Stress Induced Right Ventricular Uptake on Lexiscan Stress MPI (RVuptakeLexi)
Diagnostic and Prognostic Value of the Stress Induced Right Ventricular Uptake on Lexiscan Stress MPI in Patients With Known or Suspected Coronary Artery Disease (CAD).
The objectives of this study are to determine the:
- Diagnostic value of stress induced RV changes on Lexiscan stress MPI as compared to Exercise stress MPI in predicting a significant CAD.
- Prognostic value of stress induced RV changes on Lexiscan stress MPI in predicting adverse short-term and long-term clinical outcomes after the index test.
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Phase 1: Retrospective data collection/analysis All Lexiscan and exercise MPI images on patients performed for clinical indications in calendar year 2010 who had subsequent coronary angiogram within 3 months after index MPI will be retrieved for review by two experts. We will identify different types of RV uptake and RV overload during stress as well as presence or absence of these changes on resting images. Analysis will include increased RV uptake, enlargement, hypertrophy, thinning of RV and flattening of the interventricular septum. Diagnostic performance (sensitivity, specificity and diagnostic accuracy) of the identified pathological RV phenotypes in identifying severe and extensive disease will be evaluated by comparison with contrary angiograms. Comparison of the set of parameters identifying pathological RV changes, identifying normal and abnormal values of these novel ancillary markers, as well as assessing their diagnostic accuracy in patients with suspected and known CAD during vasodilator stress versus exercise stress MPI will be done.
Phase 2: Prospective data validation Patients referred for the Lexiscan stress MPI will be followed prospectively after obtaining an informed consent. All comers after June 1 2012 will be included. Prediction of coronary artery disease will be performed by applying the previously derived pathological RV criteria on the prospective stress MPIs. 2D-Echocardiogram will be performed for all the patients who do not have an Echocardiogram performed for clinical indication within 1 month of their index Lexiscan stress MPI. We will also include 100 patients referred for the exercise stress MPI who will serve as controls.
All patients will be prospectively followed up for a total of 12 months for the following prognostic end points:
- Hard cardiac events (cardiac death or MI);
- Total (all-cause) mortality;
- Cardiovascular hospitalization rate. Cardiac death (CD) will be defined as death attributable to any cardiac cause (eg, lethal arrhythmia, myocardial infarction [MI], or pump failure) as confirmed by review of death certificate and medical records.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Contacts and Locations
Study Locations
-
-
Arizona
-
Tucson, Arizona, United States, 85724
- University of Arizona Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Retrospective population (approximately 300 charts to be reviewed)
- Patients with MPI and 2D Echocardiogram within one month of the stress testing in calendar year 2010 at University Medical Center, Tucson AZ.
- 18 years or older
Prospective population (approximately 350 subjects to be recruited)
- Patients scheduled for MPI at University Medical Center, Tucson AZ, and invited to participate in this study.
- 18 years to 89 years old
Description
Inclusion Criteria:
Retrospective population (approximately 300 charts to be reviewed)
- Patients with MPI and 2D Echocardiogram within one month of the stress testing in calendar year 2010 at University Medical Center, Tucson AZ.
- 18 years or older.
Prospective population (approximately 350 subjects to be recruited)
- Patients scheduled for MPI at University Medical Center, Tucson AZ.
- 18 years to 89 years old
Exclusion Criteria (applied to both retrospective and prospective arms):
- patients with nondiagnostic or technically defective MPI
- incomplete clinical data
- severe valvular heart disease
- complex congenital heart disease
- life expectancy less than one year at the time of the index MPI
- unable to follow up (absence of permanent address)
- Known prisoners, pregnant women and cognitively impaired patients.
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
|---|
|
Lexiscan-Echo echo subjects
No Intervention: Observational study
|
|
Lexiscan-Echo control subjects
No intervention: observational study
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hard cardiac events (cardiac death or MI)
Time Frame: within 1 year after the index test
|
Patient follow-up evaluated for hard cardiac events (cardiac death or MI)in the year post index test determined by telephone interviews or review of medical records
|
within 1 year after the index test
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Total (all-cause) mortality
Time Frame: within 1 year after the index test
|
Total (all-cause) mortality in the year post index test determined by telephone interviews or review of medical records
|
within 1 year after the index test
|
|
Cardiovascular hospitalization rate
Time Frame: within 1 year after the index test
|
Cardiovascular hospitalization rate in the year post index test determined by telephone interviews or review of medical records
|
within 1 year after the index test
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Aiden Abidov, MD, University of Arizona
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- REGA-11J08
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