Dyspnea in Stable Patients With Coronary Artery Disease.

Study Overview
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Brief Summary
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Single-centre prospective study to characterize causes of dyspnea in stable patients with coronary artery disease and evaluate the possibility to determine the cause of dyspnea before in-depth examination.

Detailed Description
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Stable patients with dyspnea and coronary artery disease will be included in this single-centre prospective study. In addition to routine clinical examination patients will be interviewed to determine the nature of shortness of breath, angina, presence of chronic heart failure or anxiety using the Medical Research Council Dyspnea scale, the visual analog scale of dyspnea, Borg scale, modified dictionary of dyspnea, G. Rose questionnaire, Seattle Angina Questionnaire, Framingham criteria for chronic heart failure and the SHOCK scale. During the subsequent in-depth examination including thyroid hormones, NT-proBNP, hsTroponin, ECG monitoring, six-minute walk test, stress-echo with a diastolic stress test, spirometry and coronary angiography (if necessary) main reason for dyspnea will be established. Possibilities of early (before in-depth examination) determination the reason for dyspnea in stable patients with coronary artery disease will be evaluated.

Official Title
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Dyspnea in Stable Patients With Coronary Artery Disease: Causes and Opportunities for Early Differential Diagnosis.

Conditions
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Dyspnea, Coronary Artery Disease

Intervention / Treatment
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* Diagnostic Test: Scales for assessment of symptoms


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stable patients with shortness of breath and established diagnosis of coronary artery disease (at least 1 of the following signs): history of myocardial infarction; typical angina without suspected other cause of pain; myocardial ischemia documented by ECG changes during symptoms and/or by results of the stress test; coronary artery stenosis >50% according to coronary angiography. Signed informed consent. Exclusion Criteria: Acute coronary syndrome (myocardial infarction, unstable angina) in the previous month. Hospitalization with decompensation of CHF in the previous 6 months (including CHF decompensation as the main reason for current hospitalization). Diseases with an unfavourable prognosis (terminal CKD, CHF NYHA IV, a lung disease with severe respiratory failure). Contraindications to bicycle stress echocardiography. Atrial Fibrillation at the time of hospitalization, when the decision not to restore the sinus rhythm. Mental illnesses and disorders, dementia, drug or alcohol dependence. Known oncological diseases.
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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Dyspnea in stable coronary artery disease<br>Stable patients with dyspnea and coronary artery disease | Diagnostic Test: Scales for assessment of symptoms<br>* Medical Research Council Dyspnea scale, the visual analogue scale of dyspnea, Borg scale, modified dictionary of dyspnea, G. Rose questionnaire, Seattle Angina Questionnaire, Framingham criteria for chronic heart failure, the SHOCK scale.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myocardial ischemia as a reason of dyspnea | Number of patient with dyspnea related to myocardial ischemia | up to 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Other causes of dyspnea | Number of patient with non-ischemic reasons for dyspnea (heart failure, pulmonary disease, arrhythmias, psychogenic, mixed or undetermined cases). | up to 1 month | 
| Adverse events | Composite of death, myocardial infarction, stroke and rehospitalization | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dyspnea, Stable coronary artery disease, Heart failure, Diastolic stress test