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Modified Ross Score for Evaluation of Heart Failure in Children

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. Identifier: NCT03885050
Recruitment Status : Unknown
Verified March 2019 by Enas Saad Hassan, Assiut University.
Recruitment status was:  Not yet recruiting
First Posted : March 21, 2019
Last Update Posted : March 21, 2019
Information provided by (Responsible Party):
Enas Saad Hassan, Assiut University

Brief Summary:
  • Identification of Patient those at risk For heart failure associated with lower respiratory tract infection
  • Assess the value of Ross score evaluation in lower respiratory tract infection complicated with HF, as a diagnostic tool for severity of HF

Condition or disease Intervention/treatment
Heart Failure Other: Ross score

Detailed Description:

- Pneumonia in young children remains a global epidemic and a leading cause of death in under-5 children. The annual incidence is approximately 156 million patients worldwide; and pneumonia and its complications led to approximately 0.92 million under-5 deaths in 2015.

In adult patients, cardiac events such as congestive heart failure (CHF) are among the leading complications associated with increased morbidity and mortality, but the association in pediatric patients is not well Established

At Suratthani Hospital, Thailand study therefore investigated the characteristics and factors associated with CHF in under-5 children with pneumonia and respiratory failure (RF). Also, revealed that Pneumonia with respiratory failure is associated with CHF even in healthy children without cardiac risks. The awareness and early recognition of CHF, particularly in male, and bacterial pneumonia is important in order to provide immediate treatment to reduce complications.

- A diagnosis of heart failure due to right ventricular affection requires a high index of suspicion since symptoms of heart failure such as easy fatiguability and tachypnoea are obscured by the primary pulmonary disease itself.6 The American Heart Association recommends early echocardiographic studies to diagnose pulmonary hypertension in children with obstructive apnea and sickle cell anaemia.2 Systolic pulmonary artery pressure can be estimated by echocardiographic Doppler assessment using definition of mean pulmonary artery pressure of >25mmHg. A ten-year review of chronic cor pulmonale secondary to respiratory diseases in Ghana was propelled by the fact that early diagnosis can lead to treatment of the respiratory disease, which would then improve a child's cardiac status. Nine cases of chronic cor pulmonale secondary to respiratory diseases were admitted during the period. Three had bronchiectasis as shown in Table 1. Of the three with bronchiectasis, one had congenital lung aplasia; one had a repair of tracheoesophageal atresia at the age of one week. The other was HIV-positive with bronchiectasis secondary to pulmonary tuberculosis.

Children with right heart failure should be investigated for pulmonary cause since early recognition and treatment would improve outcome

Until 1987, the only system available for grading HF in children was the New York Heart Association (NYHA) classification. However, this system was based on limitations to physical activity for adults, which did not translate well for use with children, particularly infants.2 Therefore, we developed a symptom-based classification using more age-appropriate variables. new Ross HF classification from grades I to IV

Several authors have modified Ross scoring system to expand its use to older children.

with all this recent data on factors predictive of outcomes in children with HF that a revision in how we grade symptom severity is required. It also is apparent that age stratification is required to encompass the changes in signs and symptoms that children manifest from infancy to late childhood. A classification system should include the biomarkers, echo parameters of systolic function and mitral or systemic atrioventricular valve (AV) insufficiency, and reflect exercise limitations reflected by feeding and growth in infants and exercise capacity indicated by percentage of predicted maximal oxygen uptake (VO2) in older children. Therefore an age-based Ross classification using the original variables that proved to be sensitive and specific and adding the new evidence-based data.

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Study Type : Observational
Estimated Enrollment : 100 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Modified Ross Score for Evaluation of Heart Failure in Children With Lower Respiratory Tract
Estimated Study Start Date : November 1, 2019
Estimated Primary Completion Date : May 30, 2020
Estimated Study Completion Date : September 30, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Intervention Details:
  • Other: Ross score
    modified score used for evaluation of heart failure in children, as a diagnostic tool for severity of heart failure

Primary Outcome Measures :
  1. The mean score in the study population [ Time Frame: 1 hour ]
    Modified Ross Score For Evaluation of Heart Failure in Children with Lower Respiratory Tract Infection Admitted To Assiut University Pediatric Hospital

Information from the National Library of Medicine

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Ages Eligible for Study:   1 Month to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Sampling Method:   Non-Probability Sample
Study Population
Infants and children around age of (1month to 18 years old) admitted in the Intensive Care Unit and Intermediate Care Unit in Assiut Pediatric Hospital in a period of 6 months

Inclusion Criteria:

  • Children with respiratory lower tract infection

Exclusion Criteria:

  • Patients with past history of cardiac disease
  • Patients with past history of renal disease.
  • Patient less than 1 month
  • Parent refusal to participate the research

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03885050

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Contact: Enas saad, master 01127122000
Contact: Salah Eldin Amry, MD 01005787682

Sponsors and Collaborators
Assiut University
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Responsible Party: Enas Saad Hassan, Principal investigator, Assiut University Identifier: NCT03885050    
Other Study ID Numbers: MRS
First Posted: March 21, 2019    Key Record Dates
Last Update Posted: March 21, 2019
Last Verified: March 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Heart Failure
Heart Diseases
Cardiovascular Diseases