- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03280433
Influence of EPICardial Adipose Tissue in HEART Diseases: EPICHEART Study (EPICHEART)
Association of the Volume and Proteome of Epicardial Adipose Tissue With Coronary Artery Disease, Left Atrial Remodelling and Atrial Fibrillation in Severe Aortic Stenosis Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background: EAT has emerged as a new independent, and, potentially, modifiable cardiovascular risk factor for CAD. EAT volume assessed by computed tomography (CT) was independently associated with the presence of coronary stenosis, coronary calcification and myocardial ischemia in cross-sectional studies, and, prospectively, with major adverse cardiovascular events. Most of these clinical studies were, however, derived from community-based patients with low-to intermediate-risk profile and the role of EAT in high-risk patients is currently unclear. Accumulation of EAT has been also associated with left atrial (LA) dilation, presence, chronicity, and recurrence of atrial fibrillation (AF). Although there is evidence suggesting that EAT may be a major determinant of the LA vulnerable substrate of AF, the mechanisms in the causal pathway between the EAT and LA remodeling are not completely elucidated.
Aims: The main aims are to investigate if the volume of the EAT on CT and EAT proteome assessed by SWATH-mass spectrometry are associated with extent, distribution and complexity of coronary stenosis and coronary artery calcification, left atrial strain and incidence of postoperative atrial fibrillation in patients with symptomatic severe aortic stenosis.
Methods: This a prospective study enrolling symptomatic severe aortic stenosis patients referred to aortic valve replacement. The protocol includes preoperative detailed clinical and nutritional evaluations, echocardiography, CT, cardiac magnetic resonance imaging and invasive coronary angiography. During cardiac surgery, biopsies from the EAT, mediastinal and subcutaneous thoracic adipose tissues will be performed to undergo analysis of proteome using SWAT-mass spectrometry. Samples from the pericardial fluid, circulating and coronary sinus blood samples will be collected as well in order to find local and peripheral adipose tissue-derived biomarkers of the disease.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Jennifer Mancio, MD, PhD candidate
- Phone Number: 00351961529516
- Email: jennifer.mancio@cardiov.ox.ac.uk
Study Contact Backup
- Name: Nuno Bettencourt, MD, PhD
- Phone Number: 00351934258281
- Email: bettencourt.n@gmail.com
Study Locations
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-
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Porto, Portugal, 4200-319
- Enrolling by invitation
- Faculty of Medicine of Porto
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Porto
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Vila Nova de Gaia, Porto, Portugal, 4430-502
- Recruiting
- Centro Hospitalar de Vila Nova de Gaia/Espinho
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Contact:
- Jennifer Mancio, MD, PhD candidate
- Phone Number: 00351 961529516
- Email: jennifer.mancio@cardiov.ox.ac.uk
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Contact:
- Nuno Bettencourt, MD, PhD
- Phone Number: 00351 934258281
- Email: bettencourt.n@gmail.com
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Sub-Investigator:
- Vasco Gama Ribeiro, MD
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Sub-Investigator:
- Luis Vouga, MD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- symptomatic severe aortic stenosis patients (defined as aortic valve area of < 1 cm2 or 0.6 cm2/m2 by transthoracic echocardiography) referred to aortic valve replacement.
Exclusion Criteria:
- diagnosis of acute coronary syndrome in the last 3 months.
- prior history of persistent or permanent atrial or flutter fibrillation.
- coexisting moderate to severe aortic valve regurgitation or moderate to severe mitral valve disease, bicuspid aortic valve.
- left ventricular dilatation [end-diastolic volume index >75 mL/m²].
- left ventricular ejection fraction <55%.
- chronic renal failure stage 3 to 5 defined as glomerular filtration rate GFR estimated by Cockcroft-Gault formula adjusted for body surface area < 30 mL/min/1.73m².
- moderate to severe chronic obstructive pulmonary disease defined as forced expiratory volume in one second <50% according to the 2011 Global Initiative for Chronic Obstructive Pulmonary Disease guidelines.
- active malignancy (i.e. With no evidence of recurrence and no longer receiving active treatment).
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
New onset atrial fibrillation
Time Frame: Intra-hospital (i.e. from surgery until hospital discharge which means 7 days on average)
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Incidence of atrial fibrillation after aortic valve replacement
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Intra-hospital (i.e. from surgery until hospital discharge which means 7 days on average)
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Left atrial remodelling by transthoracic echocardiography and magnetic resonance imaging
Time Frame: 6-month following aortic valve replacement
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Change in left atrial strain and volumes
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6-month following aortic valve replacement
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Frailty syndrome according to Fried et al. scale
Time Frame: 6-month following aortic valve replacement
|
Change in frailty syndrome classification
|
6-month following aortic valve replacement
|
Coronary artery disease according to the presence of coronary stenosis and/or calcification
Time Frame: Baseline
|
Prevalent coronary artery stenosis and coronary calcification
|
Baseline
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Left ventricular hypertrophy by transthoracic echocardiography and magnetic resonance imaging
Time Frame: 6-month following aortic valve replacement
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Regression of left ventricular mass after aortic valve replacement
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6-month following aortic valve replacement
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Right ventricular structure and function by transthoracic echocardiography and magnetic resonance imaging
Time Frame: 6-month following aortic valve replacement
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Changes in right ventricular structure and function after aortic valve replacement
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6-month following aortic valve replacement
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mortality
Time Frame: 3- to 5-year after aortic valve replacement
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Incidence of all-cause death after aortic valve replacement
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3- to 5-year after aortic valve replacement
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Collaborators and Investigators
Collaborators
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
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
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Arterial Occlusive Diseases
- Pathological Conditions, Anatomical
- Arrhythmias, Cardiac
- Aortic Valve Disease
- Heart Valve Diseases
- Ventricular Outflow Obstruction
- Coronary Artery Disease
- Myocardial Ischemia
- Coronary Disease
- Atrial Fibrillation
- Aortic Valve Stenosis
- Arteriosclerosis
- Constriction, Pathologic
Other Study ID Numbers
- SFRH/BD/104369/2014
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.
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