NCT07616557尚未招募不适用
Association Between Admission Red Cell Distribution Width and Right Ventricular-Pulmonary Arterial Coupling in Acute Pulmonary Embolism
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 190
研究概览
简要总结
Prior work linking RDW to echocardiographic findings in PE has largely focused on isolated parameters such as TAPSE or PASP and has rarely incorporated modern measures of RV-PA coupling. Whether admission RDW reflects the integrated RV-PA interaction - and not merely contractility or pressure in isolation - has not been adequately addressed. Establishing this link would support RDW as a simple, universally available marker of RV vulnerability at first presentation, and would lay the groundwork for future prognostic and mechanistic studies.
详细描述
Consecutive adults admitted via the emergency department or transferred to the participating center with confirmed acute PE will be screened by the study team.
- Demographic and clinical
- Age, sex, body mass index and Smoking status.
- Comorbidities: hypertension, diabetes mellitus, coronary artery disease, heart failure, Chronic Obstructive Pulmonary Disease, chronic kidney disease, prior venous thromboembolism, active cancer, recent surgery, recent immobilization, history of COVID -19 infection and vaccination.
- Current medications relevant to erythropoiesis or hemodynamics (ACE inhibitors/ARBs, beta-blockers, diuretics, iron supplementation, erythropoiesis-stimulating agents, anticoagulants on admission).
- Laboratory
- Complete blood count: hemoglobin, MCV, MCH, RDW-CV, RDW, white cell count and differential, platelet count, mean platelet volume.
- Renal and hepatic function: creatinine, eGFR, AST, ALT, total bilirubin.
- Cardiac biomarkers: high-sensitivity troponin. 3 Imaging
- CTPA: anatomic location of thrombus (main, lobar, segmental, subsegmental), presence of saddle embolus, RV/LV diameter ratio on axial imaging.
4.Echocardiography
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 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
- •Age ≥ 18 years. Acute PE confirmed by computed tomography pulmonary angiogram (CTPA) performed within 24 h of presentation.
- •CBC obtained within 24 h of admission and before any blood transfusion. Transthoracic echocardiography feasible within 24 h of admission. Written informed consent.
排除标准
- •Active hematologic malignancy or recent chemotherapy with myelosuppressive intent.
- •Red blood cell transfusion within the preceding 90 days.
- •Known hemoglobinopathy (e.g., sickle cell disease, thalassemia major).
- •Chronic dialysis or eGFR < 15 mL/min/1.73 m².
- •Pre-existing severe pulmonary hypertension (resting mean PAP ≥ 35 mmHg by prior right heart catheterization or echocardiographic PASP ≥ 60 mmHg before this admission), severe left-sided valvular disease, or known severe biventricular dysfunction.
- •Hemodynamic instability requiring vasopressors at the time of echocardiography, as their hemodynamics may distort RV-PA coupling estimates.
- •Inadequate echocardiographic image quality precluding measurement of TAPSE and a quantifiable TR jet for PASP estimation.
- •Inability to provide informed consent.
研究者
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