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Use of Echocardiography in the Evaluation of Chest Pain in the Emergency Department

This study has been withdrawn prior to enrollment.
(PI no longer with institution)
Sponsor:
ClinicalTrials.gov Identifier:
NCT01125072
First Posted: May 18, 2010
Last Update Posted: November 10, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
New York University School of Medicine
May 14, 2010
May 18, 2010
November 10, 2017
June 2005
November 2017   (Final data collection date for primary outcome measure)
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Complete list of historical versions of study NCT01125072 on ClinicalTrials.gov Archive Site
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Use of Echocardiography in the Evaluation of Chest Pain in the Emergency Department
Use of Echocardiography in the Evaluation of Chest Pain in the Emergency Department

Chest pain is one of the most common complaints that brings a patient to the emergency department (ED). The differential diagnosis of chest pain is broad and includes cardiac as well as non-cardiac diseases. One of the initial goals in the ED evaluation of a patient presenting with chest pain is to rapidly and accurately diagnose the presence or absence of acute coronary syndrome. The diagnostic accuracy of the initial routine evaluation is often limited and results in frequent admissions for patients presenting with chest pain for further diagnostic testing.

Echocardiography has a high sensitivity and specificity for the diagnosis of acute myocardial infarction. Tissue Doppler imaging with strain and strain rate (SR) measurement is a new echocardiographic technique, which enables accurate assessment of regional left ventricular systolic and diastolic function. Prior studies have shown that abnormal strain and SR are highly sensitive markers of ischemia. Acute ischemia induces early systolic thinning and a delay in the onset of systolic thickening, a progressive decrease in the rate and degree of maximal systolic thickening, and an abnormal ischemia-related thickening which occurs after aortic valve closure. A major obstacle to the routine use of echocardiography in the ED is the need for portable studies, using heavy, bulky portable echo machines. There are currently available portable hand-held echo machines (GE-Vivid I) that produce high quality images and offer an opportunity to incorporate echocardiography into routine practice in the ED.

This study will use of early, portable echocardiography, with detailed assessment of wall motion and left ventricular function by strain and strain rate measurements, for the evaluation of chest pain in the ED. It is hypothesized that an early with detailed left ventricular function assessment will be highly sensitive and specific for the diagnosis of myocardial ischemia, and will enable rapid triage of patients who present to the ED with chest pain.

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Observational
Observational Model: Cohort
Time Perspective: Retrospective
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Non-Probability Sample
All patients presenting to the emergency department with chest pain and are admitted to rule out acute coronary syndrome
Chest Pain
Other: Echocardiography with strain analysis
Clinical routine echocardiogram with additional off line strain analysis
entire cohort
patients presenting to the emergency department with chest pain and being admitted to rule out acute coronary syndrome
Intervention: Other: Echocardiography with strain analysis
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Withdrawn
0
November 2017
November 2017   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  1. Age 18 or older
  2. Chief complaint on presentation to ED: chest pain
  3. Differential diagnosis includes acute coronary syndrome as determined by the Emergency physician or admitting attending.
  4. Admission to the hospital required for further cardiac work up.

Exclusion Criteria:

  1. Obvious noncardiac cause of the chest pain
  2. Patient requires urgent intervention before echo can be obtained
  3. Failure to obtain informed consent
Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
No
Contact information is only displayed when the study is recruiting subjects
United States
 
 
NCT01125072
05-264
No
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Not Provided
New York University School of Medicine
New York University School of Medicine
Not Provided
Principal Investigator: Gila Perk, MD New York University School of Medicine
New York University School of Medicine
November 2017