- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04019613
Assessment of Pulmonary Congestion During Cardiac Hemodynamic Stress Testing
June 29, 2022 updated by: Brandon M. Wiley, M.D., Mayo Clinic
The aim of this study is to utilize lung ultrasound to detect the development of extravascular lung water in patients undergoing clinically indicated invasive hemodynamic exercise stress testing for symptomatic shortness of breath.
The study will correlate the lung ultrasound findings with cardiac hemodynamics and measurements of extravascular lung water in an effort to better understand the pathophysiology of exertional dyspnea.
Study Overview
Status
Terminated
Intervention / Treatment
Detailed Description
Exercise induced elevation of left ventricular (LV) filling pressures can be the source of chronic dyspnea.
Ultimately, high LV filling pressure leads to the development of extravascular lung water (EVLW) which can cause symptoms of dyspnea.
Lung ultrasound (LUS) is a highly feasible, non-invasive procedure that is extremely sensitive for detecting EVLW.
The sonographic signature of EVLW is a reverberation artifact called a "B-Line".
The study will evaluate the etiology of sonographic B-Lines using invasive hemodynamic catheterization while simultaneously measuring the amount of EVLW present during exercise stress testing using transpulmonary thermodilution.
The study aim is to demonstrate that the severity of EVLW, assessed by number of B-Lines, will correlate with LV filling pressures.
In addition, the study will test the hypothesis that patients demonstrating dynamic increases in sonographic B-Lines with exercise will also display more severe symptoms of dyspnea, altered ventilatory mechanics (higher ratio of minute ventilation to carbon dioxide production (VE/VCO2)), and reduced aerobic capacity (lower peak oxygen consumption (VO2)).
Study Type
Interventional
Enrollment (Actual)
4
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Minnesota
-
Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- All adult patients (≥18 years) who are referred for invasive cardiac hemodynamic assessment
- Patients who have the capacity to understand and consent for the research study
Exclusion Criteria:
- Patients with known interstitial lung disease or pulmonary fibrosis
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Subjects undergoing clinical invasive hemodynamic stress test
Subjects scheduled for standard-of-care, clinically indicated, invasive hemodynamic stress test will undergo lung ultrasound and assessment of extravascular lung water by pulmonary thermodilution technique.
|
Lung ultrasound will be performed at baseline (resting), prior to exercise with passive leg elevation, after 1.5 minutes of 20 Watts exercise, during each subsequent stage, at peak workload and at 1 minute recovery.
Pulmonary thermodilution will be performed at rest, peak stress and at 1 minute recovery.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlation of the Number of Lung Ultrasound B-Lines With Intra-cardiac Filling Pressures
Time Frame: Lung ultrasound imaging for B-Lines and assessment of intracardiac hemodynamics will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Lung ultrasound will be performed during invasive stress testing.
The number of B-lines visible during stress testing will be correlated with synchronous measurements of intra-cardiac filling pressures .
|
Lung ultrasound imaging for B-Lines and assessment of intracardiac hemodynamics will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlation of the Number of Lung Ultrasound B-Lines With Ventilatory Mechanics.
Time Frame: Lung ultrasound imaging and assessment of ventilatory mechanics (using analysis of expired gas) will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Lung ultrasound will be performed during invasive stress testing.
The number of B-lines visible during stress testing will be correlated with synchronous measurements ventilatory mechanic parameters measured using expiratory gas.
|
Lung ultrasound imaging and assessment of ventilatory mechanics (using analysis of expired gas) will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Correlation of the Number of Lung Ultrasound B-Lines Developed During Invasive Stress Testing With Measurement of Extravascular Lung Water.
Time Frame: Lung ultrasound imaging and assessment of the amount of extravascular lung water using transpulmonary thermodilution will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Lung ultrasound will be performed during invasive stress testing.
The number of B-lines visible during stress testing will be correlated with synchronous measurements extravascular lung water using transpulmonary thermodilution.
|
Lung ultrasound imaging and assessment of the amount of extravascular lung water using transpulmonary thermodilution will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Lung Ultrasound B-Lines Developed During Invasive Stress and the Calculated Amount of Extravascular Lung Water Will be Correlated With Changes in the Levels of Serum Protein, Hemoglobin and Brain Natriuretic Peptide Levels.
Time Frame: Serum biomarkers, lung ultrasound and assessment of extravascular lung water will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Lung ultrasound will be performed during invasive stress testing.
The number of B-lines visible during stress testing will be correlated with synchronous measurements extravascular lung water using transpulmonary thermodilution.
In addition, serum levels of hemoglobin, protein and brain natriuretic peptide will be collected, synchronously, during the stress test.
|
Serum biomarkers, lung ultrasound and assessment of extravascular lung water will be performed during the scheduled invasive stress test (initial visit, day #1).
|
Correlation of the Number of Lung Ultrasound B-Lines Developed During Invasive Stress Testing With Clinical Outcomes.
Time Frame: 24 months post-stress test.
|
Lung ultrasound will be performed during invasive stress testing.
The number of B-lines visible during stress testing will be correlated with patient clinical outcomes defined as a composite outcome of hospital readmission, non-fatal myocardial infarction, or cardiovascular death.
|
24 months post-stress test.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
November 8, 2019
Primary Completion (ACTUAL)
December 19, 2019
Study Completion (ACTUAL)
December 19, 2019
Study Registration Dates
First Submitted
June 28, 2019
First Submitted That Met QC Criteria
July 12, 2019
First Posted (ACTUAL)
July 15, 2019
Study Record Updates
Last Update Posted (ACTUAL)
July 20, 2022
Last Update Submitted That Met QC Criteria
June 29, 2022
Last Verified
June 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 19-002499
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
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 Dyspnea
-
Assistance Publique - Hôpitaux de ParisRecruitingDyspnea Invasive Mechanical Ventilation-associatedFrance
-
Mayo ClinicCompletedShortness of Breath | Cardiac; DyspneaUnited States
-
Qure Healthcare, LLCJohnson & Johnson Pharmaceutical Research & Development, L.L.C.CompletedDyspnea | Unexplained Chronic DyspneaUnited States
-
Assistance Publique - Hôpitaux de ParisCompletedRelationship Between Dyspnea and Ventilatory VariabilityFrance
-
University of MonastirCompleted
-
University of California, Los AngelesNot yet recruitingShortness of Breath/Dyspnea
-
Assistance Publique - Hôpitaux de ParisRecruitingDyspnea and Respiratory Insufficiency in ChildrenFrance
-
Medical University of ViennaRecruitingEchocardiography | Acute DyspneaAustria
-
Intersection Medical, Inc.CompletedPulmonary Congestion | Dyspnea, | Acute Heart Failure SyndromeUnited States
-
University of CologneTeva Branded Pharmaceutical Products R&D, Inc.CompletedCancer | Dyspnea, ParoxysmalGermany
Clinical Trials on Lung ultrasound
-
Kasr El Aini HospitalCompletedExta Vascular Lung WaterEgypt
-
Yale UniversityCompletedPneumonia | Pulmonary Edema | DyspneaUnited States
-
Assiut UniversityCompleted
-
University of MilanCompletedLung Cancer | Community Acquired Pneumonia | Pulmonary Embolism | PleuritisItaly
-
Groupe Hospitalier Paris Saint JosephHopital ForcillesActive, not recruitingCOVID-19 | Weaning Failure | ICU Acquired WeaknessFrance
-
Xiangtan Central HospitalActive, not recruitingHeart Failure | Lung UltrasoundChina
-
Cliniques universitaires Saint-Luc- Université...RecruitingInterstitial Lung DiseaseBelgium
-
Phoenix Children's HospitalChildren's Hospital Los Angeles; Baylor Scott and White Health; St. Joseph's... and other collaboratorsEnrolling by invitationBronchopulmonary DysplasiaUnited States
-
Fundació Institut de Recerca de l'Hospital de la...Hospital Vall d'Hebron; Institut Hospital del Mar d'Investigacions MédiquesCompletedHeart Failure | Acute Myocardial InfarctionSpain
-
Centre Hospitalier Universitaire, AmiensCentre Hospitalier de Beauvais; Centre Hospitalier de Clermont; Centre Hospitalier... and other collaboratorsCompleted