The Role of Myocardial Fibrosis in Patients With Aortic Stenosis
2018年6月21日 更新者：University of Edinburgh
Aortic stenosis is the most common adult valvular heart disease in the western world.
Heart failure and sudden cardiac death are complications associated with aortic stenosis.
In symptomatic individuals, valve replacement is often the only effective treatment.
However, there are no good markers to identify patients who may benefit from early surgery before symptoms developed.
The purpose of the study is to test the hypothesis that the presence heart muscle scarring on the cardiac magnetic resonance imaging may predict a worse outcome in patients with aortic stenosis, and thus may be helpful in identifying patients for early valve replacement.
研究概览
地位
完全的
条件
详细说明
Congestive heart failure and sudden cardiac death are associated complications of aortic stenosis.
Currently, the indications for valvular replacement are based on the valvular severity evaluated by echocardiography and the presence of symptoms.
There is some evidence to suggest the presence of myocardial fibrosis is associated with a poor outcome in patients with aortic stenosis.
The aim of this prospective study is to investigate the prognostic implications of myocardial fibrosis in patients with aortic stenosis.
The presence of myocardial fibrosis will be identified by delayed enhancement with the cardiac magnetic resonance imaging at 3T.
We will also be evaluating the application of T1 mapping techniques to detect diffuse myocardial fibrosis.
研究类型
观察性的
注册 (实际的)
203
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
Midlothian
-
Edinburgh、Midlothian、英国、EH16 4SB
- University of Edinburgh
-
-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 及以上 (成人、年长者)
接受健康志愿者
是的
有资格学习的性别
全部
取样方法
概率样本
研究人群
A total of 240 individuals will be recruited. This includes 48 individuals who do not have aortic stenosis. A total of 192 individuals with aortic stenosis will be recruited:
- Mild aortic stenosis, n=48
- Moderate aortic stenosis, n=48
- Severe aortic stenosis, n=48
- Symptomatic aortic stenosis with planned valve replacement, n=48
描述
Inclusion Criteria:
- Patients with aortic stenosis
- Willing to undergo all investigations
Exclusion Criteria:
- Coexisting mitral valvular heart disease and aortic regurgitation (more than moderate severity)
- Active medical conditions: ongoing heart failure, infection
- Significant comorbidities: advanced malignancy with limited life expectancy
- Unable to give informed consent
- Contraindication for cardiac magnetic resonance imaging: impaired renal function, pacemaker, claustrophobia
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
Controls
Patients will undergo cardiac magnetic resonance imaging, echocardiography and 72 hour holter monitoring
|
For the evaluation of left ventricular volumes, function and mass.
Also for the assessment of myocardial fibrosis based on the presence of delayed enhancement.
Novel application of T1 mapping techniques will be evaluated.
Assessment of aortic stenosis severity.
Also evaluate diastolic and systolic function.
This will enable us to detect abnormal heart rhythms which may be associated with myocardial fibrosis
|
|
Aortic Stenosis patients
All patients who agreed to study will undergo cardiac magnetic resonance imaging, echocardiography and 72 hour holter monitoring
|
For the evaluation of left ventricular volumes, function and mass.
Also for the assessment of myocardial fibrosis based on the presence of delayed enhancement.
Novel application of T1 mapping techniques will be evaluated.
Assessment of aortic stenosis severity.
Also evaluate diastolic and systolic function.
This will enable us to detect abnormal heart rhythms which may be associated with myocardial fibrosis
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Cardiovascular events
大体时间：1 year
|
Cardiovascular events defined as cardiovascular deaths, development of heart failure symptoms, and the need for aortic valve replacement.
|
1 year
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：David E Newby, MD PhD、University of Edinburgh
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Vassiliou VS, Pavlou M, Malley T, Halliday BP, Tsampasian V, Raphael CE, Tse G, Vieira MS, Auger D, Everett R, Chin C, Alpendurada F, Pepper J, Pennell DJ, Newby DE, Jabbour A, Dweck MR, Prasad SK. A novel cardiovascular magnetic resonance risk score for predicting mortality following surgical aortic valve replacement. Sci Rep. 2021 Oct 12;11(1):20183. doi: 10.1038/s41598-021-99788-7.
- Everett RJ, Tastet L, Clavel MA, Chin CWL, Capoulade R, Vassiliou VS, Kwiecinski J, Gomez M, van Beek EJR, White AC, Prasad SK, Larose E, Tuck C, Semple S, Newby DE, Pibarot P, Dweck MR. Progression of Hypertrophy and Myocardial Fibrosis in Aortic Stenosis: A Multicenter Cardiac Magnetic Resonance Study. Circ Cardiovasc Imaging. 2018 Jun;11(6):e007451. doi: 10.1161/CIRCIMAGING.117.007451.
- Anand A, Chin C, Shah ASV, Kwiecinski J, Vesey A, Cowell J, Weber E, Kaier T, Newby DE, Dweck M, Marber MS, Mills NL. Cardiac myosin-binding protein C is a novel marker of myocardial injury and fibrosis in aortic stenosis. Heart. 2018 Jul;104(13):1101-1108. doi: 10.1136/heartjnl-2017-312257. Epub 2017 Dec 1.
- Kwiecinski J, Chin CWL, Everett RJ, White AC, Semple S, Yeung E, Jenkins WJ, Shah ASV, Koo M, Mirsadraee S, Lang CC, Mills N, Prasad SK, Jansen MA, Japp AG, Newby DE, Dweck MR. Adverse prognosis associated with asymmetric myocardial thickening in aortic stenosis. Eur Heart J Cardiovasc Imaging. 2018 Mar 1;19(3):347-356. doi: 10.1093/ehjci/jex052.
- Chin CWL, Everett RJ, Kwiecinski J, Vesey AT, Yeung E, Esson G, Jenkins W, Koo M, Mirsadraee S, White AC, Japp AG, Prasad SK, Semple S, Newby DE, Dweck MR. Myocardial Fibrosis and Cardiac Decompensation in Aortic Stenosis. JACC Cardiovasc Imaging. 2017 Nov;10(11):1320-1333. doi: 10.1016/j.jcmg.2016.10.007. Epub 2016 Dec 21.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2012年1月1日
初级完成 (实际的)
2016年1月1日
研究完成 (实际的)
2017年8月1日
研究注册日期
首次提交
2012年12月19日
首先提交符合 QC 标准的
2012年12月19日
首次发布 (估计)
2012年12月24日
研究记录更新
最后更新发布 (实际的)
2018年6月25日
上次提交的符合 QC 标准的更新
2018年6月21日
最后验证
2016年7月1日
更多信息
与本研究相关的术语
关键字
其他研究编号
- 2010/R/CAR/05
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.