Use of ΔIVC for Early Diagnosis of AHF in AECOPD

Study Overview
=================
Brief Summary
-----------------
Acute Heart failure (AHF) is a common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This association is frequently underestimated with regard to the difficulty of clinical diagnosis. The investigators expect that the application of the inferior vena cava collapsibility index (ΔIVC)could be useful in this issue.

Detailed Description
-----------------
Acute heart failure (AHF) is a common cause of COPD exacerbation however its role is very often underestimated. Until now, the use of echocardiography and some invasive hemodynamic exploration techniques such as the Swanganz catheter has been stated as reference. Other noninvasive diagnostic methods have been studied, such as systolic time intervals and Valsalva maneuver, but their application still difficult in patients with COPD exacerbation, especially in emergency department (ED) settings. the study aimed to evaluate the performance of a new diagnostic technique based on the measurement of the ΔIVC for the early identification of AHF in patients presenting to the ED with acute COPD exacerbation.

Official Title
-----------------
Diagnosis of Acute Heart Failure in Chronic Obstructive Pulmonary Disease Exacerbation Using the Inferior Vena Cava Collapsibilty Index

Conditions
-----------------
Acute Decompensated Heart Failure, COPD Exacerbation

Intervention / Treatment
-----------------
* Diagnostic Test: calculation of the inferior vena cava collapsibility index


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patient with history of COPD and admitted to the emergency departement for AECOPD Exclusion Criteria: impossibility to give consent to participate in the study, non consent patients post traumatic dyspnea instable hemodynamic or neurological status

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AHF-group<br>patients with AECOPD and acute heart failure | Diagnostic Test: calculation of the inferior vena cava collapsibility index<br>* the ΔIVC was calculated by the emergency physician who was blinded from the patient's medical history using the formula ((IVCmax-IVCmin)/IVCmax) X100.A cutoff of 15% was used to define the presence(<15%) or absence(>15%) of heart failure<br>|
| non AHF-group<br>patients with AECOPD without acute heart failure | Diagnostic Test: calculation of the inferior vena cava collapsibility index<br>* the ΔIVC was calculated by the emergency physician who was blinded from the patient's medical history using the formula ((IVCmax-IVCmin)/IVCmax) X100.A cutoff of 15% was used to define the presence(<15%) or absence(>15%) of heart failure<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the performance of ΔIVC in the diagnosis of acute heart failure | the accuracy of ΔIVC in the diagnosis of heart failure measured by sensitivity ,specificity, and area under the roc curve | 1 day | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
COPD, Acute Heart Failure, Inferior vena cava, Ultrasound, Collapsibility index