Assessment of Myocardial Tissue Damage in Aortic Stenosis
Assessment of Myocardial Tissue Damage in Aortic Stenosis for Risk Stratification
Aortic stenosis (AS) is the most common valve disease in the United States and most common indication for valve replacement surgery. Anatomical and hemodynamic severity of AS is insufficient for elucidating patients' prognosis. Therefore, the decision about the optimal timing of surgical intervention remains critical. However, the changes in structure and electrical activity of the cardiac muscle can be assessed by noninvasive imaging and electrocardiography (ECG). Degenerative myocardial changes characterized by fibrosis or collagen deposits are frequently observed in AS patients and have a negative impact on patient outcomes. In this project, our objective is to determine whether echocardiographic image analysis of integrated backscatter (IB), which can express changes in myocardial tissue composition (amount of fibrosis) based on its ultrasound reflectivity, global left ventricular (LV) load as measured by Zva, and ECG analysis of the duration of the QRS interval have a role in risk stratification for AS patients and to apply those methods to identify which patients would benefit from surgical intervention.
The investigators hypothesize that 1) the severity of myocardial damage can discriminate the prognosis in patients with AS, and 2) IB, Zva, and QRS interval can be diagnostic measures of the severity of myocardial damage. The investigators will measure the severity of myocardial fibrosis using MRI (reference) in 50 patients and will test the diagnostic significance of IB (testing method). Zva, QRS duration, and conventional echocardiographic measures will also be tested for diagnosing severity of myocardial fibrosis.
調査の概要
状態
条件
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Arizona
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Scottsdale、Arizona、アメリカ、85259
- Mayo Clinic
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Moderate or severe aortic stenosis determined by echocardiography
- Adults > 65 years old
Exclusion Criteria:
- Ejection fraction < 50%
- Valvular diseases of more than or equal to moderate degree other than aortic stenosis
- Prior myocardial infarction or coronary artery disease needs revascularization
- Atrial fibrillation (chronic)
- Pacemaker/defibrillator implanted
- Previous valve replacement performed
- Cardiomyopathy(HCM, infiltrative cardiomyopathy, constriction)
- Renal dysfunction (estimated GFR < 30ml/min/1.73m² or end stage renal failure)
- Patients with contraindication for MRI
- Patients with poor echocardiographic images
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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Moderate aortic stenosis.
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Severe aortic stenosis.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Presence of myocardial fibrotic change determined by MRI.
時間枠：1 hour
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1 hour
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Hari Chaliki, MD、Mayo Clinic
- 主任研究者：Minako Katayama, MD、Mayo Clinic
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。