Potential Role for Echocardiography in Adult Patients With Community-Acquired Pneumonia

Study Overview
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Brief Summary
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Despite the efficacy of modern treatment, community-acquired pneumonia (CAP) is the the leading cause of death. Prognostic scores have been developed to estimate the risk of adverse outcome. Several serum biomarkers have been also investigated in patients with CAP. A growing number of echocardiographic markers have been evaluated as possible predictors of prognosis in patients with pulmonary and infectious diseases such as sepsis, septic shock, human immunodeficiency virus infection, pulmonary tuberculosis, and chronic obstructive pulmonary disease. As echocardiography is a non-invasive, reliable, cost-effective, and reproducible diagnostic tool to evaluate cardiac function and structures, the investigators aimed to investigate left and right ventricular functions and aortic elastic properties in CAP patients. Furthermore, the investigators also aimed to observe relationships between echocardiographic findings and inflammatory and cardiac serum biomarkers in patients with CAP.

Detailed Description
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Despite the efficacy of modern treatment, community-acquired pneumonia (CAP) is the the leading cause of death. Prognostic scores, like the CURB-65 (confusion, urea, respiratory rate, arterial blood pressure and age) score and the pneumonia severity index (PSI) have been developed and validated to estimate the risk of adverse outcome and to register a patient with CAP for hospital admission. Serum biomarkers have been also investigated in patients with CAP like Procalcitonin and C-reactive protein. Elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) has been shown to be associated with adverse prognosis in several cardiac conditions and critically ill patients. NT-proBNP is also shown to be important predictor in the emergency department and in hospitalized patients with CAP. A growing number of echocardiographic markers have been evaluated as possible predictors of prognosis in patients with pulmonary and infectious diseases such as sepsis, pulmonary tuberculosis, and chronic obstructive pulmonary disease. Although effects of pneumonia on cardiac structures is theoretically possible due to increased systemic inflammatory activity, prothrombotic conditions, biomechanical stress on coronary arteries, variations in coronary arterial tone, and altered myocardial metabolic balance during infections, the role of transthoracic echocardiography has never been evaluated in patients with CAP. As echocardiography is a non-invasive, reliable, cost-effective, and reproducible diagnostic tool to evaluate cardiac function and structures, the investigators aimed to investigate left and right ventricular functions and aortic elastic properties in CAP patients. Furthermore, the investigators also aimed to observe relationships between echocardiographic findings and inflammatory and cardiac serum biomarkers in patients with CAP.

Official Title
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Is There a Potential Role for Echocardiography in Adult Patients With Community-Acquired Pneumonia Who Require Hospitalization ? A Pilot Study

Conditions
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Community-acquired Pneumonia

Intervention / Treatment
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* Device: echocardiography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥ 18 years of age Exclusion Criteria: Patients with active pulmonary tuberculosis Hospital-acquired pneumonia Severely immunocompromised patients Patients undergoing chronic dialysis Patients sent for ambulatory treatment

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pneumonia<br>patients with community-acquired pneumonia | Device: echocardiography<br>* echocardiography: Left and right ventricular functions and aortic elastic properties.<br>|
| control<br>patients admitted to emergency department with shortness of breath | Device: echocardiography<br>* echocardiography: Left and right ventricular functions and aortic elastic properties.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the TAPSE value to discriminate patients with pneumonia | the TAPSE (Tricuspid annular plane systolic excursion ) value to discriminate patients with pneumonia | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the BNP value to discriminate patients with pneumonia | the BNP (B-type natriuretic peptide) value to discriminate patients with pneumonia | 1 month |