Systolic Time Intervals a Prognostic Tool of Heart Failure in Emergency Departement (STI/AHF)

Study Overview
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Brief Summary
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The performance of STIs and clinical scores alone and their combination to predict short term prognosis of acute decompensated heart failure.

Detailed Description
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Acute heart failure is a leading cause of hospitalization and death.Prediction of these adverse events is still challenging. STI is an old technique based on the recording of two parameters: electrocardiogram and phonocardiogram, and from them measuring the different systolic intervals: pre-ejection period (PEP),electro-mechanic activation time (EMAT), Left ventricular ejection time (LVET) and systolic time ratio (RTS) were measured. The aim of these study is to demonstrate whether systolic time intervals (STIs) can improve clinical scores EFFECT (Enhanced Feedback for Effective Cardiac Treatment) and GWTG-HF (Get With the Guidelines-Heart Failure) for predicting 30 day mortality and readmission in patients with acute decompensated heart failure (ADHF) in the ED.

Official Title
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Systolic Time Intervals a Pronostic Tool of Heart Failure in Emergency Departement

Conditions
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Dyspnea, Heart Failure

Intervention / Treatment
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* Device: biopac
* Diagnostic Test: prognostic scores


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: non traumatic dyspnea age more than 18 years old. Exclusion Criteria: ECG diagnostic for acute myocardial infarction ischemic chest pain within the prior 24 hours history of a heart transplant pericardial effusion chest wall deformity suspected of causing dyspnea coma shock,Mechanical Ventilation, vasopressor drugs arrhythmia serious and sustained, pace maker severe mitral valve disease, severe pulmonary arterial hypertension renal failure with creatinine >350micromol/l

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AHF/HFpEF<br>AHF with preserved ejection fraction Acoustic cardiography was performed for all participants using the BIOPAC Prognostic scores were calculated for every patient | Device: biopac<br>* Acoustic cardiography was performed for all participants using the BIOPAC system with Student Lab software version 3.7.2. An electrocardiogram was obtained by two electrodes placed at the right upper limb and the lower left limb. Simultaneously heart sounds were recorded with a specific sensor placed at the mitral focus.<br>Diagnostic Test: prognostic scores<br>* Effect and GWTGHF were calculated for every patient<br>|
| AHF/HFrEF<br>AHF with reduced ejection fraction Acoustic cardiography was performed for all participants using the BIOPAC Prognostic scores were calculated for every patient | Device: biopac<br>* Acoustic cardiography was performed for all participants using the BIOPAC system with Student Lab software version 3.7.2. An electrocardiogram was obtained by two electrodes placed at the right upper limb and the lower left limb. Simultaneously heart sounds were recorded with a specific sensor placed at the mitral focus.<br>Diagnostic Test: prognostic scores<br>* Effect and GWTGHF were calculated for every patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| compare the STIs prognostic performance against clinical scores | the area under ROC curve of the Systolic Time Intervals compared to the one of the EFFECT and GWTG HF scores | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| compare the STI prognostic performance between HFpEF and HFrEF patients | compare the STI prognostic performance between HFpEF and HFrEF patients using the area under curve estimation of the ROC curve of the three systolic time intervals (PEP;EMAT measured in milliseconds,and PEP/EMAT) of the two groups | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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impedance, dyspnea, AHF, BNP, EFFECT, GWTG-HF