Cardiac Assessment by PV Loop in IPAH and Scleroderma PAH (CALIPSO)

Understanding Right Ventricular Heart Failure in Scleroderma and Idiopathic Pulmonary Arterial Hypertension

This observational study is being done to understand why people with scleroderma can develop pulmonary arterial hypertension (high blood pressure in the lungs, abbreviated PAH) and a weak heart muscle (heart failure). The study will also help the investigators understand why people with PAH from an unknown cause (called idiopathic PAH, or IPAH) can also develop a weakened heart muscle. The response of the right side of the heart or right ventricle (RV) to standard PAH therapy in scleroderma-associated PAH and in IPAH will be assessed. Blood and tissue samples will be collected from research participants during participants' normal standard of care procedures. People with scleroderma-associated PAH or idiopathic cause (IPAH) who need a right heart catheterization may join this study.

Study Overview

• Status: Completed
• Conditions: Pulmonary Artery Hypertension; Scleroderma

Detailed Description

Patients with scleroderma associated pulmonary hypertension (with or without interstitial lung disease) have a worse prognosis compared to patients with idiopathic pulmonary arterial hypertension (IPAH). The investigators have discovered through a previous protocol that patients with scleroderma associated pulmonary hypertension (SSc-PAH) have intrinsic right ventricular (RV) contractile dysfunction compared with patients with idiopathic pulmonary hypertension (IPAH) despite similar afterload imposed by the pulmonary vasculature. Patients with scleroderma or presumed/known IPAH who are clinically referred for right heart catheterization (RHC) will undergo, in addition to a clinically indicated RHC, state-of-the-art Pressure-Volume (P/V) Loop Assessment and RV biopsy for research purposes. The investigators will also do a standard pathologic assessment of the RV tissue (H&E, special staining, electron microscopy), microvascular density measurements using immunohistochemistry techniques and isolated skinned myocyte experiments. Additional experiments will include proteomics, genomics/genetics, and RV protein and microRNA expression. The investigators will compare these findings in both groups (IPAH and SSc-PAH), before and after standard treatment for 6 months, in order to fully understand the differences in how the RV adapts to pressure overload and reasons for impaired RV function in SSc-PAH as well as identifying potential therapeutic targets.

• Study Type: Observational
• Enrollment (Actual): 43

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients 18 years or older with clinically diagnosed scleroderma or presumed/known idiopathic pulmonary hypertension.

Description

Inclusion Criteria:

• Patients 18 years or older with clinically diagnosed scleroderma or presumed/known idiopathic pulmonary hypertension.

Exclusion Criteria:

• Patients found to have secondary pulmonary hypertension (PH due to left heart failure) on clinical RHC.
• Hemodynamically unstable patients (systolic blood pressure < 90mmHg, vasopressor requirement).
• Patients whom are unable to give consent for themselves.
• Patients with RV clot or septal aneurysm will be excluded.
• In order to undergo the clinical right heart catheterization procedures, pregnancy testing (urine or serum) is standard of care.
• Pregnancy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
SSc-PAH Group; Scleroderma patients referred for a clinically indicated right heart catheterization (RHC).
IPAH Group; Presumed/known IPAH patients referred for a clinically indicated right heart catheterization (RHC).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Right Ventricular Function as assessed by RHC	Assessed on the clinical RHC as normal, moderately reduced, or severely reduced.	Baseline
Change in pulmonary vascular resistance	Assessed as improved or decreased after 6 months by comparing the change in pulmonary vascular resistance in Wood units on the clinical RHC.	Baseline and 6months
Change in arterial elastance	Assessed as improved or decreased after 6 months by comparing the change in arterial elastance in pressure volume (PV) loops.	Baseline and 6 months
Change in myofilament contractility	Assessed as Normal or Abnormal after studying the collected samples in lab. Abnormal can be either reduced or increased; i.e. hyper- or hypo-contractile.	up to 4 years
Change in calcium sensitivity	Assessed as either increased- or decreased- sensitivity after 6 months, by studying the collected samples in lab.	up to 4 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of genes expressed	Gene expression as assessed by observing presence of microRNA in the lab.	up to 4 years
Number of proteins expressed	Protein expression as assessed by observing post-translational modification of candidate proteins in the lab.	up to 4 years

Collaborators and Investigators

• Sponsor: Johns Hopkins University
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI)
• Investigators: Principal Investigator: Paul Hassoun, MD, Johns Hopkins University

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2019
• Primary Completion (Actual): December 31, 2025
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: October 26, 2020
• First Submitted That Met QC Criteria: October 26, 2020
• First Posted (Actual): November 2, 2020

Study Record Updates

• Last Update Posted (Actual): January 9, 2026
• Last Update Submitted That Met QC Criteria: January 8, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Connective Tissue Diseases; Respiratory Tract Diseases; Lung Diseases; Skin Diseases; Hypertension, Pulmonary; Skin and Connective Tissue Diseases; Scleroderma, Systemic; Scleroderma, Diffuse; Familial Primary Pulmonary Hypertension
• Other Study ID Numbers: NA_00049022; R01HL114910-06 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No