Evaluering af Leverstivhedspræstation, ved FibroScan®, til at påvise Forhøjet Centralt Venøst Tryk (CVP)
Præstation af Leverstivhedsmåling (LSM) ved FibroScan® til Diagnosen af Forhøjet Central Venøst Tryk (CVP)
This is a pivotal, global, prospective, cross-sectional, multicentric clinical investigation designed to explore a non-invasive, reliable alternative to invasive, catheter-based hemodynamic assessments, which are associated with procedural risks and limited applicability in certain participant populations.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
CHF, as defined by the American College of Cardiology and the American Heart Association, is "a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood." These patients will often develop congestion that may require urgent hospitalization, especially if pulmonary congestion is present. However, congestion can be difficult to assess, especially when symptoms are mild, or in patients nearing discharge from an HF hospitalization.8 Increased cardiac filling pressures, including the CVP, often silently precede the appearance of congestive symptoms by days resulting in hepatic congestion.
Invasive methods, such as RHC, remain the gold standard method of measuring CVP, offering accurate and direct hemodynamic data. However, RHC requires specialized training and invasive vascular access and is associated with procedural risks including bleeding, infection, arrhythmia, and patient discomfort.
Echocardiography is the most common non-invasive adjunct tool for estimating CVP and assessing cardiac function. It evaluates indirect parameters, right atrial size, IVC diameter, and collapsibility to detect elevated CVP.
LSM by VCTE™ has emerged as a novel non-invasive approach to detecting elevated CVP indirectly. Liver elastography relies on imaging techniques to assess LSM, with high values equating to increased stiffness. While this was developed to assess fibrosis in chronic liver diseases, LSM also reflects increased CVP and hepatic congestion. Multiple studies have shown promising correlations between increased liver stiffness and invasively measured CVP, indicating a potential clinical strategy for detecting hemodynamic congestion non-invasively.
Given these considerations, the current clinical investigation aims to evaluate the 13.3 kPa cutoff performance of LSM with FibroScan (Echosens, Paris, France) to diagnose elevated CVP (>10 mm Hg).
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: CAROLE MEILLEROUX, PharmD
- Telefonnummer: +33622649277
- E-mail: carole.meilleroux@echosens.com
Studiesteder
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California
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Los Angeles, California, Forenede Stater, 90033
- Ikke rekrutterer endnu
- Keck Medicine of USC-Norris Healthcare Center - Transplant Clinic
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Kontakt:
- Michael Fong, MD
- E-mail: michael.fong@usc.edu
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Minnesota
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Minneota, Minnesota, Forenede Stater, 55455
- Rekruttering
- University of Minnesota
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Kontakt:
- Tamas Alexy, MD
- Telefonnummer: 612-626-1240
- E-mail: alexy001@umn.edu
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South Carolina
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Charleston, South Carolina, Forenede Stater, 29425
- Rekruttering
- Medical University of South Carolina
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Kontakt:
- Michele Esposito, MD
- Telefonnummer: 843-792-1105
- E-mail: espositm@musc.edu
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Texas
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Dallas, Texas, Forenede Stater, 75390
- Rekruttering
- University of Texas Southwestern Medical Center - Clinical Heart and Vascular Center - West Campus Building 3 Location
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Kontakt:
- Ambarish Pandey, MD, MSCS, FAHA
- Telefonnummer: 214-645-2101
- E-mail: ambarish.pandey@utsouthwestern.edu
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Ile Et Vilaine
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Rennes, Ile Et Vilaine, Frankrig, 35000
- Rekruttering
- Centre Hospitalier Universitaire (CHU) de Rennes - Hopital de Pontchaillou
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Kontakt:
- Erwan Donal, MD
- Telefonnummer: 33617708567
- E-mail: erwan.donal@chu-rennes.fr
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Basse-Silésie
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Wroclaw, Basse-Silésie, Polen
- Rekruttering
- Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu, Instytut Chorob Serca
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Kontakt:
- Jan Biegus, MD
- Telefonnummer: 48606674114
- E-mail: janbiegus@gmail.com
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Berlin, Tyskland, 13353
- Rekruttering
- Deutsches Herzzentrum der Charité (DHZC) - Klinik fuer Herz-, Thorax- und Gefaesschirurgie
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Kontakt:
- Felix Schoenrath, MD
- Telefonnummer: 4.93046E+11
- E-mail: felix.schoenrath@dhzc-charite.de
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Have read, understood, and signed the informed consent form (ICF)
- Be ≥18 years of age at the time of screening
- Have suspected or diagnosed acute or chronic HF and be scheduled to undergo right-sided cardiac catheterization
Exclusion Criteria:
- Inability to consent
- Chronic liver disease (self-reported alcohol use >14 drinks/week in females and >21 drinks/week in males), positive hepatitis C virus serology, positive hepatitis B surface antigen, autoimmune hepatitis, hemochromatosis, or cholestatic disease)
- BMI >40 kg/m2
- Fontan-type circulation
- Ascites
- Heart transplantation
- Pregnancy, breastfeeding, or intent to become pregnant during the study
- Intent to donate/bank or retrieve eggs (ova, oocytes) or donate sperm during the study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Full Cohort
This population will be defined by patients fulfilling all inclusion and exclusion criteria. |
At Day 0: 1 FibroScan examination to collect Liver Stiffness Measurement (LSM) at Day 0: Right-sided Heart Catheterization (RHC) to measure Central Venous Pressure (CVP) at Day 0 assessment of cardiac function At Day0: To assess baseline organ function that may impact participant safety, and blood samples for clinical laboratory tests |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Proportion of individuals with elevated CVP (>10 mm Hg) who are correctly identified by LSM (cutoff of 13.3 kPa) [Sensitivity]
Tidsramme: at Day 0
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Sensitivity (true positive rate) = TP / (TP + FN) |
at Day 0
|
|
Proportion of individuals without elevated CVP (>10 mm Hg) who are correctly identified by LSM (cutoff of 13.3 kPa) [Specificity]
Tidsramme: at Day 0
|
Specificity (1 - false negative rate) = TN / (TN + FP) |
at Day 0
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Andelen af personer korrekt identificeret ved LSM (Youden-indeks) til diagnostik af forhøjet CVP (>10 mm Hg)
Tidsramme: på dag 0
|
på dag 0
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Andel af individer korrekt identificeret ved LSM (Youdens indeks) for diagnostik af abnorm IVC-diameter
Tidsramme: på dag 0
|
på dag 0
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Logistisk regressionsmodel til identifikation af kliniske, laboratorie- og ekkokardiografiske faktorer forbundet med LSM/CVP-diskordans.
Tidsramme: på Dag 0
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på Dag 0
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Andel af personer korrekt identificeret for diagnosen forhøjet CVP (>10 mm Hg) sammenlignet mellem LSM, ekokardiografiparameter og NT-proBNP ved brug af DeLong's test for korrelerede ROC-kurver
Tidsramme: på dag 0
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på dag 0
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Correlation between LSM and echocardiographic parameters evaluated with Pearson or Spearman correlation coefficients
Tidsramme: at Day 0
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at Day 0
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Correlation between LSM and NT-proBNP evaluated with Pearson or Spearman correlation coefficients
Tidsramme: at Day 0
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at Day 0
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Correlation between LSM and CA-125 evaluated with Pearson or Spearman correlation coefficients
Tidsramme: at Day 0
|
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at Day 0
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Correlation between LSM and clinical parameters evaluated with Pearson or Spearman correlation coefficients
Tidsramme: at Day 0
|
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at Day 0
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Antal patienter med mindst én bivirkning
Tidsramme: 7 dage
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7 dage
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- Cs002
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