Analysis of Myocardial Layer Specific Systolic and Diastolic Function During and After PCI (PCI-Strain)
Comprehensive Analysis of Myocardial Layer Specific Systolic and Diastolic Function in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PART 1: ANALYSIS OF LAYER SPECIFIC SYSTOLIC AND DIASTOLIC FUNCTION DURING ACUTE ISCHEMIA INDUCED BY PERCUTANEOUS CORONARY INTERVENTION 35 patients with normal systolic left ventricular function at baseline with indication for elective percutaneous coronary angioplasty will be included in the study. In these patients acute ischemia will be induced by elective percutaneous coronary angioplasty with balloon inflation and thus vessel occlusion for 60 sec. During these 60 seconds ischemia will develop throughout all layers of the myocardium affecting diastolic systolic and diastolic function. During the subsequent reperfusion period signs of ischemia with systolic and diastolic dysfunction of all layers will subside. Echocardiographic imaging at short intervals of 10 sec during ischemia and at intervals of 20 sec during reperfusion up to 10 min after reopening of the vessel as well as 1 hour and 24 hours later will allow serial comparison of strain curves and thereby allow definition of the time sequence systolic and diastolic function abnormalities occur in three myocardial layers as well as the resolution of abnormalities during reperfusion. The analysis of circumferential as well as radial strain will allow definition of differences between radial and circumferential strain during ischemia induction and resolution.
PART 2: ANALYSIS OF LOCAL WORK INDEX DURING ACUTE ISCHEMIA INDUCED BY PERCUTANEOUS CORONARY INTERVENTION.
In the same 35 patients as in Clinical step 1 the local work index of the ischemic area as well as the contralateral non-ischemic areas will be determined in serial studies to determine the onset of abnormality, the amount of abnormality and the resolution of abnormality. Changes in local work index in the ischemic area will be related to changes in peak systolic strain and strain imaging diastolic index.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
NRW
-
Aachen, NRW, Germany, 52074
- University Hospital Aachen
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Signed informed consent.
- Adequate quality of echocardiographic images.
- Significant stenosis of the proximal left anterior descending artery, the right coronary artery or the left circumflex artery
- Anginal pain or proven myocardial ischemia due to the coronary stenosis
- Elective percutaneous coronary intervention planned
- Planned direct stenting of the coronary artery
Exclusion Criteria:
- Prior myocardial infarction
- Significant coronary collaterals
- Significant valvular regurgitation (>Sellers II)
- Congestive heart failure
- Pacemaker dependency
- Bundle branch block or significant arrhythmia
- Atrial fibrillation
- Previous coronary bypass grafting
- Impaired kidney function corresponding to a GFR(Glomerular filtration rate) below 60 mL/min.
- Women, who are pregnant or breastfeeding.
- Patient taking part in another clinical study
- Subjects who are committed to an institution and/or penitentiary by judicial or official order.
- Complex coronary lesion requiring balloon angioplasty or rotational atherectomy prior to stenting
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Percutaneous Coronary Intervention
Each patient will get elective percutaneous coronary angioplasty with balloon inflation(PCI).
During and after PCI 2D-echography (strain) will be performed.
|
Percutaneous coronary intervention is performed according to standard practice.
Direct stenting is required for the procedure as it is done in most coronary interventions today.
After insertion of the non-inflated stent into the coronary lesion there should still be flow to the distal vessel.
The stent should be implanted at high-pressure with balloon inflation lasting for 60 seconds to allow adequate expansion of the stent.
Post-dilatation should be performed if required.
However, this should be done more than 5 minutes after stent implantation.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
systolic and diastolic function
Time Frame: during 60 seconds ischemia caused by PCI
|
Echocardiographic imaging at short intervals of 10 sec during ischemia, which will be induced by elective percutaneous coronary angioplasty with balloon inflation and thus vessel occlusion for 60 sec.
|
during 60 seconds ischemia caused by PCI
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
systolic and diastolic function
Time Frame: during 10 minutes, after 1 hour and after 24 hours after PCI
|
Echocardiographic imaging of layer specific systolic and diastolic function at intervals of 20 sec during reperfusion up to 10 min after reopening of the vessel as well 1 hour and 24 hours after percutaneous coronary intervention.
|
during 10 minutes, after 1 hour and after 24 hours after PCI
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Rainer Hoffmann, Prof.Dr., RWTH Aachen University Hospital
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 10-091
- 032/10 (Other Identifier: Ethics)
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