Misdiagnosis Between Interstitial Lung Disease and Cardiac Patients

NCT ID: NCT06198608

Last Updated: 2024-01-10

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 80 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-01-01
• Study Completion Date: 2024-12-30

Brief Summary

Aim of the study To determine the frequency misdiagnosis of cardiac congestion as interstitial lung disease based on initial High Resolution CT interpretation alone.

To identify specific HRCT findings that are more commonly associated with misdiagnosis versus correct diagnosis of the underlying condition.

To establish diagnostic criteria or HRCT patterns that distinguish cardiac congestion from interstitial lung disease

Detailed Description

Observational study of 150 patients found that cardiac congestion was misdiagnosed as interstitial lung disease in 24% of cases on initial HRCT imaging alone. Echocardiography and clinical correlation were needed to make the correct diagnosis .

Misdiagnosis can lead to inappropriate treatment with immunosuppressive drugs which could exacerbate right heart failure in patients who actually have cardiac congestion. Correct diagnosis is important for prognosis and management.

Subtle findings like upper lobe predominance of opacities, septal lines and a mosaic attenuation pattern on HRCT favor interstitial lung disease, while diffuse ground glass with central and perihilar distribution favors cardiac congestion .

Associated findings on HRCT like enlarged cardiac silhouette, pleural and pericardial effusions help suggest the diagnosis of cardiac congestion over idiopathic interstitial pneumonia .

Integrating clinical data on risk factors for heart failure, echocardiography findings and follow-up imaging response to diuretic therapy can help differentiate the two conditions when HRCT is non-specific

Conditions

ILD

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Eligibility Criteria

Inclusion Criteria

• Patients who underwent HRCT imaging of the chest for evaluation of suspected interstitial lung disease
• Initial radiology report included a definitive diagnosis of interstitial lung disease patterns
• Age 18+ years
• No prior history of pulmonary or cardiac

Exclusion Criteria

• Inconclusive or unclear initial HRCT report
• Underlying diagnosis other than interstitial lung disease or cardiac congestion

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Hend Mohamed Sayed Mohamed

doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

marwan sayed, MD

Role: STUDY_CHAIR

lecture in cardiac diseases

samaa elkossi, MD

Role: STUDY_CHAIR

Lecture inradiology departement

Central Contacts

Hend saleh, MD

Role: CONTACT

hend.m.saleh@gmail.com

01098988712

Mohamed Abdalrahman, MD

Role: CONTACT

dr.mga2011@aun.edu.eg

0102660007

References

Nathan SD, Pastre J, Ksovreli I, Barnett S, King C, Aryal S, Ahmad K, Fukuda C, Ramalingam V, Chung JH. HRCT evaluation of patients with interstitial lung disease: comparison of the 2018 and 2011 diagnostic guidelines. Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620968496. doi: 10.1177/1753466620968496.

Reference Type: BACKGROUND

PMID: 33121391 (View on PubMed)

Case AH, Beegle S, Hotchkin DL, Kaelin T, Kim HJ, Podolanczuk AJ, Ramaswamy M, Remolina C, Salvatore MM, Tu C, de Andrade JA. Defining the pathway to timely diagnosis and treatment of interstitial lung disease: a US Delphi survey. BMJ Open Respir Res. 2023 Nov 24;10(1):e001594. doi: 10.1136/bmjresp-2022-001594.

Reference Type: BACKGROUND

PMID: 38007235 (View on PubMed)

Other Identifiers

ILD&Cardiac patient

Identifier Type: -

Identifier Source: org_study_id