Investigation of Dysynchrony in Patients With Pulmonary Hypertension
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Purpose
The purpose of the study is to determine whether patients with pulmonary hypertension (PH) have dysynchrony, and if so whether it is electrical or mechanical. Once this has been determined, during a catheterization the investigators will test if pacing the heart improves blood circulation.
| Condition | Intervention |
|---|---|
|
Pulmonary Hypertension |
Procedure: Catheterization Pacing |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control |
| Official Title: | Investigation of Dysynchrony in Patients With Pulmonary Hypertension |
| Estimated Enrollment: | 100 |
| Study Start Date: | September 2006 |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Study
Patients with pulmonary hypertension.
|
Procedure: Catheterization Pacing
The second part of the study will include patients with pulmonary hypertension >5 who are scheduled for a cardiac catheterization for clinical reasons. We will at the conclusion of the routine catheterization, place two pacing catheters within the right atrium and right ventricle and pace the heart at a rate approximately 10% higher than sinus rhythm for 5 minutes. We will then measure dP/dT max in the ventricles, blood pressure and cardiac output using a Fick equation to assess hemodynamics. We will repeat this 3 times using different sites in the right ventricle while simultaneously obtaining echoes to assess mechanical synchrony.
|
|
Control
ASD patients or patients with normal hearts
|
Detailed Description:
This is a two part study of ventricular dysynchrony in patients with pulmonary hypertension. The first part is an observational study, reviewing routinely obtained clinical information (such as echocardiograms) to assess whether patients with pulmonary hypertension have electrical or mechanical dysynchrony. If so, we will proceed to the second part of the study which will assess whether temporarily pacing the right ventricle, during a clinically indicated catheterization can acutely improve hemodynamics. We will also gather control data for phase 1 from clinically indicated echos and ECG's in patients with ASD's (RV volume load) and in patients who are evaluated for an innocent murmur ( Nl heart). We hope to learn whether patients with pulmonary hypertension, and compromised right ventricles have electrical and mechanical dysnchrony. If this is true, it is theoretically possible that resynchronization (pacing) of the right ventricle could improve hemodynamics, symptoms and long term outcomes.
Eligibility| Ages Eligible for Study: | 5 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients will be approached during their routine pulmonary hypertension clinic visit.
Inclusion Criteria:
- Pulmonary artery mean pressure at rest of 25 mm Hg
- Controls (for phase 2) Patients undergoing transcatheter closure of secundum ASD Patients undergoing echocardiogram and ECG as part of work-up for functional murmur who have normal intracardiac anatomy
Exclusion Criteria:
- Reversible cause of pulmonary hypertension
- Age < 5 yrs (for phase 2)
Contacts and Locations| Contact: Jeffrey Feinstein, MD, MPH | 660-723-7913 | jeff.feinstein@stanford.edu |
| United States, California | |
| Stanford Hospital | Recruiting |
| Stanford, California, United States, 94305 | |
| Contact: Jeffrey Feinstein, MD, MPH 650-723-7913 jeff.feinstein@stanford.edu | |
More Information
No publications provided
| Responsible Party: | Stanford University |
| ClinicalTrials.gov Identifier: | NCT01571700 History of Changes |
| Other Study ID Numbers: | DS6901 |
| Study First Received: | April 3, 2012 |
| Last Updated: | April 4, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Stanford University:
|
Mechanical Dysynchrony Electrical Dysynchrony |
Additional relevant MeSH terms:
|
Hypertension Hypertension, Pulmonary Vascular Diseases |
Cardiovascular Diseases Lung Diseases Respiratory Tract Diseases |
ClinicalTrials.gov processed this record on May 23, 2013