markers have been evaluated as possible predictors of prognosis in patients with pulmonary and infectious diseases such as sepsis, septic shock, human immunodeficiency virus infection, pulmonary tuberculosis, and chronic obstructive pulmonary disease. As echocardiography is a non-invasive, reliable, cost-effective, and reproducible diagnostic tool to evaluate cardiac function and structures, the investigators aimed to investigate left and right ventricular functions and aortic elastic properties in CAP patients. Furthermore, the investigators also aimed to observe relationships between echocardiographic findings and inflammatory and cardiac serum biomarkers in patients with CAP.

Detailed Description

Despite the efficacy of modern treatment, community-acquired pneumonia (CAP) is the the leading cause of death. Prognostic scores, like the CURB-65 (confusion, urea, respiratory rate, arterial blood pressure and age) score and the pneumonia severity index (PSI) have been developed and validated to estimate the risk of adverse outcome and to register a patient with CAP for hospital admission. Serum biomarkers have been also investigated in patients with CAP like Procalcitonin and C-reactive protein. Elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) has been shown to be associated with adverse prognosis in several cardiac conditions and critically ill patients. NT-proBNP is also shown to be important predictor in the emergency department and in hospitalized patients with CAP. A growing number of echocardiographic markers have been evaluated as possible predictors of prognosis in patients with pulmonary and infectious diseases such as sepsis, pulmonary tuberculosis, and chronic obstructive pulmonary disease. Although effects of pneumonia on cardiac structures is theoretically possible due to increased systemic inflammatory activity, prothrombotic conditions, biomechanical stress on coronary arteries, variations in coronary arterial tone, and altered myocardial metabolic balance during infections, the role of transthoracic echocardiography has never been evaluated in patients with CAP. As echocardiography is a non-invasive, reliable, cost-effective, and reproducible diagnostic tool to evaluate cardiac function and structures, the investigators aimed to investigate left and right ventricular functions and aortic elastic properties in CAP patients. Furthermore, the investigators also aimed to observe relationships between echocardiographic findings and inflammatory and cardiac serum biomarkers in patients with CAP.

Study Timeline

• Study Start: 2015-03
• Primary Completion: 2015-05
• Study Completion: 2015-05
• Study First Submitted: 2015-05-08
• Study First Submitted QC: 2015-05-11
• Study First Posted: 2015-05-12
• Status Verified: 2015-06
• Last Update Submitted: 2015-06-02
• Last Update Posted: 2015-06-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 210

Inclusion Criteria

• ≥ 18 years of age

Exclusion Criteria

• Patients with active pulmonary tuberculosis
• Hospital-acquired pneumonia
• Severely immunocompromised patients
• Patients undergoing chronic dialysis
• Patients sent for ambulatory treatment

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
control	echocardiography	patients admitted to emergency department with shortness of breath
pneumonia	echocardiography	patients with community-acquired pneumonia

Primary Outcome Measures

Name	Time	Method
the TAPSE value to discriminate patients with pneumonia	1 month	the TAPSE (Tricuspid annular plane systolic excursion ) value to discriminate patients with pneumonia

Secondary Outcome Measures

Name	Time	Method
the BNP value to discriminate patients with pneumonia	1 month	the BNP (B-type natriuretic peptide) value to discriminate patients with pneumonia

Trial Locations

Locations (1)

Mugla Sitki Kocman University Education and Research Hospital; 🇹🇷 Mugla, Turkey