Improving Pulmonary Hypertension Screening by Echocardiography (IMPULSE)

Royal United Hospitals Bath NHS Foundation Trust

Status: Enrolling

Conditions: Pulmonary Hypertension

Treatments: Diagnostic Test: Transthoracic echocardiogram

Study type: Observational

Funder types: Other; Industry

Identifiers

NCT06038149

IMPULSE

Details and patient eligibility

About

This study aims to assess the application of the novel IMPULSE algorithm for the detection of pulmonary hypertension (PH) in those with a low or intermediate probability of PH according to the British Society of Echocardiography (ESC) and European Society of Cardiology (ESC) guidelines.

Full description

This is a prospective, multi-centre cross-sectional study with a planned 18 month longitudinal component.

Participants will be recruited from patients referred for the first time for transthoracic echocardiography at the Royal United Hospitals Bath National Health Service (NHS) Foundation Trust, Royal Free Hospital NHS Foundation Trust, Sheffield Teaching Hospitals, Royal Papworth Hospital, and Golden Jubilee Hospital.

The investigators will prospectively recruit patients without a diagnosis of Pulmonary Hypertension.

Transthoracic echocardiographic (TTE) imaging will be performed in line with British Society of Echocardiography minimum dataset guidelines, and comprehensive right heart echocardiographic imaging and analysis will be performed following the British Society of Echocardiography recommendations for assessing right heart function, in addition to the IMPULSE algorithm;

A right ventricular free wall longitudinal strain value of less than -23%, or, right ventricular fractional area change (FAC) less than 35% in females/30% in males, in addition to a right ventricular isovolumetric relaxation time in excess of 73ms in patients with low/Intermediate probability of PH by current guidelines would categorise that patient as being IMPULSE positive.

Enrollment: 200 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Unexplained breathlessness
• Risk factors for Pulmonary arterial hypertension (PAH), chronic thromboembolic pulmonary hypertension (CTEPH)
• Unexplained elevation of B-type natriuretic peptide (BNP/proBNP)
• Referred for catheterisation.

Exclusion criteria

• ESC / BSE echo high probability of PH
• Known or suspected congenital heart disease
• Patients unlikely to benefit from management of PH or its underlying causes.

Trial design

200 participants in 2 patient groups

Low PH probability

Description:

Individuals identified as being of a low risk of pulmonary hypertension on routine echocardiography through existing British Society of Echocardiography/ European Society of Cardiology guidelines will undergo a research echocardiogram on the day of their planned right heart catheter.

Treatment:

Diagnostic Test: Transthoracic echocardiogram

Intermediate PH probability

Description:

Individuals identified as being of an intermediate risk of pulmonary hypertension on routine echocardiography through existing British Society of Echocardiography/ European Society of Cardiology guidelines will undergo a research echocardiogram on the day of their planned right heart catheter.

Treatment:

Diagnostic Test: Transthoracic echocardiogram