Lung Cancer Clinical Trial
Official title:
Cardiac Magnetic Resonance Assessment of Right Ventricular Inflammation After Lung Resection - a Feasibility Study
The purpose of this study is explore the impact of lung cancer surgery on inflammation and function of the right side of the heart.
Lung cancer is the second most common cancer in the UK and is the leading cause of cancer
related death. Where appropriate, surgery to remove the tumour and the surrounding lung (lung
resection) provides the best chance of cure. Frequently patients are either current or
ex-smokers with related lung or heart problems which increase the risks associated with
surgery. Following surgery patients may suffer long term shortness of breath, greatly
limiting their day-to-day function and lowering quality of life. The investigators believe
this shortness of breath is not solely caused by the removal of part of the lung but also
from a decrease in the performance of the heart. Although the surgery does not directly
involve the heart it is thought that the damage is caused indirectly by the surgery and by
the removal of part of the lung.
In a previous study, the investigators showed that the function of the right side of the
heart (the right heart) is decreased following lung resection. The decrease in right heart
(the part that supplies blood to the lungs) function was associated with a prolonged stay in
the high dependency unit and blood markers indicating damage to the heart. The process by
which the damage occurs is poorly understood, but it is thought that an increase in the
forces preventing the right heart pumping blood (resistance) is to blame. The decrease in
function in the right heart may be triggered during surgery by the diminished blood supply to
the cancerous lung and, and maintained post operatively, as lung resection can cause a
long-term increase in resistance.
Diseases that cause an increase in resistance to the right heart have been shown to cause
damage to different parts of the right heart. An acute sudden increase in resistance can
cause inflammation, thinning and scarring whilst a long-term increase in resistance causes
the right heart to thicken. The investigators believe that the potential damage during the
operation could cause permanent damage to the right heart and contribute to shortness of
breath and functional limitation.
To investigate the potential inflammation/scarring and the function of the heart the
investigators will image the heart with specialised Magnetic Resonance Imaging (MRI) scans.
The aim of the research is to determine whether inflammation occurs in the right heart during
and following lung resection and, if so, does it result in scarring?. The investigators will
compare the function of the right heart before, during and after surgery to determine if
inflammation contributes to the decrease in right heart function following lung resection
seen in our previous study. The investigators anticipate that the study will increase
understanding of how the right heart may be damaged by lung resection. The investigators
believe this will guide further studies aiming to prevent such damage, ultimately limiting
the disabling breathlessness and decrease in heart function that so greatly affects patients'
lives.
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