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

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.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Acute Coronary Syndrome Angina Pectoris Angina, Unstable Cardiac Function Tests Cardiovascular Diseases Chest Pain Echocardiography Emergency Medicine Heart Diseases Infarction Ischemia Myocardial Infarction Myocardial Infarction (MI) Myocardial Ischemia Necrosis Neurologic Manifestations Non-ST Elevated Myocardial Infarction Non-ST Elevation Myocardial Infarction Pain Pathologic Processes Pathological Conditions, Signs and Symptoms Signs and Symptoms Tissue Doppler Unstable Angina Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cliniques Universitaires Saint-Luc

Brussels, 1200, Belgium

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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)

Treatment and study plan

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).

Primary outcomes

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

Time frame: 3 months

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.

Sponsors and collaborators

Lead sponsor

Cliniques universitaires Saint-Luc- Université Catholique de Louvain

Other

Registry information

Acronym: CLEAR_ECHO

Important dates

Study start: 2025
Primary completion: 2026
Study completion: 2026
First posted: Mar 6, 2025
Registry last updated: Apr 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed