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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 bijgewerkt door: 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.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Geschat)

150

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

    • North Rhine-Westphalia
      • Bad Oeynhausen, North Rhine-Westphalia, Duitsland, 32545
        • Werving
        • Herz- und Diabeteszentrum NRW

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Fundamentele wetenschap
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: 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

Actieve vergelijker: 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

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Gut Microbial Metabolite Plasma Levels
Tijdsspanne: 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)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Plasma Levels of Gut Microbial Metabolites at 30 Days
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)

Medewerkers en onderzoekers

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Sponsor

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 september 2025

Primaire voltooiing (Geschat)

1 juni 2029

Studie voltooiing (Geschat)

1 juni 2029

Studieregistratiedata

Eerst ingediend

11 augustus 2025

Eerst ingediend dat voldeed aan de QC-criteria

8 november 2026

Eerst geplaatst (Werkelijk)

12 november 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

12 november 2026

Laatste update ingediend die voldeed aan QC-criteria

8 november 2026

Laatst geverifieerd

1 november 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • HDZ-KA_0525_INTEGRITY

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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