- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04294849
Exercise Intolerance and Skeletal Muscle Bioenergetics in Children With Deep Venous Thrombosis
November 28, 2023 updated by: Ayesha Zia, University of Texas Southwestern Medical Center
This is a prospective cohort study of 30 patients who are 8-21 years of age with venous thromboembolism (VTE)- either lower extremity deep venous thrombosis (DVT) or pulmonary embolism (PE).
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
Participants will be in three groups- those with lower extremity DVT, those with PE, or those with both lower extremity DVT and PE.
Patients will have blood drawn for thrombin generation assay, thromboelastography assay, and thromboinflammatory panel in addition to standard of care labs for diagnosis of VTE and management of anticoagulation.
The patients will then fill out questionnaires on quality of life and level of exercise at their first outpatient visit 4 weeks after diagnosis.
At approximately 3-6 months after diagnosis, patients will undergo two days of testing for the research study.
All patients will have exercise testing using bicycle ergometry to measure global aerobic fitness.
They will once again fill out questionnaires about their quality of life and level of physical activity.
After a 24 hour rest period, DVT patients will undergo 31P-MR Spectroscopy and non-invasive spin labeling MRI to provide data on skeletal muscle bioenergetics (phosphocreatine metabolism), and lymphatic and venous flow respectively in the affected leg compared to the unaffected leg.
This will allow each patient to be his or her own control.
After these research procedures, patients will continue to receive standard of care treatment for their VTE in the Bleeding and Thrombosis clinic.
Study Type
Interventional
Enrollment (Estimated)
30
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
-
-
Texas
-
Dallas, Texas, United States, 75235
- UT Southwestern Medical Center / Children's Medical Center
-
-
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
8 years to 21 years (Child, Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Age 8- ≤ 21 years old AND
- Lower extremity deep venous thrombosis OR
- Lower extremity deep venous thrombosis AND pulmonary embolism OR
- Pulmonary Embolism
Exclusion Criteria:
- Contraindications to exercise, such as post-surgical patients with cast immobility or fractures
- Patients unable to follow instructions/commands at baseline due to developmental delay
- Patients with congenital heart disease and abnormal pulmonary circulation/perfusion
- Contraindications to undergoing magnetic resonance imaging
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: Basic Science
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Venous Thromboembolism Arm
This will be a cohort of patients age 8- ≤ 21 years old with objectively diagnosed DVT and/or PE.
|
A. Phosphorous 31 MR Spectroscopy to evaluate skeletal muscle metabolism via measurement of depletion and recovery of phosphocreatine (PCr) B. Non-invasive arterial spin labeling MRI to evaluate lymphatic flow velocities and venous flow
To measure peak VO2 as a representation of global aerobic fitness
A. Inflammatory lab panel (IL-6, IL-8, TNF alpha, P-selectin, high sensitivity CRP, IL-6 receptor, TNF R1/R2) drawn at diagnosis B. Thrombin Generation Assay to measure hypercoagulability and Thromboelastography prior to initiating anticoagulation
A. Dalhousie Dyspnea Scale B. Godin Leisure Time Exercise Questionnaire C. Pediatric Venous Quality of Life Questionnaire
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Phosphocreatine Depletion and Recovery
Time Frame: 31P MR Spectroscopy will be performed one time between 3-6 months after diagnosis.
|
Phosphocreatine (PCr) will be measured at baseline, during performance of submaximal exercise to fatigue and then at rest in the 31 P MR Spectroscopy Scan.
|
31P MR Spectroscopy will be performed one time between 3-6 months after diagnosis.
|
Assessment for Venous Occlusion
Time Frame: Arterial Spin labeling MRI will be performed one time between 3-6 months after diagnosis.
|
Arterial spin labeling MRI will be utilized to examine venous flow in bilateral lower extremities to assess for venous occlusion.
|
Arterial Spin labeling MRI will be performed one time between 3-6 months after diagnosis.
|
Assessment of Lymphatic flow
Time Frame: Arterial Spin labeling MRI will be performed one time between 3-6 months after diagnosis
|
Arterial spin labeling MRI will be utilized to assess lymphatic flow in bilateral lower extremities to assess for adequate lymphatic drainage.
|
Arterial Spin labeling MRI will be performed one time between 3-6 months after diagnosis
|
Inflammatory markers
Time Frame: Diagnosis to 4 weeks.
|
A custom blood assay will be used to assess inflammation at the time of the thrombotic event.
Assay will include measurements of IL-6, IL-8, TNF-alpha, CRP, IL-10, IL-6 receptor, TNF alpha receptors.
|
Diagnosis to 4 weeks.
|
Coagulation markers
Time Frame: Diagnosis to 4 weeks.
|
Thrombin generation assay (TGA) will be used to assess hypercoagulability, and thromboelastography will be used to assess fibrinolysis.
These will be drawn at the time of the thrombotic event.
|
Diagnosis to 4 weeks.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Exercise Intolerance
Time Frame: Pulmonary embolism patients will undergo this testing at 4-6 weeks after diagnosis. Deep venous thrombosis only patients will undergo testing at 3 months.
|
Participants will undergo Cardiopulmonary Exercise testing to assess maximal aerobic fitness.
|
Pulmonary embolism patients will undergo this testing at 4-6 weeks after diagnosis. Deep venous thrombosis only patients will undergo testing at 3 months.
|
Godin Leisure Time Activity Questionnaire
Time Frame: Questionnaire to be filled out to assess activity at baseline, then one month after diagnosis, and 3-6 months after diagnosis.
|
Patients will be asked to fill out a questionnaire to determine levels of physical activity for comparison at different time points throughout treatment.
|
Questionnaire to be filled out to assess activity at baseline, then one month after diagnosis, and 3-6 months after diagnosis.
|
Pediatric Venous Quality of Life Questionnaire
Time Frame: Participants will be asked to fill this questionnaires 4 weeks after diagnosis, and 3-6 months after diagnosis.
|
Questionnaire to determine quality of life in various areas including school, leisure time, home, and relationships with peers.
|
Participants will be asked to fill this questionnaires 4 weeks after diagnosis, and 3-6 months after diagnosis.
|
OSA-18 Sleep Apnea Questionnaire
Time Frame: Participants will be asked to fill out this questionnaire at one month post diagnosis.
|
Patients will be asked to complete this questionnaire to assess sleep quality and screen for obstructive sleep apnea.
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Participants will be asked to fill out this questionnaire at one month post diagnosis.
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PHQ-9 Questionnaire
Time Frame: Participants will be asked to fill this questionnaire one month after diagnosis.
|
Participants will fill out this questionnaire to screen for depression.
|
Participants will be asked to fill this questionnaire one month after diagnosis.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Ayesha Zia, MD, University of Texas Southwestern Medical Center
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)
February 6, 2020
Primary Completion (Estimated)
June 30, 2024
Study Completion (Estimated)
June 30, 2024
Study Registration Dates
First Submitted
February 13, 2020
First Submitted That Met QC Criteria
March 2, 2020
First Posted (Actual)
March 4, 2020
Study Record Updates
Last Update Posted (Actual)
November 29, 2023
Last Update Submitted That Met QC Criteria
November 28, 2023
Last Verified
November 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- STU-2019-1406
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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