Assessment of Myocardial Tissue Damage in Aortic Stenosis
Assessment of Myocardial Tissue Damage in Aortic Stenosis for Risk Stratification
Aortic stenosis (AS) is the most common valve disease in the United States and most common indication for valve replacement surgery. Anatomical and hemodynamic severity of AS is insufficient for elucidating patients' prognosis. Therefore, the decision about the optimal timing of surgical intervention remains critical. However, the changes in structure and electrical activity of the cardiac muscle can be assessed by noninvasive imaging and electrocardiography (ECG). Degenerative myocardial changes characterized by fibrosis or collagen deposits are frequently observed in AS patients and have a negative impact on patient outcomes. In this project, our objective is to determine whether echocardiographic image analysis of integrated backscatter (IB), which can express changes in myocardial tissue composition (amount of fibrosis) based on its ultrasound reflectivity, global left ventricular (LV) load as measured by Zva, and ECG analysis of the duration of the QRS interval have a role in risk stratification for AS patients and to apply those methods to identify which patients would benefit from surgical intervention.
The investigators hypothesize that 1) the severity of myocardial damage can discriminate the prognosis in patients with AS, and 2) IB, Zva, and QRS interval can be diagnostic measures of the severity of myocardial damage. The investigators will measure the severity of myocardial fibrosis using MRI (reference) in 50 patients and will test the diagnostic significance of IB (testing method). Zva, QRS duration, and conventional echocardiographic measures will also be tested for diagnosing severity of myocardial fibrosis.
研究概览
地位
条件
研究类型
注册 (实际的)
联系人和位置
学习地点
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Arizona
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Scottsdale、Arizona、美国、85259
- Mayo Clinic
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Moderate or severe aortic stenosis determined by echocardiography
- Adults > 65 years old
Exclusion Criteria:
- Ejection fraction < 50%
- Valvular diseases of more than or equal to moderate degree other than aortic stenosis
- Prior myocardial infarction or coronary artery disease needs revascularization
- Atrial fibrillation (chronic)
- Pacemaker/defibrillator implanted
- Previous valve replacement performed
- Cardiomyopathy(HCM, infiltrative cardiomyopathy, constriction)
- Renal dysfunction (estimated GFR < 30ml/min/1.73m² or end stage renal failure)
- Patients with contraindication for MRI
- Patients with poor echocardiographic images
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
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Moderate aortic stenosis.
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Severe aortic stenosis.
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
Presence of myocardial fibrotic change determined by MRI.
大体时间:1 hour
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1 hour
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合作者和调查者
赞助
调查人员
- 首席研究员:Hari Chaliki, MD、Mayo Clinic
- 首席研究员:Minako Katayama, MD、Mayo Clinic
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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