Clinical trial NCT04494152: Reliability of Echocardiography From Subcostal View
Official title: Reliability of Echocardiographic Assessment of Cardiac Dimensions and Function From Subcostal View
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Transthoracic Echocardiography
Lead sponsor: Emergency Medical Service of the Central Bohemian Region, Czech Republic
Sponsor class: OTHER
Collaborators: name: Masaryk Hospital Usti nad Labem
First posted: 2020-07-31
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Adult critically ill patients.

Brief summary: The purpose of this study is to assess reliability of echocardiographic assessment of ventricular dimensions and function from subcostal view.

Detailed description: Assessment of the function and dimensions of the right and left ventricles is a key part of Point-of-Care ultrasound in critically ill patients. According to the recent guidelines, this evaluation is performed from apical and parasternal views. However, these views may not be clearly visible in the clinical setting of critical illness and subcostal view is often preferred for its higher feasibility. Before clinical adoption, it is necessary to assess whether the isolated examination from subcostal view is reliable enough in the detection of the impairment of systolic function and the size of both ventricles and the investigators decided to evaluate this issue.

Transverse and longitudinal dimensions and function of both ventricles will be measured calculated by transthoracic echocardiography in critically ill patients in the intensive care unit from parasternal and apical views following the recent guidelines. Systolic function of the left ventricle will be expressed by the left ventricular ejection fraction (calculated by biplane method of disc summation) and by the fraction shortening. Systolic function of the right ventricle will be assessed by the tricuspid annular plane systolic excursion, fractional area change, tricuspid lateral annular systolic velocity, and right ventricular index of myocardial performance. From subcostal view, transverse dimensions of both ventricles and novel parameters of systolic function (subcostal tricuspid annular plane systolic excursion, right ventricular subcostal fraction shortening, right ventricular modified subcostal fraction shortening, left ventricular subcostal fraction shortening and left ventricular modified fraction shortening) will be measured.

Then, the reliability of parameters measured in subcostal view will be tested by comparison with conventional parameters taken from apical and parasternal view by correlation analysis and diagnostic test evaluation. The most reliable thresholds of parameters from subcostal view will be calculated by receiver operating characteristic analysis.

Eligibility criteria: Inclusion Criteria:

* Inpatients
* All patients hospitalised in intensive care unit indicated for transthoracic echocardiography examination

Exclusion Criteria:

* Age \<18 years
* Insufficient imaging quality of transthoracic echocardiography
* Refusal of echocardiographic examination by patient

Primary outcomes:
measure: Reliability of left ventricular subcostal fractional shortening and left ventricular modified subcostal fractional shortening in determining the global left ventricular systolic function in critically ill patients.
timeFrame: During the procedure
measure: Reliability of right ventricular subcostal fractional shortening and right ventricular modified subcostal fractional shortening in determining the global right ventricular systolic function in critically ill patients.
timeFrame: During the procedure
Secondary outcomes:
measure: Reliability of echocardiographic parameters evaluating the structure of the left ventricle measured in a subcostal view in critically ill patients.
timeFrame: During the procedure
measure: Reliability of echocardiographic parameters evaluating the size of the right ventricle measured in a subcostal view in critically ill patients.
timeFrame: During the procedure
Other outcomes:
Locations:
city: Usti nad Labem
country: Czechia
facility: Masaryk Hospital Usti nad Labem
Study officials:
affiliation: Masaryk Hospital Usti nad Labem
name: Roman Skulec, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14. doi: 10.1016/j.echo.2014.10.003.