- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01940328
Measurements of Doppler Signals Noninvasively From the Lung in Congestive Heart Failure
Evaluation of Lung Doppler Signals in Congestive Heart Failure(CHF)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Participants A total of 150 patients will be recruited for this study over a span of 18 months.
Patients will be divided into 3 subgroups:
Acute decompensated left heart failure- Patients are eligible for enrollment if they presented to the emergency department within the previous few hours with acute pulmonary congestion or pulmonary edema, diagnosed on the basis of all of the following criteria:
- Dyspnea at rest or with minimal activity
- Rales on auscultation
- Evidence of pulmonary congestion or edema on chest X-ray.
- BNP level >400 pg/ml This subgroup will be recruited in the emergency medicine department (EMD) following initial treatment and stabilization.
- Compensated left heart failure - Patients with significant stable left HF (NYHA II-III) who are on optimal medical treatment for CHF and are without clinical or laboratory evidence of pulmonary congestion (i.e. patients without dyspnea at rest, without rales on auscultation and with BNP levels < 100 pg/ml). This subgroup will be recruited among inpatients and/or outpatients at the Rambam campus.
- Non-CHF controls (patients without CHF and without uncontrolled hypertension). This subgroup will be recruited among inpatients and/or outpatients at the Rambam health care campus.
Study measurements
For the compensated left HF patients and the non-CHF controls, measurements will be done once following inclusion.
For the decompensated left HF patients, several measurements will be conducted, both following inclusion (at the EMD) and each day during hospitalization (at the internal medicine department).
Measurements following inclusion:
Following informed consent and applying the inclusion and exclusion criteria, all eligible patients will undergo physical examination including weight, vital signs (blood pressure, heart rate, respiratory rate, O2 saturation by pulse oximetry) and a full assessment of CHF status by physical examination (lung auscultation, assessment of leg edema, weight, JVP etc.). (See figure 2). An ECG recording will be performed and a blood test for BNP will be drawn for all patients.
For the assessment of dyspnea, decompensated left HF patients will be asked to indicate their level of dyspnea on a visual analogue scale (3) and/or a 7-points categorical Likert scale (4).
Chest X-ray: Decompensated patients will undergo chest X ray (CXR) as part of the regular evaluation in the EMD. The 2 other subgroups will undergo CXR only if a recent CXR (<6 months) is not available, or if clinically indicated.
Echocardiography: an attempt will be made to perform echocardiography in the EMD for all decompensated patients who are in sinus rhythm, including a full diastolic assessment. However, due to the limited availability of the echocardiography service, not all patients will undergo echo at the EMD and therefore this examination is considered optional.
A recent (<6 months) echocardiography is required for the 2 other subgroups. If a recent echo is not available, a new one will be done as close as possible to inclusion.
Lung Doppler signals will be recorded in sitting position from selected locations over the right chest wall. If the subject is unable to sit in a chair, the headrest of the patient's bed will be tilted upwards to about 45 degrees. Regarding the decompensated left HF patients, the first measurement of LDS will take place as soon as possible after admission to the emergency medicine department, providing the patient has been adequately treated and stabilized and is willing and able to sign an informed consent form. The LDS measurement will be repeated twice more at the EMD at 1 hour intervals. LDS will be recorded only once for the compensated patients and the non-CHF controls.
Follow up measurements during hospitalization (decompensated patients only) During their hospital stay in the internal medicine department, decompensated left HF patients will repeat part of the former study measurements.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Haifa, Israel
- EMD Rambam Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age over 18 years
- Belongs to one of the following categories:
A. Acute decompensated left HF: patients with acute pulmonary congestion or pulmonary edema diagnosed on the basis of all of the following criteria:
- Dyspnea at rest or with minimal activity
- Rales on auscultation
- Evidence of pulmonary congestion or edema on chest X-ray.
- BNP level >400 pg/ml
B. Compensated left HF: patients with significant stable left HF (NYHA II-III) who are on optimal medical treatment for CHF, and are without clinical or laboratory evidence of pulmonary congestion. The following 3 criteria must be met:
- No dyspnea at rest
- No rales on auscultation
- BNP levels < 100 pg/ml
C. Non-CHF controls: patients without CHF and without uncontrolled hypertension.
3 Signed Informed Consent
Exclusion Criteria:
- Decompensated left HF subgroup & Non CHF controls
- Pneumonia- currently or in the past 1 month prior to inclusion
- Non-cardiogenic pulmonary edema or lung injury (e.g. ARDS)
- Interstitial lung disease
- Severe kyphosis, scoliosis or chest wall deformity
- Pregnant women
Compensated left HF subgroup
- Chronic obstructive pulmonary disease (COPD)
- Asthma
- Interstitial lung disease
- Any other obstructive or restrictive lung diseases
- Pneumonia- currently or in the past 3 months prior to inclusion
- Non-cardiogenic pulmonary edema or lung injury (e.g. ARDS)
- Current or past pulmonary embolism
- Large right sided pleural effusion
- Severe kyphosis, scoliosis or chest wall deformity
- Pregnant woman
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Decompensated CHF
patients with acute pulmonary congestion or pulmonary edema
|
|
Compensated CHF
patients with significant stable left HF (NYHA II-III) who are on optimal medical treatment for CHF, and are without clinical or laboratory evidence of pulmonary congestion
|
|
Non CHF patients
patients without CHF and without uncontrolled hypertension.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Diagnose specific pattern of LDS in patients by features as velocity, power etc in comparison to controls
Time Frame: 1.5y to collect all data and obtain a diagnostic pattern
|
1.5y to collect all data and obtain a diagnostic pattern
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Shmuel Rispler, MD, PhD, Rambam Health Care Campus
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- DOP13
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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