- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06253104
Changes in Skeletal Muscle Thickness in Patients With Acute Heart Failure
Study Overview
Status
Intervention / Treatment
Detailed Description
The investigators will be recruiting subjects with advanced cardiomyopathy in cardiogenic shock in the inpatient setting. This is an observational study to better understand changes in lean body mass during critical illness through a quick, safe, and non-invasive method. This study will also validate the use of the BodyMetrix BX 2000 Pro ultrasound machine for the assessment of body composition, particularly muscle wasting, in the cardiogenic shock population.
The ultrasound device received 501(k) designation from the FDA in 2009 for measurement of localized fat and muscle thickness. Baseline US muscle thickness assessments will occur at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (discharge or death). Each measurement session will take about 20-30 minutes.The investigators will take measurements at two sites: the lateral thigh and bicep (participant's dominant side). Clear ultrasound gel will be applied to the skin and the ultrasound probe placed against the skin, and the muscle thickness measurement made five times at each position.
The US images are read after a study visit completion, with measurements taken at pre-specified anatomic landmarks to obtain the muscle thickness, which is averaged accross the duplicate measurements. The primary endpoints are: Percentage change in skeletal muscle thickness from admission to nadir; Percentage change in skeletal muscle thickness after advanced therapies; and the Relationship between muscle mass loss during cardiogenic shock and subsequent clinical outcomes.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Amanda R Vest, MBBS
- Phone Number: 617-636-8068
- Email: avest@tuftsmedicalcenter.org
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02111
- Recruiting
- Tufts Medical Center
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Contact:
- Olivia Lovegreen
- Phone Number: 617-636-5000
- Email: OLovegreen@tuftsmedicalcenter.org
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Contact:
- Amanda R Vest, MBBS
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Over 18 years of age
- Ejection fraction <40%
- Cardiogenic shock defined by clinical criteria (including any of: lactate >2.5 mmol/L, systolic blood pressure <90 mmHg, acute kidney or liver injury, or cardiac index <2.1 on hemodynamic monitoring) plus the clinical requirement for at least one pressor, inotrope, or temporary mechanical circulatory support device (MCSD)
Exclusion Criteria:
- History of LVAD or other durable ventricular assist device
- An identified clinical disorder associated with skeletal muscle weakness/wasting (e.g., muscular dystrophy, mitochondrial disorder, active cancer, modified Rankin score greater or equal to 4 post-stroke
- Chronic enteric and parenteral nutrition support patients
Intubation or prior history of heart transplantation are not exclusion criteria if the inclusion criteria are otherwise met.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Study Cohort
All enrolled participants with no randomization group allocations
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We will use a BodyMetrix Pro A-mode ultrasound device (BodyMetrix Pro, Intelametrix Inc., Livermore, CA) which is a lay imaging tool designed specifically to assess body composition.
Images will be taken at two sites; the lateral thigh and bicep on the dominant side if able to identify, or else on the right side.
On each visit, five images will be taken at each site (the lateral thigh and bicep).
Participants will be measured 2-3 days from initiation in study, then 7 days after, and then weekly from the first measurement until time of advanced therapy, discharge, or death.
This measurement sequence will then be repeated following advanced therapy up until discharge or death.
Each measurement session will last about 20-30 minutes.
This will be performed by the PI or members of the study team who have been trained by the research coordinator.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage change in skeletal muscle thickness from admission to nadir of muscle thickness
Time Frame: Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (until discharge or death)
|
Quantify the percentage change in skeletal muscle thickness from admission to nadir of muscle thickness and describe the time course of muscle loss.
We hypothesize that all patients will experience a decrease in skeletal muscle thickness in the days-to-weeks after admission, as indicated by change in skeletal muscle thickness on ultrasound, and anticipate the magnitude of this muscle thickness change to be in the range of -5%.
This aim will be investigated in both patients who ultimately receive the HT or LVAD advanced therapies, and also those who do not.
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Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (until discharge or death)
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Percentage change in skeletal muscle thickness after advanced therapies
Time Frame: Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (until discharge or death)
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Quantify the percentage change in skeletal muscle thickness achieved early after advanced therapies (LVAD/HT).
We hypothesize that hospitalized patients with advanced heart failure will experience a minor muscle recovery during the hospital stay following advanced therapy surgeries, but not a recovery in the range of +5% which would likely require a 3-month follow-up period.
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Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (until discharge or death)
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Relationship between muscle mass loss during cardiogenic shock and subsequent clinical outcomes
Time Frame: Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (discharge or death)
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Evaluate the relationship between muscle mass loss during cardiogenic shock and subsequent clinical outcomes.
We hypothesize that a greater negative percent change in muscle thickness from admission to the nadir thickness value will be associated with higher inhospital mortality, and for those who receive an LVAD/HT a longer post-operative length of stay and greater probably of discharge to a rehabilitation facility as opposed to home.
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Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (discharge or death)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Geriatric nutritional risk index (GNRI)
Time Frame: Once at baseline
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Evaluating the association between malnutrition risk as assessed by geriatric nutritional risk index (GNRI) on admission and change in skeletal muscle thickness from admission to nadir.
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Once at baseline
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Upper extremity versus lower extremity US muscle thickness decreases
Time Frame: Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (discharge or death)
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Determine if an upper extremity or lower extremity US muscle site location for percentage change is most strongly associated with mortality and with GNRI on admission.
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Images obtained at baseline after consent; then days 3 and 7 after baseline study visit; then every 7 days thereafter until end of the index hospitalization (discharge or death)
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Inhospital mortality
Time Frame: Index Hospitalization
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Occurence of mortality during index hospitalization
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Index Hospitalization
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Post-LVAD/HT length of stay
Time Frame: Index Hospitalization
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Days from LVAD/HT surgery until discharge from hospital or death
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Index Hospitalization
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Discharge to a rehabilitation facility versus home
Time Frame: Conclusion of index Hospitalization
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Discharge destination at conclusion of index hospitalization
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Conclusion of index Hospitalization
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Ischemia
- Pathologic Processes
- Necrosis
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Nervous System Diseases
- Neurologic Manifestations
- Shock
- Neuromuscular Manifestations
- Pathological Conditions, Anatomical
- Myocardial Infarction
- Infarction
- Heart Failure
- Muscular Atrophy
- Atrophy
- Shock, Cardiogenic
Other Study ID Numbers
- STUDY00004088
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
product manufactured in and exported from the U.S.
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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