MRI as a Predictor of Outcomes in Patients Undergoing Mitral Valve Surgery (MRI-MVS)
Prospective Evaluation of MRI as a Predictor of Outcomes in Patients Undergoing Mitral Valve Surgery: MRI-MVS Study
研究概览
详细说明
Mitral regurgitation is a common disease which can lead to heart failure and death if left untreated. The only known therapy for mitral regurgitation is correction of the mitral valve, most commonly performed by surgical repair or replacement. According the STS database, there were 15,748 lone mitral valve surgeries in 2014. The number of mitral valve surgeries has been increasing with a 23% increase between the years 2010 and 2014. Based on the ACC/AHA guidelines for the management of mitral valve disease, quantifying the severity of mitral regurgitation is central to determining which patients are appropriate for correction of their mitral valve by surgery. Specifically, once the diagnosis of severe MR is made, patients are considered appropriate for mitral valve surgery in almost all clinical circumstances. However, there is a significant mortality and morbidity associated with mitral valve surgery. In the STS database, 30 day mortality was ~2% for repair and ~5% for replacement. This data does not take into account long-term mortality and morbidity from re-operation and life-long anti-coagulation as well as changes in quality of life.
The most common diagnostic tool to assess the severity of MR is echocardiography. Several studies have shown that echocardiography parameters used to quantify and qualify MR have high inter-observer and intra-observer variability, calling the accuracy of these parameters into question. Furthermore, studies have shown that there is a significant degree of discordance between echocardiography and MRI when assessing MR, particularly among patients referred for mitral valve surgery. In a recent study, quantification of mitral regurgitant volume MRI was found to be more accurate than echocardiography in patients who underwent mitral valve surgery. All 38 patients who underwent mitral valve surgery in this study were deemed appropriate according the ACC/AHA guidelines based on echocardiographic findings. However, more than 2/3rds of patients who underwent mitral valve surgery in this study did not have severe MR by MRI. Thus, we propose this prospective multicenter trial to assess: 1) the severity of MR by MRI in patients undergoing mitral valve surgery. 2) the impact of mitral valve surgery on quality of life and healthcare costs in the context of MR severity by MRI, 3) assess patient outcomes post surgery in the context of MR severity by MRI and 4) the likelihood of valve replacement vs. repair according to MR severity by MRI.
研究类型
注册 (预期的)
联系人和位置
学习地点
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New Jersey
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Morristown、New Jersey、美国、07960
- 招聘中
- Morristown Medical Center
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接触:
- Seth Uretsky, MD
- 电话号码:973-971-5597
- 邮箱:seth.uretsky@atlantichealth.org
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接触:
- Susan Miller, RN
- 电话号码:9739715597
- 邮箱:susan.miller@atlantichealth.org
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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:
- Age 18 years and older.
- Able to give informed consent.
- Undergoing lone mitral valve surgery for chronic primary mitral regurgitation within 30 days.
- Indication for mitral valve surgery is a class I or IIa according to the 2014 ACC/AHA guidelines for the management of valvular heart disease.
Exclusion Criteria:
- Secondary mitral regurgitation.
- Have a device which is not compatible with MRI
- Claustrophobia preventing MRI.
- Concomitant CABG, other valve surgery, or other cardiac surgery.
- Atrial fibrillation or other substantial arrhythmia that would substantially degrade MRI image acquisition.
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 |
干预/治疗 |
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Mitral Valve Surgery
Patients undergoing ACC/AHA guideline directed mitral valve surgery for mitral insufficiency.
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ACC/AHA guideline directed mitral valve repair or replacement
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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 |
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Operative and peri-operative outcomes according to the mitral regurgitation severity quantified by MRI.
大体时间:2 years
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Operative and peri-operative outcomes (mortality, morbidity, hospitalizations, reoperation, bleeding, and CVA) in the context of mitral regurgitation severity quantified by MRI.
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2 years
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Quality of life
大体时间:2 years
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Operative and peri-operative outcomes (mortality, morbidity, hospitalizations, reoperation, bleeding, and CVA) in the context of mitral regurgitation severity quantified by MRI.
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2 years
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Repair vs Replacement
大体时间:4 months
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Assess if the likelihood of mitral valve repair vs. replacement is associated with mitral regurgitant severity as quantified by MRI.
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4 months
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Severity of mitral regurgitation as quantified MRI in subjects who are undergoing guideline directed mitral valve surgery.
大体时间:0 days
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Cross sectional data regarding severity of mitral regurgitation as quantified MRI in subjects who are undergoing guideline directed mitral valve surgery
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0 days
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Correlation of pre-surgical regurgitant volume as quantified by MRI with post-surgical change in LV EDV.
大体时间:4 months
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Correlation of pre-surgical regurgitant volume as quantified by MRI with post-surgical change in LV EDV.
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4 months
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合作者和调查者
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
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 (实际的)
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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Mitral valve surgery的临床试验
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Edwards Lifesciences主动,不招人
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Chinese Academy of Medical Sciences, Fuwai Hospital尚未招聘