Clinical trial NCT06860997: Clinical Echocardiography and S' Wave for Early Recognition of Acute Coronary Syndrome in the Emergency Department, A Prospective Study
Official title: Clinical Echocardiography and S' Wave for Early Recognition of Acute Coronary Syndrome in the Emergency Department, A Prospective Study
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Acute Coronary Syndrome
Myocardial Infarction (MI)
Non-ST Elevation Myocardial Infarction
Unstable Angina
Echocardiography
Tissue Doppler
Emergency Medicine
Cardiac Function Tests
Keywords: Acute Coronary Syndrome (ACS)
Non-ST Elevation Myocardial Infarction (NSTEMI)
Unstable Angina
Tissue Doppler Imaging (TDI)
Echocardiography
S' wave velocity
Mitral Annular Plane Systolic Excursion (MAPSE)
Tricuspid Annular Plane Systolic Excursion (TAPSE)
Emergency Medicine
Diastolic function
Point-of-Care Ultrasound (PoCUS)
Bedside Echocardiography
Cardiac Function Assessment
Early ACS Detection
Regional Wall Motion Abnormalities
Diagnostic Accuracy
Lead sponsor: Cliniques universitaires Saint-Luc- Université Catholique de Louvain
Sponsor class: OTHER
First posted: 2025-03-06
Enrollment: 150
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: DIAGNOSTIC

Brief summary: The goal of this prospective observational study is to assess the diagnostic accuracy of the tissue Doppler imaging (TDI) S' wave in detecting acute coronary syndrome (ACS) in adult patients presenting to the emergency department (ED) with acute chest pain. This study focuses on patients aged 18 years or older, who require continuous cardiac monitoring but do not show ST-elevation myocardial infarction (STEMI) on their initial ECG.

The main questions it aims to answer are:

* Can TDI S' wave velocity serve as an early diagnostic marker for ACS in the emergency department?
* How does the diagnostic performance of TDI S' compare with other echocardiographic markers (MAPSE, TAPSE, and diastolic parameters such as E, E', A, E/A, E/E')?
* Do demographic factors (age, sex, BMI, echogenicity) influence the diagnostic accuracy of echocardiographic parameters for ACS? If there is a comparison group: Researchers will compare TDI S' wave velocity findings with the final adjudicated diagnosis of ACS (determined after 3 months) to evaluate its sensitivity and specificity.


Eligibility criteria: Inclusion Criteria:

* Age ≥18 years
* Presenting to the emergency department (ED) with acute chest pain
* No ST-elevation myocardial infarction (STEMI) on initial ECG
* Requiring continuous cardiac monitoring based on triage decision
* Able to provide informed consent (written consent required)

Exclusion Criteria:

* Known pre-existing cardiomyopathy (e.g., hypertrophic cardiomyopathy, dilated cardiomyopathy)
* Severe valvular heart disease
* Left bundle branch block (LBBB) or presence of a pacemaker
* Arrhythmias (e.g., atrial fibrillation, frequent premature ventricular contractions)
* Cardiac arrest or cardiogenic shock at presentation
* Pulmonary hypertension
* Pericardial effusion or tamponade
* Non-cardiac cause of chest pain suspected as the primary diagnosis
* Language barrier preventing informed consent (study materials available in English, French, and Dutch)

Primary outcomes:
measure: Sensitivity and Specificity of Tissue Doppler Imaging (TDI) S' Wave for Acute Coronary Syndrome (ACS) Diagnosis
timeFrame: 3 months
Secondary outcomes:
Other outcomes:
Locations:
city: Bruxelles
country: Belgium
facility: Cliniques Universitaires Saint-Luc
Study officials:
affiliation: Cliniques universitaires Saint-Luc- Université Catholique de Louvain
name: Bastian Rodrigues de Castro, MD
role: PRINCIPAL_INVESTIGATOR
References: