Clinical trial NCT02441855: Potential Role for Echocardiography in Adult Patients With Community-Acquired Pneumonia
Official title: Is There a Potential Role for Echocardiography in Adult Patients With Community-Acquired Pneumonia Who Require Hospitalization ? A Pilot Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Community-acquired Pneumonia
Lead sponsor: Muğla Sıtkı Koçman University
Sponsor class: OTHER
First posted: 2015-05-12
Enrollment: 210
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Pneumonia group is defined as patients with community acquired pneumonia diagnosis hospitalised through emergency department. The control group will be consisted of consecutive sex- and age-matched patients admitted to the emergency department.

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: the TAPSE value to discriminate patients with pneumonia
timeFrame: 1 month
Secondary outcomes:
measure: the BNP value to discriminate patients with pneumonia
timeFrame: 1 month
Other outcomes:
Locations:
city: Mugla
country: Turkey
facility: Mugla Sitki Kocman University Education and Research Hospital
Study officials:
affiliation: Muğla Sıtkı Koçman University
name: Murat Biteker, Assoc. Prof.
role: STUDY_DIRECTOR
References:
citation: Biteker FS, Biteker M, Basaran O, Dogan V, Ozlek B, Yildirim B, Ozlek E, Celik O. A small pericardial effusion is a marker of complicated hospitalization in patients with community-acquired pneumonia. J Crit Care. 2018 Apr;44:294-299. doi: 10.1016/j.jcrc.2017.11.030. Epub 2017 Nov 23.
citation: Biteker FS, Basaran O, Dogan V, Caylak SD, Yildirim B, Sozen H. Prognostic value of transthoracic echocardiography and biomarkers of cardiac dysfunction in community-acquired pneumonia. Clin Microbiol Infect. 2016 Dec;22(12):1006.e1-1006.e6. doi: 10.1016/j.cmi.2016.08.016. Epub 2016 Sep 3.