Gut Microbial Metabolites and Intestinal Permeability in Patients With Severe Tricuspid Regurgitation Undergoing Transcatheter Tricuspid Valve Intervention (INTEGRITY)
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.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Muhammed Gercek
- Telefonnummer: 0049571971258
- E-Mail: mugercek@hdz-nrw.de
Studienorte
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North Rhine-Westphalia
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Bad Oeynhausen, North Rhine-Westphalia, Deutschland, 32545
- Rekrutierung
- Herz- und Diabeteszentrum NRW
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
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• 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:
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• 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
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Grundlegende Wissenschaft
- Zuteilung: Nicht randomisiert
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Aktiver 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. |
transcatheter tricuspid valve intervention |
|
Aktiver 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. |
Patent Foramen Ovale (PFO) Closure |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in Gut Microbial Metabolite Plasma Levels
Zeitfenster: Baseline (prior to intervention) and 6 months post-intervention (180 ± 14 days)
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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)
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change in Plasma Levels of Gut Microbial Metabolites at 30 Days
Zeitfenster: Baseline and 30 days post-intervention
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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
Zeitfenster: Baseline and 6 months post-intervention (180 ± 14 days)
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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)
|
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Moderate-to-Severe or Severe Tricuspid Regurgitation at 30 Days
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
|
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Heart Failure Rehospitalization
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: Baseline and 6 months post-intervention (180 ± 14 days)
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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)
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Change in Left Ventricular Ejection Fraction (LVEF)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- HDZ-KA_0525_INTEGRITY
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