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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 oppdatert av: 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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

150

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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

Studiekontakt

Studiesteder

  • Tyskland
    • North Rhine-Westphalia
      • Bad Oeynhausen, North Rhine-Westphalia, Tyskland, 32545
        • Rekruttering
        • Herz- und Diabeteszentrum NRW

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:

  • • 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

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Grunnvitenskap
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv 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.
Fremgangsmåte: transcatheter tricuspid valve intervention

transcatheter tricuspid valve intervention
Aktiv 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.
Fremgangsmåte: PFO Control Cohort

Patent Foramen Ovale (PFO) Closure

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Gut Microbial Metabolite Plasma Levels
Tidsramme: 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)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Plasma Levels of Gut Microbial Metabolites at 30 Days
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)

Samarbeidspartnere og etterforskere

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

Sponsor

Heart and Diabetes Center North-Rhine Westfalia

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 (Faktiske)

1. september 2025

Primær fullføring (Antatt)

1. juni 2029

Studiet fullført (Antatt)

1. juni 2029

Datoer for studieregistrering

Først innsendt

11. august 2025

Først innsendt som oppfylte QC-kriteriene

8. november 2026

Først lagt ut (Faktiske)

12. november 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

12. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

8. november 2026

Sist bekreftet

1. november 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • HDZ-KA_0525_INTEGRITY

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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