Incidence of Significant Mitral Regurgitation in Acute Heart Failure Patients

Study Overview
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Brief Summary
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The purpose of this study is to determine the prevalence of moderate-to-severe Mitral Regurgitation (MR) in acute Heart Failure (HF) patients requiring hospital admission.

Detailed Description
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All patients admitted with symptoms of HF- (shortness of breath (SOB), peripheral oedema, palpitations and irregular heart beats) will be assessed by the Research Team. The level of BNP will be checked using a small device (i-STAT BNP) at the bedside. If results of the test suggest HF they will undergo special procedure called transthoracic echocardiography (TTE). TTE is an ultrasound scan of the heart which will enable the investigators' to grade severity of Mitral Regurgitation (MR) as well as strength of the heart muscle. The investigators will use bi-plane Simpton's method to calculate left ventricular (LV) ejection fraction (EF). Colour Doppler and PISA method will be used to quantify severity of MR or valve leak. Simultaneously there will be recording of heart sounds to find out if auscultation is reliable in identifying leaky valves.

Official Title
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Incidence of Significant Mitral Regurgitation in Patients Presenting With Acute Heart Failure: Journey to Tertiary Centre

Conditions
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Acute Heart Failure, Mitral Regurgitation

Intervention / Treatment
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* Procedure: Transthoracic Echocardiogram (TTE) Assesment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute Heart Failure patients admitted to the Hospital Elevated BNP level (>30pg/ml) Exclusion Criteria: Patients with BNP level (< 30pg/ml)

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acute Heart Failure Patients<br>Acute Heart Failure patients with elevated levels of BNP ( >30pg/ml) will undergo Transthoracic Echocardiogram (TTE) for grading of MR severity within 7 days. | Procedure: Transthoracic Echocardiogram (TTE) Assesment<br>* Transthoracic Echocardiogram (TTE) will be carried out on all heart failure patients with elevated BNP level (>30 pg/ ml) for grading of MR severity within 7 days.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Grade 3 and above mitral regurgitation in acute heart failure. | TTE Grading is done on colour Doppler and proximal isovelocity surface area (PISA) method. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Establish correlation between BNP level and severity of MR in acute HF | Standard statistical analysis of BNP level and grade of MR severity | 12 months | 
| The validity of Hospital Episode Statistics (HES) data against prevalence of grade 3-4 MR in the study. | Standard statistical analysis of 2 sets of data | 12 month |