Congestive Heart Failure Clinical Trial
Official title:
Non-Invasive Detection of Revascularizable Cardiomyopathy
The purpose of this study is to test the ability of a new X-ray technique called CT angiography to identify significant narrowing of the coronary arteries compared to traditional coronary angiogram.
Objective:
In patients with newly diagnosed cardiomyopathy it is the standard of care to perform
coronary angiography. This procedure can separate ischemic from non-ischemic cardiomyopathy
and identifies patients who may be eligible for revascularization as a therapeutic modality.
With the advent of multidectector row-computed tomography technology, it is becoming
possible to non-invasively identify significant atherosclerotic stenoses with acceptable
sensitivity and specificity. The goal of this study is to compare non-invasive computed
tomography (CT) angiography with traditional coronary angiography to identify proximal, and
hence revascularizable, coronary artery disease in patients with cardiomyopathy.
Revascularizable is defined a 3 vessel proximal disease, left main disease, or left main
equivalent disease (ostial left anterior descending and ostial left circumflex).
Research Design:
This study is prospective, interventional, single site with the interpreting radiologists
blinded to the results from previous angiography.
Methods:
Subjects will be patients with cardiomyopathy, defined as an ejection fraction less than
40%. Exclusion criteria include known allergy to contrast medium, previous anaphylaxis, and
renal insufficiency (serum creatinine greater than 1.5). We would like to enroll 30
patients. After giving informed consent, all eligible patients will undergo CT angiography,
performed using new multi-slice technology. The results of previously obtained transthoracic
echocardiography and standard coronary angiography will be reviewed. Following CT
angiography all patients will have a repeat measurement of serum creatinine to screen for
contrast induced nephropathy. Results of the CT angiography will be analyzed to determine
sensitivity and specificity for identifying revascularizable coronary artery disease,
compared to coronary angiography as the gold standard.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind, Primary Purpose: Diagnostic
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