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Efficacy and Safety of Ultrasound Modulation of Stellate Ganglion for the Prevention of Ventricular Arrhythmia in Patients With ST-segment Elevation Myocardial Infarction (US-PRAY)

12. mai 2026 oppdatert av: Songyun Wang, Renmin Hospital of Wuhan University

Efficacy and Safety of Ultrasound Modulation of Stellate Ganglion for the Prevention of Ventricular Arrhythmia in Patients With ST-segment Elevation Myocardial Infarction: A Multicenter, Double-blind Randomised Controlled Trial

The goal of this multicenter, double-blind, randomized controlled trial is to evaluate the efficacy and safety of low-intensity focused ultrasound (LIFU) stellate ganglion modulation for preventing ventricular arrhythmias after ST-segment elevation myocardial infarction (STEMI) in patients undergoing percutaneous coronary intervention (PCI).

The main questions it aims to answer are:

  1. Does LIFU reduce the frequency and duration of ventricular arrhythmias within 72 hours post-PCI compared to sham ultrasound?
  2. Does LIFU improve electrophysiological stability, myocardial injury markers, cardiac function and heart rate variability, and reduce inflammatory markers and sympathetic neurotransmitters?
  3. What is the safety profile of LIFU in this population?

100 eligible patients will be randomized 1:1 to receive either active LIFU (2.0W, 1MHz, 50% duty cycle, 30min per session: 1 intra-PCI session + 7 daily post-PCI sessions) plus standard care, or identical sham ultrasound plus standard care. A comprehensive double-blind design (subjects, operators, assessors, statisticians) will be implemented. The study will run from May 2026 to April 2027 at 7 centers in China, led by Renmin Hospital of Wuhan University.

Participants will:

  1. Complete pre-PCI screening and baseline assessments (informed consent, demographic/medical history, physical examination, electrocardiogram, echocardiogram, blood sample collection) within 12 hours of symptom onset
  2. Receive 1 assigned ultrasound intervention during PCI, followed by 1 daily intervention for 7 consecutive days postoperatively
  3. Undergo 72h continuous ECG monitoring post-PCI, blood sampling at baseline and postoperative days 1, 3, 7, and echocardiography assessment at postoperative day 7
  4. Have all adverse events and arrhythmias recorded throughout the study
  5. May withdraw voluntarily at any time without affecting routine medical care

Studieoversikt

Studietype

Intervensjonell

Registrering (Antatt)

100

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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

Studiekontakt

  • Navn: Songyun Wang, MD
  • Telefonnummer: +86 13871262107
  • E-post: wsy7982@126.com

Studiesteder

    • Hubei
      • Huangshi, Hubei, Kina, 430060
        • Huangshi Central Hospital
        • Ta kontakt med:
      • Jingzhou, Hubei, Kina, 430060
        • Jingzhou Central Hospital
        • Ta kontakt med:
      • Shiyan, Hubei, Kina, 430060
        • Shiyan Taihe Hospital
        • Ta kontakt med:
      • Wuhan, Hubei, Kina, 430060
        • Renmin Hospital of Wuhan University
        • Ta kontakt med:
      • Wuhan, Hubei, Kina, 430060
        • Wuhan Central Hospital
        • Ta kontakt med:
      • Wuhan, Hubei, Kina, 430060
        • Wuhan Third Hospital
        • Ta kontakt med:
      • Xiangyang, Hubei, Kina, 430060
        • Xiangyang Central Hospital
        • Ta kontakt med:

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

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  1. Age between 18 and 80 years (including 18 and 80 years); gender is not restricted;
  2. Agree to be randomly assigned to a treatment strategy and be able to undergo follow-up as required;
  3. Patients with a clinical diagnosis of acute ST-segment elevation myocardial infarction;
  4. Presented within 12 hours of symptom onset and underwent PCI;
  5. Killip functional class I-III;
  6. Agree to participate in this study and voluntarily sign the informed consent form.

Exclusion Criteria:

  1. Patients with a history of myocardial infarction;
  2. Patients with a history of cardiac pacemaker or implantable cardioverter-defibrillator (ICD) implantation;
  3. Patients with severe bradycardia or high-degree atrioventricular block;
  4. Patients with severe heart failure (left ventricular ejection fraction <30%);
  5. Patients with cardiogenic shock (Killip Class IV);
  6. Patients admitted with frequent ventricular fibrillation or cardiac arrest;
  7. Patients with a history of malignant hematological disorders or renal failure (estimated eGFR <30 ml/min);
  8. Patients with skin lesions, infections, or benign or malignant tumors in the left neck;
  9. Pregnant or breastfeeding women, or women planning to become pregnant during the study;
  10. Patients with severe cognitive impairment, psychiatric disorders, epilepsy, etc.;
  11. Patients with concurrent malignant tumors or diseases of vital organs;
  12. Patients with active systemic infections;
  13. Patients who have participated in other drug or medical device clinical trials within the past 3 months;
  14. Patients who are unable or unwilling to provide informed consent;
  15. Patients deemed unsuitable for participation in this clinical trial by the investigator.

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Ultrasound stimulation group
Subjects in this arm will receive low-intensity focused ultrasound (LIFU) intervention targeting the left stellate ganglion. The ultrasound probe and skin are disinfected, ultrasound coupling gel is applied, the probe is placed on the skin surface corresponding to the anatomical location of the left stellate ganglion, fixed with a robotic arm, and the instrument is activated. Ultrasound parameters: power 2.0 W, frequency 1 MHz, 50% duty cycle, 30 minutes per session. One session is performed during PCI, followed by once daily for 7 consecutive days postoperatively. All subjects will receive standard cardiovascular care in accordance with 2025 ACC/AHA guidelines, including PCI and indicated medications.
Subjects in this arm will receive low-intensity focused ultrasound (LIFU) intervention targeting the left stellate ganglion. The ultrasound probe and skin are disinfected, ultrasound coupling gel is applied, the probe is placed on the skin surface corresponding to the anatomical location of the left stellate ganglion, fixed with a robotic arm, and the instrument is activated. Ultrasound parameters: power 2.0 W, frequency 1 MHz, 50% duty cycle, 30 minutes per session. One session is performed during PCI, followed by once daily for 7 consecutive days postoperatively. All subjects will receive standard cardiovascular care in accordance with 2025 ACC/AHA guidelines, including PCI and indicated medications.
Andre navn:
  • LIFU
  • Ultrasound stellate ganglion modulation
Placebo komparator: Sham group
Subjects in this arm will receive sham ultrasound intervention targeting the left stellate ganglion. The ultrasound probe and skin are disinfected, ultrasound coupling gel is applied, the probe is placed on the skin surface corresponding to the anatomical location of the left stellate ganglion and fixed with a robotic arm. No ultrasound energy is delivered, while the instrument maintains an identical appearance and operational state to the active LIFU arm. Ultrasound parameters: power 2.0 W, frequency 1 MHz, 50% duty cycle, 30 minutes per session. One sham session is performed during PCI, followed by once daily for 7 consecutive days postoperatively. All subjects will receive standard cardiovascular care in accordance with 2025 ACC/AHA guidelines, including PCI and indicated medications.
Subjects in this arm will receive sham ultrasound intervention targeting the left stellate ganglion. The ultrasound probe and skin are disinfected, ultrasound coupling gel is applied, the probe is placed on the skin surface corresponding to the anatomical location of the left stellate ganglion and fixed with a robotic arm. No ultrasound energy is delivered, while the instrument maintains an identical appearance and operational state to the active LIFU arm. Ultrasound parameters: power 2.0 W, frequency 1 MHz, 50% duty cycle, 30 minutes per session. One sham session is performed during PCI, followed by once daily for 7 consecutive days postoperatively. All subjects will receive standard cardiovascular care in accordance with 2025 ACC/AHA guidelines, including PCI and indicated medications.
Andre navn:
  • Sham LIFU
  • Sham ultrasound neuromodulation

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Number of ventricular arrhythmias
Tidsramme: 72 hours after PCI
Measurement: Count of ventricular arrhythmia episodes. Measurement device: Wearable Holter monitors.
72 hours after PCI
Duration of ventricular arrhythmias
Tidsramme: 72 hours after PCI
Measurement: Duration of ventricular arrhythmia episodes. Measurement device: Wearable Holter monitors.
72 hours after PCI
NT-proBNP
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum N-terminal pro-brain natriuretic peptide concentration; Unit: pg/mL
Baseline and 1, 3, 7 days after PCI

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
IL-1β level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum IL-1β concentration; Unit: pg/mL
Baseline and 1, 3, 7 days after PCI
Norepinephrine level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum norepinephrine concentration; Unit: pg/mL
Baseline and 1, 3, 7 days after PCI
Cardiac troponin T (cTnT) level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum cardiac troponin T concentration; Unit: ng/L
Baseline and 1, 3, 7 days after PCI
SDNN
Tidsramme: 72 hours after PCI
Standard deviation of normal-to-normal intervals; Unit: ms Measurement device: Wearable Holter monitors
72 hours after PCI
Left ventricular ejection fraction (LVEF)
Tidsramme: 7 days after PCI
Echocardiographic measurement of left ventricular systolic function; Unit: % Measurement device: Echocardiographic.
7 days after PCI
Alanine aminotransferase (ALT) level
Tidsramme: Baseline and 7 days after PCI
Serum alanine aminotransferase activity; Unit: U/L
Baseline and 7 days after PCI
Local skin temperature before and after stimulation
Tidsramme: Baseline (before stimulation) and 30 minutes after stimulation
Baseline (before stimulation) and 30 minutes after stimulation
Serum creatinine level
Tidsramme: Baseline and 7 days after PCI
Serum creatinine concentration; Unit: μmol/L
Baseline and 7 days after PCI
IL-6 level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum IL-6 concentration; Unit: pg/mL
Baseline and 1, 3, 7 days after PCI
TNF-α level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum TNF-α concentration; Unit: pg/mL
Baseline and 1, 3, 7 days after PCI
Neuropeptide Y level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum neuropeptide Y concentration; Unit: pg/mL
Baseline and 1, 3, 7 days after PCI
SDANN
Tidsramme: 72 hours after PCI
Standard deviation of the averages of normal-to-normal intervals in all 5-minute segments; Unit: ms Measurement device: Wearable Holter monitors
72 hours after PCI
Creatine kinase-MB (CK-MB) level
Tidsramme: Baseline and 1, 3, 7 days after PCI
Serum creatine kinase-MB activity; Unit: U/L
Baseline and 1, 3, 7 days after PCI
SDANN
Tidsramme: 72 hours after PCI
Standard deviation of the averages of NN intervals in all 5-minute segments; Unit: ms Measurement device: Wearable Holter monitors.
72 hours after PCI
SDNN Index
Tidsramme: 72 hours after PCI
Mean of the standard deviations of all NN intervals for all 5-minute segments ;Unit: ms Measurement device: Wearable Holter monitors.
72 hours after PCI
RMSSD
Tidsramme: 72 hours after PCI

Root mean square of successive differences between normal heartbeats

; Unit: ms Measurement device: Wearable Holter monitors.

72 hours after PCI
pNN50
Tidsramme: 72 hours after PCI

Percentage of successive NN intervals that differ by more than 50 ms

; Unit: % Measurement device: Wearable Holter monitors.

72 hours after PCI
LF power
Tidsramme: 72 hours after PCI
Low frequency power of heart rate variability; Unit: ms² Measurement device: Wearable Holter monitors.
72 hours after PCI
HF power
Tidsramme: 72 hours after PCI
High frequency power of heart rate variability; Unit: ms² Measurement device: Wearable Holter monitors.
72 hours after PCI
LF/HF ratio
Tidsramme: 72 hours after PCI
Ratio of low frequency to high frequency power; Unit: ratio Measurement device: Wearable Holter monitors.
72 hours after PCI
Left ventricular end-systolic volume (LVESV)
Tidsramme: 7 days after PCI
Echocardiographic measurement of left ventricular volume at end-systole; Unit: mL Measurement device: Echocardiographic.
7 days after PCI
Left ventricular end-systolic diameter (LVESD)
Tidsramme: 7 days after PCI
Echocardiographic measurement of left ventricular diameter at end-systole; Unit: mm Measurement device: Echocardiographic.
7 days after PCI
Aspartate aminotransferase (AST) level
Tidsramme: Baseline and 7 days after PCI
Serum aspartate aminotransferase activity; Unit: U/L
Baseline and 7 days after PCI
Blood urea nitrogen (BUN) level
Tidsramme: Baseline and 7 days after PCI
Blood urea nitrogen concentration; Unit: mmol/L
Baseline and 7 days after PCI
Estimated glomerular filtration rate (eGFR)
Tidsramme: Baseline and 7 days after PCI
Estimated glomerular filtration rate calculated using serum creatinine; Unit: mL/min
Baseline and 7 days after PCI
TP
Tidsramme: 72 hours after PCI
Total power of heart rate variability; Unit: ms² Measurement device: Wearable Holter monitors.
72 hours after PCI

Samarbeidspartnere og etterforskere

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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 (Antatt)

5. mai 2026

Primær fullføring (Antatt)

1. april 2027

Studiet fullført (Antatt)

1. april 2027

Datoer for studieregistrering

Først innsendt

28. april 2026

Først innsendt som oppfylte QC-kriteriene

12. mai 2026

Først lagt ut (Faktiske)

14. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

14. mai 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

12. mai 2026

Sist bekreftet

1. april 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • WDRY2026-K086
  • 82570593 (Annet stipend/finansieringsnummer: National Natural Science Foundation of China (NSFC))

Plan for individuelle deltakerdata (IPD)

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IPD-planbeskrivelse

IPD sharing is currently undecided due to ongoing evaluation of participant privacy safeguards, data security requirements, and multicenter regulatory frameworks.

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Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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