Clinical trial NCT03998410: Evaluation of the Diagnostic Value of the TPD System in Determining ADHF Causing Acute Dyspnea
Official title: Evaluation of the Diagnostic Value of the TPD System in Determining ADHF Causing Acute Dyspnea
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: ADHF
Keywords: ADHF Dyspnea ED
Lead sponsor: Echosense Ltd.
Sponsor class: INDUSTRY
First posted: 2019-06-26
Enrollment: 130
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: Recording Doppler US signals over the right wall chest
Primary purpose: DIAGNOSTIC

Brief summary: The objective of this study is to evaluate Lung Doppler signals (LDS) among patients presenting to the emergency department with acute dyspnea, in order to determine the diagnostic value of this non-invasive method to discriminate ADHF causing dyspnea from any other cause i.e., non-ADHF causes of dyspnea.

Detailed description: Dyspnea (shortness of breath) is a common symptom affecting as many as 25% of patients seen in ambulatory settings. It can be caused by many different underlying conditions, some of which arise acutely and can be life-threatening, making rapid clinical evaluation and targeted diagnostic studies of central importance. A number of disorders cause dyspnea, including acute decompensated heart failure (ADHF), chronic obstructive pulmonary disease (COPD), asthma, pulmonary embolism, pneumonia, metabolic acidosis, neuromuscular weakness, and others. The overlapping clinical presentations of these conditions and comorbid diseases can make the diagnostic evaluation of dyspnea a significant challenge.

Acute heart failure (AHF) is a major cause of serious morbidity and death in the general population and one of the most common medical causes of hospitalization among people aged over 60. Patients presenting to the ED with ADHF must be evaluated and treated rapidly to ensure the best possible outcomes. The diagnosis should be made as soon as possible and therapy initiated. Delayed diagnosis at presentation may also result in patients being inappropriately transferred to non-specialist wards, resulting in longer stays, increased re-admission and poorer outcomes. The key to improving the time to diagnosis depends on the clinical evaluation alongside a readiness to initiate relevant additional tests.

Previous studies showed that the TPD has the potential to differentiate between the cardiac cause of dyspnea and any other cause.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years
* Patients with acute onset dyspnea (defined as shortness of breath (SOB) at rest or on exertion) and diagnostic uncertainty of etiology where heart failure is in consideration.
* Patients designated to undergo chest X-ray as part of standard of care assessment.

Exclusion Criteria:

* Obvious trauma contributing to dyspnea
* Inability to provide written informed consent
* Not speaking English or Spanish
* Right-sided lobectomy
* Patients with implanted ventricular assist device
* Patient is unable to undergo the TPD test
* Patient is already enrolled in a clinical study with experimental medications

Primary outcomes:
measure: Accuracy of diagnosis
timeFrame: Average of 1 year
Secondary outcomes:
measure: Sensitivity, Specificity, PPV, NPV of TPD diagnosis
timeFrame: Average of 1 year
Other outcomes:
Locations:
city: Detroit
country: United States
facility: Wayne State University
state: Michigan
city: Dallas
country: United States
facility: The university of Texas Southwestern Medical Center
state: Texas
city: Houston
country: United States
facility: Baylor College of Medicine
state: Texas
Study officials:
affiliation: judd.hollander@jefferson.edu
name: Judd Hollander, MD
role: PRINCIPAL_INVESTIGATOR
References: