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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05935605
Other study ID # 17-008263
Secondary ID 1R01HL162828-01A
Status Recruiting
Phase
First received
Last updated
Start date July 20, 2023
Est. completion date May 2028

Study information

Verified date January 2024
Source Mayo Clinic
Contact Circulatory Failure Research Team
Phone (507) 255-2200
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The goal is to compare patients with and without varying severity of pulmonary vascular disease based upon hemodynamic signatures, echocardiographic measures, and lung ultrasound, in tandem with expired gas metabolic testing and blood sampling.


Recruitment information / eligibility

Status Recruiting
Enrollment 300
Est. completion date May 2028
Est. primary completion date May 2028
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Patients referred to the cardiac catheterization laboratory for invasive right heart catheterization for any reason. - Left Heart Disease, defined as one (or more) of the following: - Symptomatic HFpEF, defined by signs and symptoms of HF (dyspnea, fatigue), normal left ventricular (LV) EF (=50% within 12 months of enrollment), and objective evidence of HF fulfilling at least one of the following criteria: Prior hospitalization for decompensated HF treated with intravenous diuretics; Invasively verified HFpEF defined by pulmonary capillary wedge pressure (PCWP) of =15 mmHg at rest and/or =25 mmHg during exercise; Clinical diagnosis of HFpEF that does not meet criteria i. or ii. but verified with NTproBNP>300 pg/ml in sinus rhythm or >900 pg/ml in AF; H2FPEF score =6 or HFA-PEFF score=5 according to current guidelines. - Symptomatic HFrEF, defined by defined by signs and symptoms of HF (dyspnea, fatigue) and reduced EF (<50%). - Symptomatic valvular heart disease (VHD), defined by signs and symptoms of HF (dyspnea, fatigue) in tandem with clinically significant aortic or mitral valve disease (regurgitation and/or stenosis). Exclusion Criteria: - Patient inability or unwillingness to undergo noninvasive echocardiography, or if echocardiography would, in the opinion of the investigator, somehow compromise the quality of data acquisition for the clinical case. - WSPH Group 1 Pulmonary hypertension or PH (Pulmonary arterial hypertension; including congenital heart disease) - Group 3 PH (Hypoxia/Lung disease-related PH) - Group 4 PH (Thromboembolic PH) - Group 5 PH (Miscellaneous) - Clinically significant parenchymal lung disease, hypoxemia, or lung infection - Amyloid/infiltrative cardiomyopathy - Acute Myocarditis - Acute coronary syndrome or revascularization within 90 days - Use of PH-specific drugs - Constrictive pericarditis - High output heart failure - HF hospitalization within the preceding 30 days - Severe or greater aortic (AVA < 1.0 cm2, Mean Gradient > 40 mmHg) or severe mitral (MVA < 1.0 cm) stenosis - Inability or unwillingness to exercise - Inadequate echocardiographic imaging windows - Inability or unwillingness to cooperate with breath holding

Study Design


Intervention

Diagnostic Test:
Transthoracic Echocardiography (TTE)
Transthoracic echocardiography using ultrasound waves will be conducted during the rest and exercise phases of the clinically indicated invasive hemodynamic assessment by right heart catheterization to gather additional measurements of right ventricular function.
Lung ultrasound
A lung ultrasound, which uses sound waves to produce images of the lungs, will be used to assess extravascular lung fluid during the rest and exercise phases of the clinically indicated invasive hemodynamic assessment by right heart catheterization.

Locations

Country Name City State
United States Mayo Clinic in Rochester Rochester Minnesota

Sponsors (2)

Lead Sponsor Collaborator
Mayo Clinic National Heart, Lung, and Blood Institute (NHLBI)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Peak Exercise Cardiac Output Peak exercise cardiac output (L/min) will be measured using the direct Fick technique during the invasive hemodynamic assessment by right heart catheterization. Baseline
Primary Peak Exercise Oxygen Consumption (VO2) Peak exercise VO2 (ml/kg/min) will be measured using expired gas analysis collected during the invasive hemodynamic assessment by right heart catheterization. Baseline
Secondary Right Ventricular function assessed by Tricuspid Annular Plane Systolic Excursion (TAPSE) TAPSE is measured as the displacement (in mm) of the lateral tricuspid annulus toward the apex during systole measured using transthoracic echocardiography during the invasive hemodynamic assessment by right heart catheterization. Baseline
Secondary Right Ventricular function assessed by tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (PASP) ratio TAPSE/PASP ratio (mm/mmHg) will be measured using transthoracic echocardiography during the invasive hemodynamic assessment by right heart catheterization. Baseline
Secondary Extravascular Lung Fluid Content (B-line score) Extravascular Lung Fluid Content (B-line score) will be measured using lung ultrasound during the invasive hemodynamic assessment by right heart catheterization. Baseline
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