Clinical Echocardiography and S' Wave for Early Recognition of Acute Coronary Syndrome in the Emergency Department, A Prospective Study

NCT06860997 | Completed

• 1 other identifier: 2024/28OCT/476
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

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.

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

Outcome Measures

Primary Outcomes (1)

• Sensitivity and Specificity of Tissue Doppler Imaging (TDI) S' Wave for Acute Coronary Syndrome (ACS) Diagnosis

  The study will assess the diagnostic accuracy (sensitivity and specificity) of TDI S' wave velocity in detecting ACS in patients presenting to the emergency department (ED) with acute chest pain. The reference standard for comparison will be the final ACS diagnosis, determined by an adjudication committee based on a review of medical records, ECG findings, cardiac biomarkers (troponins), and follow-up assessments at 3 months.

  3 months

Study Arms (1)

Echocardiographic Assessment for Early ACS Detection

OTHER

This arm involves bedside echocardiographic assessment using tissue Doppler imaging (TDI) S' wave velocity to evaluate its diagnostic accuracy for acute coronary syndrome (ACS) in patients presenting with acute chest pain in the emergency department (ED).

Diagnostic Test: Tissue Doppler Imaging (TDI) S' Wave Echocardiography

Interventions

Tissue Doppler Imaging (TDI) S' Wave Echocardiography DIAGNOSTIC_TEST

This intervention involves bedside echocardiographic assessment using TDI S' wave velocity to evaluate its diagnostic accuracy for acute coronary syndrome (ACS) in patients presenting with acute chest pain in the emergency department (ED).

Echocardiographic Assessment for Early ACS Detection

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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)

You may not qualify if:

• 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)

Sponsors & Collaborators

• Cliniques universitaires Saint-Luc- Université Catholique de Louvain: lead

Study Sites (1)

Cliniques Universitaires Saint-Luc

Brussels, 1200, Belgium

Location

MeSH Terms

Conditions

Acute Coronary Syndrome; Myocardial Infarction; Non-ST Elevated Myocardial Infarction; Angina, Unstable

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis; Angina Pectoris; Chest Pain; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Bastian Rodrigues de Castro, MD

  Cliniques universitaires Saint-Luc- Université Catholique de Louvain

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 28, 2025
• First Posted: March 6, 2025
• Study Start: January 12, 2025
• Primary Completion: March 31, 2026
• Study Completion: March 31, 2026
• Last Updated: April 27, 2026

Record last verified: 2026-04

Locations

BE (1)