- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03176862
Left Ventricular Fibrosis in Chronic Kidney Disease (FibroCKD)
Onset and Functional Consequences of Left Ventricular (LV) Fibrosis in Chronic Kidney
Study Overview
Status
Detailed Description
Aim and objectives:
The primary objective of this study is to test the following hypotheses:
i) Patients with early stage chronic kidney disease (CKD) exhibit diffuse LV fibrosis manifest by prolonged native myocardial T1 times and expansion of the extracellular volume (ECV) measured on MRI with a graded relationship to eGFR (stage of CKD), independent of blood pressure and arterial stiffness.
The secondary research objectives are to test the following hypotheses:
i) Prolonged native myocardial T1 times are associated with impaired diastolic function, altered arterial-ventricular interaction and impaired effort tolerance.
ii) Prolonged T1 times correlate with increases in serum biomarkers of collagen turnover associated with myocardial fibrosis that could be used to risk stratify individuals and enable targeted, personalized clinical care.
iii) Renal transplantation results in a regression of myocardial fibrosis as measured by T1 mapping.
DESIGN:
A cross-sectional analysis of 40 patients in each stage 2-5 CKD will be undertaken. These individuals will only be studied once (at baseline). In addition to this, at least 20 patients will be studied who are about to undergo a kidney transplant. These individuals will be studied at baseline (around the time of surgery), at 6 weeks post-operatively, and then 1 year post-operatively to assess the effect on renal transplantation on myocardial fibrosis.
SUBJECTS:
Patients will be recruited from the clinics run by University Hospitals Birmingham NHS Foundation Trust (UHB) with stages 2, 3, 4 and 5 CKD defined using eGFR calculated with the 4-variable 'Modification of Diet in Renal Disease' (MDRD) equation, with a minimum of two consecutive tests at least 90 days apart. Forty patients will be recruited per group of CKD. All study subjects will undergo a cardiac MRI scan, a cardiopulmonary exercise tests with stress echocardiogram, a 24-hour ECG holter monitor, and blood tests.
CONTROLS:
Forty healthy control subjects and forty hypertensive control subjects will be studied. All patients will undergo the identical research protocol to the CKD subjects, except they will not have a stress echocardiogram or an ECG holter monitor.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Manvir K Hayer, MBChB
- Phone Number: 07812732857
- Email: manvir.hayer@uhb.nhs.uk
Study Contact Backup
- Name: Jonathan N Townend, MD
- Phone Number: 01213712000
Study Locations
-
-
West Midlands
-
Birmingham, West Midlands, United Kingdom, B15 2QT
- Recruiting
- University Hospital Birmingham
-
Contact:
- Jonathan N Townend, MD
- Phone Number: 01213712000
-
Contact:
- Manvir K Hayer, MBChB
- Phone Number: 01213712000
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- >18 years old
- CKD stage 2, 3, 4 and 5
Exclusion Criteria:
- Pregnancy
- Ischaemic heart disease (angina, ACS)
- Cerebral vascular disease
- Peripheral vascular disease
- Renovascular disease
- Diabetes mellitus
- Valvular heart disease (more than mild)
- Established diagnosis of heart failure
- Cannot have an MRI scan
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
CKD
40 patients per group of CKD from stage 2 to stage 5.
|
An MRI scan of the heart
An exercise bicycle test with echocardiogram done during the exercise.
3 stickers attached to a small monitor are worn for 24 hours.
Can be done immediately by the bedside.
20 mls of blood will be taken to measure routine laboratory tests and biomarkers of fibrosis.
|
Kidney transplant recipients
20 live-donor recipients will be studied pre-operatively and then followed up at 6 weeks and 1 years post-operatively.
|
An MRI scan of the heart
3 stickers attached to a small monitor are worn for 24 hours.
Can be done immediately by the bedside.
20 mls of blood will be taken to measure routine laboratory tests and biomarkers of fibrosis.
An exercise bicycle test.
No stress echocardiogram.
|
Controls
40 healthy controls and 40 hypertensive controls.
|
An MRI scan of the heart
An exercise bicycle test with echocardiogram done during the exercise.
Can be done immediately by the bedside.
20 mls of blood will be taken to measure routine laboratory tests and biomarkers of fibrosis.
An exercise bicycle test.
No stress echocardiogram.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The effect of eGFR on heart muscle scarring (measured from cardiac MRI using T1 times).
Time Frame: One baseline visit only
|
eGFR is a measurement of kidney function.
Heart muscle scarring levels can be derived from cardiac MRI using a technique called T1 mapping.
T1 maps of the heart will be acquired using cardiac MRI.
eGFR will be measured from a blood tests, using the MDRD equation.
The relationship between the measured T1 times and eGFR will be analysed using statistical tests.
|
One baseline visit only
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The relationship between prolonged myocardial T1 and diastolic function.
Time Frame: One baseline visit only
|
The following diastolic function parameters will be measured on echocardiography: E/A, deceleration time and E/e'.
|
One baseline visit only
|
The relationship between prolonged myocardial T1 and effort tolerance.
Time Frame: One baseline visit only
|
The percent predicted peak oxygen uptake during exercise testing will be used as a surrogate marker of effort tolerance.
|
One baseline visit only
|
The effect of renal transplantation on myocardial fibrosis.
Time Frame: Baseline visit (pre-operation), then follow up at 6 weeks and 1 year.
|
Myocardial T1 times (cardiac MRI) and eGFR (blood testing) will best measured.
|
Baseline visit (pre-operation), then follow up at 6 weeks and 1 year.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Nicola C Edwards, PhD, University Hospital Birmingham NHS Foundation Trust
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UHB
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Myocardial Fibrosis
-
Virginia Commonwealth UniversityWake Forest UniversityRecruitingMyocardial Fibrosis | Myocardial Injury | Chemotherapeutic ToxicityUnited States
-
Johns Hopkins UniversityGuerbetNot yet recruitingMyocardial FibrosisUnited States
-
Medical University of ViennaUnknown
-
Cell Therapy Ltd.Royal Brompton & Harefield NHS Foundation TrustUnknownMyocardial Fibrosis
-
Assistance Publique Hopitaux De MarseilleCompleted
-
Chang Gung Memorial HospitalCompletedFibrosis Myocardial
-
University of EdinburghActive, not recruiting
-
Nanjing First Hospital, Nanjing Medical UniversityRecruiting
-
Shanghai Zhongshan HospitalBeijing Continent Pharmaceutical Co, Ltd.Active, not recruitingMyocardial FibrosisChina
-
University of MessinaNatasha Irrera; Gianluca Di Bella; Antonio Micari; Roberto LicordariRecruitingMyocardial Infarction | Myocardial Fibrosis | Myocardial Remodeling, VentricularItaly
Clinical Trials on cardiac magnetic resonance scan
-
University Hospital, BonnRecruitingEpilepsy | CardiomyopathiesGermany
-
University Hospital, BonnRecruitingCardiomyopathies | Hypertension, PortalGermany
-
University Hospital, BonnCompleted
-
University Hospital, BonnRecruitingCardiomyopathies | Acute Kidney Injury | Cardio-Renal SyndromeGermany
-
Massachusetts General HospitalWithdrawn
-
University Hospital Southampton NHS Foundation...CompletedHeart Failure With Reduced Ejection FractionUnited Kingdom
-
IRCCS San RaffaeleCompletedLeft Ventricular Diastolic DysfunctionItaly
-
Assiut UniversityActive, not recruiting
-
Antonio EspositoMinistry of Health, ItalyUnknownMyocardial Inflammation | Myocarditis AcuteItaly
-
Alejandro Rodriguez Oviedo , MDTerminatedMyocardial Ischemia | Pneumonia, PneumococcalSpain