Classification of Heart Failure in Children

Evaluation of Severity of Heart Failure in Children Attending Cardiology Unit, Assiut University Children Hospital

Evaluation of Severity of Heart Failure in Children Attending Cardiology Unit, Assiut University Children Hospital

Study Overview

• Status: Unknown
• Conditions: Heart Failure
• Intervention / Treatment: Radiation: echocardiography

Detailed Description

Heart failure (HF) has been defined as an abnormality of cardiac structure or function leading to failure of the heart to deliver oxygen at a rate commensurate with the requirements of the metabolizing tissues, despite normal filling pressures (or only at the expense of increased filling pressures). Heart failure may result from ventricular pump dysfunction, volume overload with preserved pump function, and pressure overload with preserved pump function.Determinations of the degree of heart failure severity are essential for clinical assessment and treatment evaluation. Remarkably, no readily applied standardized method of quantifying heart failure severity exists for pediatric patients. Although standard index methods from the adult population, such as the New York Heart Association Classification, have been applied to non-infant pediatric populations, none have been validated in children. The NYHA classification measures functional capacity, not heart failure severity. The NYHA classification is inappropriate for use in pediatrics because functional capacity and responses to heart failure states differ in children compared with adults. Children have markedly different cardiac physiology, clinical presentations, and compensatory mechanisms. Moreover, the etiologies of heart failure in children are very different from those in adults. For these reasons, Ross et al.,developed a scale that is useful for grading heart failure severity in infants from birth to 6 months of age but is not applicable to older children and adolescents (Original Ross Classification).

Many have since used the "Ross Classification," including Wu et al., who confirmed an incremental rise in PNE (Plasma Norepinephrine) concentrations and progressive down-regulation of β-receptor density in children with increasing Ross class. In 1994, the Canadian Cardiovascular Society's Consensus Conference statement on the "Diagnosis and Management of Heart Failure," adopted the Ross Classification as their official scoring system for children. Ross propose an age-based Ross classification using the original variables that proved to be sensitive and specific and adding the new evidence-based data. The age ranges of 0-3 months, 4-12 months, 1-3 years, 4-8 years, and 9-18 years were chosen because the variables in the classification are generally stable during these periods but vary between them. The scoring system can be used as a continuous data set for comparison with outcomes, or it can be categorized by points.

• Study Type: Observational
• Enrollment (Anticipated): 50

Contacts and Locations

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 year to 16 years (Child, Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Cases admitted at Pediatric Cardiology Unit, Assiut University with Heart Failure Manifestations.

Description

Inclusion Criteria:

• Cases admitted at Pediatric Cardiology Unit, Assiut University with Heart Failure Manifestations.

Exclusion Criteria:

• Primary liver diseases.
• Hematological diseases associated with organomegaly.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of Severity of Heart Failure in Children Attending Cardiology Unit, Assiut University Children Hospital	Evaluation of Severity of Heart Failure in Children Attending Cardiology Unit, Assiut University Children Hospital using Age based Ross classification	baseline

Collaborators and Investigators

• Sponsor: Assiut University

Study record dates

Study Major Dates

• Study Start (Anticipated): April 1, 2018
• Primary Completion (Anticipated): October 1, 2018
• Study Completion (Anticipated): December 30, 2018

Study Registration Dates

• First Submitted: February 24, 2018
• First Submitted That Met QC Criteria: February 28, 2018
• First Posted (Actual): March 1, 2018

Study Record Updates

• Last Update Posted (Actual): March 1, 2018
• Last Update Submitted That Met QC Criteria: February 28, 2018
• Last Verified: February 1, 2018

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Heart Diseases; Cardiovascular Diseases; Heart Failure
• Other Study ID Numbers: age based ross classification

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No