Pulmonary Embolism in Patients With Acute Heart Failure (PEHF Study)

Recruiting now · Not applicable

Conditions studied: Acute Heart Failure (AHF), Pulmonary Embolism (Diagnosis), Venous Thromboembolism

In brief

This study focuses on two serious and common medical conditions: heart failure and pulmonary embolism (a blood clot in the lungs). Heart failure happens when the heart cannot pump blood effectively, and it is one of the main reasons older adults are admitted to the hospital. Pulmonary embolism can be life-threatening and may worsen heart failure or even trigger it. Doctors believe that pulmonary embolism may often go undetected in patients who come to the hospital with symptoms of acute heart failure, such as sudden shortness of breath. This is because both conditions can cause similar symptoms, making it difficult to tell them apart. As a result, doctors may sometimes assume the symptoms are only due to heart failure and not investigate further for a possible blood clot. However, missing a pulmonary embolism can have serious consequences. Studies suggest that some patients with heart failure who die may actually have had an undiagnosed pulmonary embolism. Current medical guidelines recommend checking for pulmonary embolism when the cause of breathing problems is unclear, but in real-life practice, this is not always done. The goal of this study is to find out whether pulmonary embolism is underdiagnosed in patients with suspected acute heart failure and whether systematically testing for it could improve patient outcomes. To do this, the study will compare two approaches in several hospitals. In half of the hospitals, doctors will follow their usual practice and decide case by case whether to test for pulmonary embolism. In the other half, doctors will systematically test all eligible patients for pulmonary embolism using recommended diagnostic methods. Adult patients admitted with recent or worsening breathing difficulties and signs of acute heart failure may be included in the study, provided they give their consent. Researchers will collect information about their symptoms, tests, diagnosis, and treatments. Patients will be monitored during their hospital stay and for three months afterward. The study will track important outcomes such as survival, new blood clots, bleeding events, repeated hospital visits for breathing problems, and overall time spent in the hospital. The researchers expect to include about 740 patients in total. They estimate that pulmonary embolism may be found in about 1% of patients with usual care, but up to 5% when doctors systematically look for it. This study aims to better understand how often pulmonary embolism occurs in patients with acute heart failure and whether more systematic testing could lead to earlier diagnosis and better care. The results could help improve medical practice and reduce complications or deaths related to missed diagnoses.

Key facts

Study ID: NCT07499661
Run by: University Hospital, Angers
People needed: 740
Starts: 2026-07-15
Expected to finish: 2028-10-01
Last updated by the study team: 2026-07-17

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Adult patient (≥18 years)
Admission to the emergency department or cardiology unit of a participating center
Recent onset or worsening dyspnea and/or orthopnea
Diagnosis of acute heart failure defined by recent dyspnea associated with at least one of the following:
Bilateral pulmonary crackles on auscultation and/or peripheral edema
Signs of pulmonary congestion on chest X-ray or lung/cardiac ultrasound
Elevated natriuretic peptide levels (BNP or NT-proBNP)
Documented history of heart failure (known chronic heart failure or prior hospitalization for acute heart failure)
Patient affiliated with or beneficiary of a social security system
Patient able and willing to provide free, informed, and written consent

You may not qualify if…

Shock state suggesting cardiogenic shock and/or severe pulmonary embolism
Severe respiratory distress at inclusion preventing appropriate positioning or performance of imaging examinations
Evidence of acute coronary syndrome on electrocardiogram at admission
Severe renal impairment (creatinine clearance <30 mL/min)
Known hypersensitivity or allergy to iodinated contrast agents
Ongoing therapeutic anticoagulation for more than 48 hours prior to admission
Hospitalization for more than 48 hours prior to inclusion
Inability to ensure 90-day follow-up (e.g., end-of-life situation, no fixed address, patient not reachable)
Inadequate understanding of the French language preventing proper study information and consent
Pregnant, breastfeeding, or postpartum women
Individuals under legal protection or other vulnerable populations, including minors and protected adults, in accordance with applicable public health regulations (Articles L.1121-5 to L.1121-8 and L.1122-1-2 of the French Public Health Code)

Where it is running

Angers University Hospital, Emergency Department — Angers, France (enrolling)
Brest University Hospital (site Cavale Blanche), Cardiology Department — Brest, France
Tours University Hospital (site Trousseau), Adult Emergency Department — Chambray-lès-Tours, France
Cholet Hospital, Emergency Department — Cholet, France
Clermont-Ferrand University Hospital, Emergency Department — Clermont-Ferrand, France
Grenoble Alpes University Hospital, Adult Emergency Department — La Tronche, France
Lyon University Hospital (site Edouard Herriot), Emergency Department — Lyon, France
Poitiers University Hospital, Emergency Department — Poitiers, France
Agen Hospital, Emergency department — Agen, France
Toulouse University Hospital, Emergency Department — Toulouse, France

Full record on ClinicalTrials.gov

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