Acute Coronary Syndrome, Cardiac Function Tests, Echocardiography, Emergency Medicine, Myocardial Infarction (MI), Non-ST Elevation Myocardial Infarction, Tissue Doppler, Unstable Angina
Conditions
Keywords
Acute Coronary Syndrome (ACS), Non-ST Elevation Myocardial Infarction (NSTEMI), Unstable Angina, Tissue Doppler Imaging (TDI), Echocardiography, S' wave velocity, Mitral Annular Plane Systolic Excursion (MAPSE), Tricuspid Annular Plane Systolic Excursion (TAPSE), Emergency Medicine, Diastolic function, Point-of-Care Ultrasound (PoCUS), Bedside Echocardiography, Cardiac Function Assessment, Early ACS Detection, Regional Wall Motion Abnormalities, Diagnostic Accuracy
Brief summary
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.
Interventions
DIAGNOSTIC_TESTTissue Doppler Imaging (TDI) S' Wave Echocardiography
This intervention involves bedside echocardiographic assessment using 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).
Sponsors
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
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)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity and Specificity of Tissue Doppler Imaging (TDI) S' Wave for Acute Coronary Syndrome (ACS) Diagnosis | 3 months | The study will assess the diagnostic accuracy (sensitivity and specificity) of TDI S' wave velocity in detecting ACS in patients presenting to the emergency department (ED) with acute chest pain. The reference standard for comparison will be the final ACS diagnosis, determined by an adjudication committee based on a review of medical records, ECG findings, cardiac biomarkers (troponins), and follow-up assessments at 3 months. |
Countries
Belgium
Contacts
PRINCIPAL_INVESTIGATORBastian Rodrigues de Castro, MD
Cliniques universitaires Saint-Luc- Université Catholique de Louvain
Outcome results
None listed