Heart Failure Ventricular Pressure Time Profile

Study Overview
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Brief Summary
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This proposed study aim to: Determine intra-LV pressure-time profile non-invasively using recently developed echo Doppler VFM analysis and applanation tonometry and myocardial elastic properties, in HF subjects (both HFNEF and HFREF) compared to normal volunteers. Correlate calculated intra-LV pressure parameters with NT ProBNP levels.

Detailed Description
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Heart failure (HF) is a common disease and its syndrome is difficult to diagnose. HF with reduced ejection fraction (HFREF) may be diagnosed based on impaired LVEF (<50%). However, diagnosis of HF with normal ejection fraction (HFNEF) is mainly based on the presence of signs and symptoms. Central to diagnosis of HF is estimation of intra-cardiac pressure, which can only be obtained from invasive catheterization. This proposed study aim to: Determine intra-LV pressure-time profile non-invasively using recently developed echo Doppler VFM analysis and applanation tonometry and myocardial elastic properties, in HF subjects (both HFNEF and HFREF) compared to normal volunteers. Correlate calculated intra-LV pressure parameters with NT ProBNP levels.

Official Title
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Non-invasive Determination of Intra-left Ventricular Pressure-time Profile for Diagnosis of Heart Failure With Normal and Reduced Ejection Fraction.

Conditions
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Heart Failure

Intervention / Treatment
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* Other: NTproBNP
* Other: Echocardiography
* Other: Arterial tonometry


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Either has presented to hospital with a primary diagnosis of Heart Failure or is attending a hospital clinic for management of Heart Failure within 6 months of an episode of decompensated heart failure, which either: resulted in a hospital admission (primary diagnosis) or was treated in out-patient clinic LVEF >50% is used as cut-off value for HFNEF and LVEF < 50% for HFREF. NT-proBNP within 7 days of admission > 220pg/ml. If there is no result available, NT-proBNP on the same day as echo scan must be > 220pg/ml. Exclusion Criteria: Haemodynamically significant valve disease defined as more than mild degree of valve stenosis, or more than moderate degrees of mitral or aortic valve regurgitation. History of valvular disease, i.e. rheumatic heart disease and/or having undergone valvular replacement. Isolated right heart failure due to pulmonary disease. Presence of haemodynamically significant obstructive lesions of left ventricular outflow tract. History of any organ transplant or who was on a transplant list (life expectancy < 6 months at time of enrollment). Presence of end-stage renal failure. Pregnancy. The patient is unable to provide written informed consent.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 90 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 |
| --- | --- |
| Control<br>Healthy Volunteers will undergo the following studying procedures: Echocardiography Arterial tonometry | Other: Echocardiography<br>* To measure heart chamber size, heart function, blood vessel size and blood vessel function. These measurements will help us understand the type and severity of heart failure.<br>Other: Arterial tonometry<br>* A noninvasive method to obtain arterial pressure waveform.<br>|
| Heart Failure Patients<br>Patients will undergo the following studying procedures: NTproBNP Echocardiography Arterial tonometry | Other: NTproBNP<br>* To assess its level in the blood, as a marker of heart failure presence and severity.<br>Other: Echocardiography<br>* To measure heart chamber size, heart function, blood vessel size and blood vessel function. These measurements will help us understand the type and severity of heart failure.<br>Other: Arterial tonometry<br>* A noninvasive method to obtain arterial pressure waveform.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First occurrence of cardiovascular event |  | 1 Year |