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Gut Microbial Metabolites and Intestinal Permeability in Patients With Severe Tricuspid Regurgitation Undergoing Transcatheter Tricuspid Valve Intervention (INTEGRITY)

8. november 2026 opdateret af: Muhammed Gerçek, Heart and Diabetes Center North-Rhine Westfalia

MicrobIal Metabolites and Gut Leakiness assessmeNT in Patients With sevEre Tricuspid reGuRgItation Undergoing Transcatheter Tricuspid Valve inTervention: a Multidimensional analYsis (INTEGRITY-Trial)

Emerging evidence highlights a bidirectional gut-heart axis, particularly relevant in patients with right heart failure. Elevated right atrial pressures and systemic congestion may impair intestinal perfusion and compromise epithelial integrity, leading to increased gut permeability ("leaky gut") and translocation of microbial products. These processes can trigger systemic inflammation and exacerbate cardiac dysfunction. Alterations in the gut microbiome-collectively referred to as dysbiosis-have also been linked to heart failure pathogenesis. However, the role of intestinal barrier dysfunction and microbial signatures in patients with severe tricuspid regurgitation (TR) remains largely unexplored.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

150

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Tyskland
    • North Rhine-Westphalia
      • Bad Oeynhausen, North Rhine-Westphalia, Tyskland, 32545
        • Rekruttering
        • Herz- und Diabeteszentrum NRW

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • • Patients with functional tricuspid regurgitation (TR) who were evaluated for transcatheter tricuspid valve intervention

    • Written informed consent in accordance with Good Clinical Practice (GCP) and local legislation
    • Patients undergoing PFO closure without any other known comorbidities will serve as control group

Exclusion Criteria:

  • • Previous tricuspid valve repair or replacement

    • Echocardiographic evaluation not available or not suitable for analysis at baseline
    • Key information from patients (e.g. NYHA, TR grade) not available
    • Known allergy or intolerance against the studied device
    • Persons held in an institution by legal or official order

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Grundvidenskab
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: TTVI Cohort

Patients with severe functional tricuspid regurgitation undergoing transcatheter tricuspid valve intervention (TTVI) as part of routine clinical care. The decision to perform TTVI is made independently of study participation. Patients undergo longitudinal assessment of gut microbial metabolites, intestinal permeability, and clinical parameters.
Procedure: transcatheter tricuspid valve intervention

transcatheter tricuspid valve intervention
Aktiv komparator: PFO Control Cohort

relevant comorbidities or heart failure. The decision to perform PFO closure is made independently of study participation. This cohort serves as a reference group for the assessment of gut microbial metabolite profiles and intestinal permeability.
Procedure: PFO Control Cohort

Patent Foramen Ovale (PFO) Closure

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Gut Microbial Metabolite Plasma Levels
Tidsramme: Baseline (prior to intervention) and 6 months post-intervention (180 ± 14 days)

Change in plasma concentrations of gut microbial metabolites from baseline to 6 months after intervention, assessed by liquid chromatography-tandem mass spectrometry (LC-MS/MS).
Baseline (prior to intervention) and 6 months post-intervention (180 ± 14 days)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Plasma Levels of Gut Microbial Metabolites at 30 Days
Tidsramme: Baseline and 30 days post-intervention

Changes in plasma concentrations of gut microbial metabolites from baseline to 30 days after intervention, quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS).
Baseline and 30 days post-intervention
Change in Intestinal Permeability at 6 Months
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Changes in intestinal permeability from baseline to 6 months after intervention, assessed using a differential sugar absorption test with lactulose, rhamnose, and sucrose.
Baseline and 6 months post-intervention (180 ± 14 days)
Moderate-to-Severe or Severe Tricuspid Regurgitation at 30 Days
Tidsramme: 30 days post-intervention

Number of participants with moderate-to-severe or severe TR assessed by transthoracic echocardiography.
30 days post-intervention
Moderate-to-Severe or Severe Tricuspid Regurgitation at 6 Months
Tidsramme: 6 months post-intervention (180 ± 14 days)

Number of participants with moderate-to-severe or severe TR assessed by transthoracic echocardiography.
6 months post-intervention (180 ± 14 days)
All-Cause Mortality
Tidsramme: From intervention up to 6 months post-intervention

Number of participants who die from any cause during the follow-up period.
From intervention up to 6 months post-intervention
Heart Failure Rehospitalization
Tidsramme: From intervention up to 6 months post-intervention

Number of participants experiencing at least one rehospitalization due to worsening heart failure during the follow-up period.
From intervention up to 6 months post-intervention
Change in New York Heart Association (NYHA) Functional Class
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in NYHA functional class from baseline to 6 months after intervention. NYHA functional class ranges from I (no limitation of physical activity) to IV (symptoms at rest). A lower class indicates better functional status.
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) Score
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in health-related quality of life assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ) from baseline to 6 months after intervention. Scores range from 0 to 100, with higher scores indicating better health status.
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Serum N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) Levels
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in serum NT-proBNP concentration from baseline to 6 months after intervention, assessed using laboratory blood analysis.
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Right Ventricular Basal Diameter
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in right ventricular basal diameter from baseline to 6 months after intervention, assessed by transthoracic echocardiography. Measurements are expressed in millimeters (mm).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Right Ventricular Fractional Area Change (RV FAC)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in right ventricular fractional area change from baseline to 6 months after intervention, assessed by transthoracic echocardiography as a measure of right ventricular systolic function. Measurements are expressed as percentages (%).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Right Ventricular Global Longitudinal Strain (RV GLS)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in right ventricular global longitudinal strain from baseline to 6 months after intervention, assessed by transthoracic echocardiography using speckle-tracking analysis. Measurements are expressed as percentages (%).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Tricuspid Annular Plane Systolic Excursion (TAPSE)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in tricuspid annular plane systolic excursion from baseline to 6 months after intervention, assessed by transthoracic echocardiography as a measure of right ventricular longitudinal systolic function. Measurements are expressed in millimeters (mm).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Estimated Systolic Pulmonary Artery Pressure (sPAP)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in estimated systolic pulmonary artery pressure from baseline to 6 months after intervention, assessed by transthoracic echocardiography using the tricuspid regurgitation jet pressure gradient and estimated central venous pressure. Measurements are expressed in millimeters of mercury (mmHg).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Left Ventricular Ejection Fraction (LVEF)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in left ventricular ejection fraction from baseline to 6 months after intervention, assessed by transthoracic echocardiography using the biplane Simpson method. Measurements are expressed as percentages (%).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Left Ventricular End-Systolic Volume (LVESV)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in left ventricular end-systolic volume from baseline to 6 months after intervention, assessed by transthoracic echocardiography. Measurements are expressed in milliliters (mL).
Baseline and 6 months post-intervention (180 ± 14 days)
Change in Left Ventricular End-Diastolic Volume (LVEDV)
Tidsramme: Baseline and 6 months post-intervention (180 ± 14 days)

Change in left ventricular end-diastolic volume from baseline to 6 months after intervention, assessed by transthoracic echocardiography. Measurements are expressed in milliliters (mL).
Baseline and 6 months post-intervention (180 ± 14 days)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Heart and Diabetes Center North-Rhine Westfalia

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. september 2025

Primær færdiggørelse (Anslået)

1. juni 2029

Studieafslutning (Anslået)

1. juni 2029

Datoer for studieregistrering

Først indsendt

11. august 2025

Først indsendt, der opfyldte QC-kriterier

8. november 2026

Først opslået (Faktiske)

12. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • HDZ-KA_0525_INTEGRITY

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