Systolic Time Intervals: a Diagnostic Tool of Acute Heart Failure in Emergency Departement Settings
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 530
- 试验地点
- 1
- 主要终点
- PEP/EMAT values between the AHF and non AHF groups
研究概览
简要总结
the gold standard for the diagnostic of acute heart failure is based on clinical, biological (BNP levels) and echocardiographic findings, but still in some cases, the diagnosis is difficult and requires further investigations.
BNP dosages and echocardiography are not always available in many medical centers, especially in emergency departements, and are expensive.
we investigated the use of alternative methods, such as the systolic time intervals (STI), in the diagnosis of acute heart failure (AHF) in emergency departement patients consulting for dyspnea.
详细描述
AHF is a common cause for dyspnea, but still hard to diagnose. in emergency departements, physicians dispose of a variety of techniques helping them to identify patients with acute onset dyspnea due to cardiac causes and allowing them to initiate the appropriate therapeutics.
techniques such as the N type brain natriuretic peptid (NT BNP) dosages and echocardiography, in addition to the clinical exam, are efficient in these cases but they encounter many problems:
- the BNP dosages are non-conclusive in some cases (grey zone) and must be repeated wich takes time.
- echocardiography is operator - dependent technique and could be misleading in some conditions.
- both BNP and echocardiography are expensive and not found in many emergency structures, especially in poor countries.
all the arguments pushed us to investigate other simpler and cheaper techniques to apply in these conditions.
STI is an old technique based on the recording of two parameters: electrocardiogram and phonocardiogram, and from them measuring the different systolic intervals:
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 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
- 是
入选标准
- •non traumatic dyspnea
- •age more than 18 years old.
排除标准
- •ECG diagnostic for acute myocardial infarction or ischemic chest pain within the prior 24 hours
- •history of a heart transplant
- •pericardial effusion
- •chest wall deformity suspected of causing dyspnea
- •coma, shock,Mechanical Ventilation, vasopressor drugs
- •arrhythmia serious and sustained, pace maker severe mitral valve disease, severe pulmonary arterial hypertension
- •renal failure with creatinine >350micromol/l
结局指标
主要结局
PEP/EMAT values between the AHF and non AHF groups
时间窗: at admission (an average of 24 hours)
compare the PEP/EMAT values between the two study groups: AHF and non-AHF. the diagnosis of AHF is made based on clinical, BNP, and echocardiographic findings.
次要结局
- compare the STI diagnostic performance against BNP(at hospital admission (an average of 24 hours))
- PEP values between the two study groups(at admission (an average of 24 hours))
- compare the EMAT values between the two study groups(at admission (an average of 24 hours))
研究者
Pr. Semir Nouira
Professor
University of Monastir