Effects of Acute Systemic Inflammation on Arterial Stiffness and Microcirculation. (IRIGA)
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Purpose
This study aims to assess the effect of acute inflammation on arterial stiffness and microcirculation. Patients with severe sepsis will be compared with age- and sex-matched healthy volunteers.
The primary outcome is the carotid-femoral pulse wave velocity. The other outcome measures are: systemic hemodynamics (systolic, diastolic, mean and pulse blood pressures, heart rate, cardiac output, left ventricular ejection fraction, systemic vascular resistances), central hemodynamics (aortic systolic, diastolic, mean and pulse pressures, and augmentation index), thenar tissue oxygen saturation, biological makers of inflammation (plasma fibrinogen, C-reactive protein, interleukin-6, matrix metalloproteinases -2, -9, tissue inhibitor of metalloproteinase 1), and plasma catecholamine concentrations (epinephrine, norepinephrine).
| Condition | Intervention |
|---|---|
|
Severe Sepsis |
Other: NA : non interventional study |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Effects of Acute Systemic Inflammation on Arterial Stiffness and Microcirculation. |
- Carotid-femoral pulse wave velocity [ Time Frame: 1 day ] [ Designated as safety issue: No ]
- Systemic hemodynamics [ Time Frame: 1 day ] [ Designated as safety issue: No ]
- Systolic, diastolic, mean, and pulse blood pressures, and heart rate
- Cardiac output, left ventricular ejection fraction, systemic vascular resistances
- Central aortic hemodynamic [ Time Frame: 1 day ] [ Designated as safety issue: No ]
- Aortic systolic, diastolic, mean and pulse pressures,
- Augmentation index
- Micro-circulation [ Time Frame: 1 day ] [ Designated as safety issue: No ]Thenar tissue oxygen saturation
- Biological markers from plasma samples [ Time Frame: 1 day ] [ Designated as safety issue: No ]
- fibrinogen
- C-reactiv protein
- Interleukin-6
- matrix metalloproteinases -2, -9, and tissue inhibitor of metalloproteinase 1
- epinephrine and norepinephrine
Biospecimen Retention: Samples Without DNA
serum
| Estimated Enrollment: | 40 |
| Study Start Date: | February 2012 |
| Estimated Study Completion Date: | May 2013 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
severe sepsis
patients with severe sepsis
|
Other: NA : non interventional study
NA : non interventional study
Other Name: NA : non interventional study
|
|
healthy volunteers
healthy volunteers matched to patients on age and sex
|
Other: NA : non interventional study
NA : non interventional study
Other Name: NA : non interventional study
|
Detailed Description:
In a model of acute inflammation induced by salmonella typhi vaccination in healthy volunteers, it has been shown that acute systemic inflammation increased arterial stiffness. Since increased arterial stiffness (assessed by carotid-femoral pulse wave velocity) is an independent prognosis marker of cardiovascular risk in many chronic diseases such as hypertension, renal failure or diabetes mellitus, it could also be a marker of severity in acute inflammation states. Severe sepsis is a leading cause of hospitalisation in intensive care units, and constitutes a state of acute inflammation. It remains however to confirm that arterial stiffness is increased in this clinical conditions before evaluating its prognosis value.
This study aims to assess the effect of severe sepsis on arterial stiffness and microcirculation. Patients with severe sepsis will be compared with age- and sex-matched healthy volunteers.
The primary outcome is the carotid-femoral pulse wave velocity. The other outcome measures are: systemic hemodynamics (systolic, diastolic, mean and pulse blood pressures, heart rate, cardiac output, left ventricular ejection fraction, systemic vascular resistances), central hemodynamics (aortic systolic, diastolic, mean and pulse pressures, and augmentation index), thenar tissue oxygen saturation, biological makers of inflammation (plasma fibrinogen, C-reactive protein, interleukin-6, matrix metalloproteinases -2, -9, tissue inhibitor of metalloproteinase 1), and plasma catecholamine concentrations (epinephrine, norepinephrine).
Eligibility| Ages Eligible for Study: | 18 Years to 40 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
20 patients with severe sepsis. 20 healthy volunteers age- and sex-matched .
Inclusion Criteria:
Group of healthy volunteers:
- male or female aged 18 to 40 years, age- and sex-matched with septic patients
- Normal clinical examination and normal 12-lead ECG
- Routines biological tests in the normal range of the laboratories.
- Body mass index between 18 and 27 kg/m²
- No smoker (for at least one year)
- Without hypertension, diabetes mellitus, dyslipidemia, or family history of premature vascular disease
- Written informed consent
Patients group :
- Male or female aged 18 to 40 years
Severe sepsis defined by the presence of:
- a systemic inflammatory response syndrome
- the evidence of an infection
- the presence of at least one organ failure or signs of tissue hypoperfusion.
- Body mass index between 18 and 27 Kg/m²
- No smoker (for at least one year)
- Without hypertension, diabetes mellitus, dyslipidemia, or family history of premature vascular disease
- Written informed consent from the patients or their relatives
Exclusion Criteria:
Healthy volunteers group:
- legal protection or persons deprived of liberty
- bacterial or viral infection in the month preceding inclusion
- current medication
- pregnancy or breastfeeding
- exclusion period stated on the national register for persons who participate to biomedical research
Patients group :
- legal protection or persons deprived of liberty
- vasopressor therapy
- bacterial or viral infection in the month preceding inclusion
- known cardiomyopathy
- pregnancy or breastfeeding
Contacts and Locations| Contact: Bruno LAVIOLLE, MD, PhD | +33-299-2896-68 | bruno.laviolle@chu-rennes.fr |
| Contact: Eric BELLISSANT, MD, PhD | +33-299-289-200 | eric.bellissant@chu-rennes.fr |
| France | |
| Unité d'Investigation Clinique - Hôpital de Pontchaillou | Recruiting |
| Rennes, France, 35033 | |
| Contact: Bruno LAVIOLLE, MD, PhD bruno.laviolle@chu-rennes.fr | |
| Principal Investigator: Bruno LAVIOLLE, MD, PhD | |
| Service de Réanimation Chirurgicale - Hôpital de Pontchaillou | Recruiting |
| Rennes, France, 35033 | |
| Contact: Bruno LAVIOLLE, MD, PhD bruno.lavioll@chu-rennes.fr | |
| Principal Investigator: Bruno LAVIOLLE, MD, PhD | |
| Sub-Investigator: Pascale LE MAGUET, MD | |
| Principal Investigator: | Bruno LAVIOLLE, MD, PhD | Rennes University Hospital |
| Study Chair: | Eric BELLISSANT, MD, PhD | Rennes University Hospital |
More Information
No publications provided
| Responsible Party: | Rennes University Hospital |
| ClinicalTrials.gov Identifier: | NCT01556373 History of Changes |
| Other Study ID Numbers: | 2010-A00612-37 |
| Study First Received: | February 23, 2012 |
| Last Updated: | December 3, 2012 |
| Health Authority: | France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) |
Keywords provided by Rennes University Hospital:
|
acute systemic inflammation arterial stiffness Carotid-femoral pulse wave velocity |
Additional relevant MeSH terms:
|
Inflammation Sepsis Pathologic Processes Infection Systemic Inflammatory Response Syndrome |
ClinicalTrials.gov processed this record on May 19, 2013