Portosystemic Shunt-associated Pulmonary Hypertension Multi-center Prospective Cohort Study
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Zhihong Liu, MD, PhD
- Phone Number: +86 13269276067
- Email: zhihongliufuwai@163.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age ≥ 18 years.
- Diagnosis of Portosystemic Shunts:Imaging evidence suggestive of portosystemic shunts (congenital or acquired) or unequivocal clinical signs of portal hypertension (e.g., splenomegaly, varices).
Diagnosis of Pulmonary Hypertension (PH):
- Confirmed by Right Heart Catheterization (RHC): mPAP > 20 mmHg; OR
- Highly suspected by Echocardiography: Peak TRV > 3.4 m/s or compliant with ESC/ERS guidelines for high probability of PH (Note: RHC is encouraged for all enrolled patients).
- Signed informed consent and willingness to strictly adhere to the follow-up schedule.
Exclusion Criteria:
- PH caused by other reasons
- Hepatocellular carcinoma (HCC) exceeding the Milan criteria.
- Active extrahepatic malignancy.
- Transjugular intrahepatic portosystemic shunt (TIPS) placement within the previous month.
- Pregnancy or lactation.
- Participation in other interventional clinical trials (drug or device) within the last 3 months.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
|---|
|
Portosystemic shunt-associated pulmonary hypertension
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Clinical worsening
Time Frame: Up to 24 months
|
The rate of clinical worsening during the follow-up period, which is a composite endpoint comprising all-cause death, decline in exercise capacity [defined as a ≥15% reduction in 6-minute walk distance (6MWD) compared with baseline], deterioration in World Health Organization (WHO) functional class, and non-elective hospitalizations for pulmonary hypertension (due to worsening heart failure or initiation of parenteral prostanoids).
|
Up to 24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline in model for End-Stage Liver Disease (MELD) score
Time Frame: Baseline, Month 12, and Month 24
|
The MELD score is a reliable measure of mortality risk in patients with end-stage liver disease, calculated using serum bilirubin, serum creatinine, and the international normalized ratio (INR).
The total score ranges from 6 to 40.
Higher scores indicate more severe hepatic impairment and worse prognosis in patients with portosystemic shunt-associated pulmonary hypertension.
The change in MELD score from baseline will be evaluated at each specified follow-up visit.
|
Baseline, Month 12, and Month 24
|
|
Change from baseline in Child-Pugh Score
Time Frame: Baseline, Month 12, and Month 24
|
The Child-Pugh score assesses the severity and prognosis of chronic liver disease based on five clinical measures: total bilirubin, serum albumin, prothrombin time (INR), ascites, and hepatic encephalopathy.
The total score ranges from 5 to 15, where 5-6 indicates Class A (well-compensated), 7-9 indicates Class B (significant functional compromise), and 10-15 indicates Class C (decompensated).
Higher scores represent worse liver function.
The change in the total Child-Pugh score from baseline will be reported.
|
Baseline, Month 12, and Month 24
|
|
Listing for or receipt of liver transplant or lung transplant
Time Frame: Up to 24 months
|
This measure assesses the time elapsed from study enrollment to the first documented occurrence of a transplant-related event due to the progression of portosystemic shunt-associated pulmonary hypertension.
A transplant-related event is strictly defined as either being officially placed on an active waiting list for a liver or lung transplant, or the actual surgical receipt of a liver or lung transplant.
The time to whichever event occurs first will be recorded.
|
Up to 24 months
|
|
Initiation or escalation of oral pulmonary hypertension (PH)-targeted therapy
Time Frame: Up to 24 months
|
This measure assesses the time elapsed from study enrollment to the first documented initiation or escalation of oral targeted therapy for portosystemic shunt-associated pulmonary hypertension.
"Initiation or escalation" is strictly defined as the sequential addition of a new class of oral PH-targeted medication.
This encompasses the clinical transition from no PH therapy to oral monotherapy, from monotherapy to double combination therapy, or from double to triple combination therapy.
Dose increases of pre-existing oral medications are excluded from this definition.
|
Up to 24 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
- PROSPECT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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