Clinical Echocardiography and S' Wave for Early Recognition of Acute Coronary Syndrome in the Emergency Department, A Prospective Study (CLEAR_ECHO)

Cliniques universitaires Saint-Luc- Université Catholique de Louvain

Status: Enrolling

Conditions: Cardiac Function Tests; Emergency Medicine; Unstable Angina; Acute Coronary Syndrome; Non-ST Elevation Myocardial Infarction; Myocardial Infarction (MI); Echocardiography; Tissue Doppler

Treatments: Diagnostic Test: Tissue Doppler Imaging (TDI) S' Wave Echocardiography

Study type: Interventional

Funder types: Other

Identifiers

NCT06860997

2024/28OCT/476

Details and patient eligibility

About

The goal of this prospective observational study is to assess the diagnostic accuracy of the tissue Doppler imaging (TDI) S' wave in detecting acute coronary syndrome (ACS) in adult patients presenting to the emergency department (ED) with acute chest pain. This study focuses on patients aged 18 years or older, who require continuous cardiac monitoring but do not show ST-elevation myocardial infarction (STEMI) on their initial ECG.

The main questions it aims to answer are:

• Can TDI S' wave velocity serve as an early diagnostic marker for ACS in the emergency department?
• How does the diagnostic performance of TDI S' compare with other echocardiographic markers (MAPSE, TAPSE, and diastolic parameters such as E, E', A, E/A, E/E')?
• Do demographic factors (age, sex, BMI, echogenicity) influence the diagnostic accuracy of echocardiographic parameters for ACS? If there is a comparison group: Researchers will compare TDI S' wave velocity findings with the final adjudicated diagnosis of ACS (determined after 3 months) to evaluate its sensitivity and specificity.

Enrollment: 150 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age ≥18 years
• Presenting to the emergency department (ED) with acute chest pain
• No ST-elevation myocardial infarction (STEMI) on initial ECG
• Requiring continuous cardiac monitoring based on triage decision
• Able to provide informed consent (written consent required)

Exclusion criteria

• Known pre-existing cardiomyopathy (e.g., hypertrophic cardiomyopathy, dilated cardiomyopathy)
• Severe valvular heart disease
• Left bundle branch block (LBBB) or presence of a pacemaker
• Arrhythmias (e.g., atrial fibrillation, frequent premature ventricular contractions)
• Cardiac arrest or cardiogenic shock at presentation
• Pulmonary hypertension
• Pericardial effusion or tamponade
• Non-cardiac cause of chest pain suspected as the primary diagnosis
• Language barrier preventing informed consent (study materials available in English, French, and Dutch)

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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150 participants in 1 patient group

Echocardiographic Assessment for Early ACS Detection

Other group

Description:

This arm involves bedside echocardiographic assessment using tissue Doppler imaging (TDI) S' wave velocity to evaluate its diagnostic accuracy for acute coronary syndrome (ACS) in patients presenting with acute chest pain in the emergency department (ED).

Treatment:

Diagnostic Test: Tissue Doppler Imaging (TDI) S' Wave Echocardiography