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Microvessels and Heart Problems in Sickle Cell Disease

26. oktober 2017 oppdatert av: National Heart, Lung, and Blood Institute (NHLBI)

Microvascular and Cardiac Dysfunction in Sickle Cell Disease

Background:

- Small blood vessels (microvessels) in many different organs are affected by diseases such as diabetes and atherosclerosis. These microvessels may also be abnormal in people who have sickle cell disease. Stiffness of the red blood cells leads to problems in the microvessels of the heart and kidneys. However, these problems may not be detected until these organs are severely affected. Researchers want to study problems with microvessels in people with and without sickle cell disease.

Objectives:

- To study how microvessels in the heart and other organs are affected by sickle cell disease.

Eligibility:

  • Individuals at least 18 years of age who have sickle cell disease.
  • Healthy volunteers at least 18 years of age.

Design:

  • Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected.
  • All participants will have about 3 to 4 hours of testing for the study. Participants with sickle cell disease who are having a pain crisis at the time they enter the study may be asked to have the testing again when the crisis is over. The repeat testing will occur at least 4 weeks after the pain crisis ends.
  • All participants will have the following tests:
  • Blood draws to check kidney and liver function, and other blood tests
  • Measure of blood flow in the brachial (upper arm) artery
  • Heart ultrasound
  • Ultrasound scans of arm muscles to study blood flow
  • Ultrasound scans after taking vasodilators to increase blood flow
  • Healthy volunteers will also have a magnetic resonance imaging scan. It will show blood flow in the heart. This scan will involve another dose of a vasodilator.

Studieoversikt

Status

Fullført

Forhold

Detaljert beskrivelse

Sickle cell disease is the most common genetic disease affecting African-Americans. It is characterized by an abnormal hemoglobin S, which polymerizes when deoxygenated leading to red cell rigidity and microvascular flow obstruction. Recurrent episodes of ischemia and a chronic inflammatory state lead to ischemia-reperfusion injury in multiple vital organ systems. Endothelial dysfunction has been demonstrated in patients with sickle cell disease and new therapies are targeted specifically towards the endothelium. Contrast ultrasound is a non-invasive technique that has been used to assess microvascular flow in coronary artery disease, diabetes, and other disease states. We propose to use this technique in sickle cell patients to compare their myocardial and skeletal muscle flow with that of normal controls, to detect changes during pain crisis, and to compare flow abnormalities with cardiac functional abnormalities.

Studietype

Observasjonsmessig

Registrering (Faktiske)

65

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Maryland
      • Bethesda, Maryland, Forente stater, 20892
        • National Institutes of Health Clinical Center, 9000 Rockville Pike

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

  • INCLUSION CRITERIA:
  • Adult subject age greater than or equal to 18 years
  • Able to give written informed consent
  • For SCD groups, must have confirmed diagnosis of sickle cell disease

EXCLUSION CRITERIA:

  • Atrial fibrillation or other irregular rhythm that would preclude adequate image acquisition
  • Subjects with a contraindication for the ultrasound contrast agent.
  • Pregnant or lactating women
  • Known obstructive coronary or peripheral vascular disease
  • SCD subjects at steady-state must not have acute pain crisis requiring intravenous analgesics within the prior 4 weeks
  • SCD subjects in crisis must be within 72 hours of hospital admission
  • Subjects with contraindications to MRI scanning will complete all other procedures but will not undergo the MRI scan. Subjects with an estimated glomerular filtration rate of <30 ml/min/1.73 m(2) will not receive gadolinium as per 2011 NHLBI gadolinium administration policy.
  • Subjects with a contraindication to regadenson
  • Any condition that in the clinical opinion of the investigators renders study procedures inadvisable.

Diagnosis of acute chest syndrome is not an exclusion criteria for this protocol. Subjects may be concurrently enrolled in any other protocols with the exception of investigational new drug studies.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Tidsperspektiver: Potensielle

Hva måler studien?

Primære resultatmål

Resultatmål
To use contrast-enhanced ultrasound to evaluate microvascular blood flow (MBF) and capillary RBC velocity (CBV) in skeletal muscle and the heart (at rest and during vasodilator stress) in patients with SCD in comparison to normal control patient...

Sekundære resultatmål

Resultatmål
To determine whether MBF and CBV worsen during pain crisis in patients with SCD
To determine the relation between MBF and CBV and brachial artery flow or LV dysfunction.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

National Heart, Lung, and Blood Institute (NHLBI)

Etterforskere

  • Hovedetterforsker: Vandana Sachdev, M.D., National Heart, Lung, and Blood Institute (NHLBI)

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

30. april 2012

Studiet fullført

25. oktober 2017

Datoer for studieregistrering

Først innsendt

18. mai 2012

Først innsendt som oppfylte QC-kriteriene

18. mai 2012

Først lagt ut (Anslag)

21. mai 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

27. oktober 2017

Siste oppdatering sendt inn som oppfylte QC-kriteriene

26. oktober 2017

Sist bekreftet

25. oktober 2017

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 120124
  • 12-H-0124

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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