Imaging Assessment of Diastolic Function
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Purpose
Diastolic function is poorly studied in children with congenital heart disease. This is mainly due to the lack of validated techniques. Cardiac MRI offers two advantages compared to echocardiography: 1. accurate measurements of ventricular volumes and mass; 2. tissue characterization. The main advantage of echocardiography is a better temporal resolution which allows the study of short events like early relaxation. Overall there is a lack of studies correlating different echocardiographic and MRI parameters of heart function in pediatric populations with congenital or acquired heart diseases. This study will address specific questions on specific groups of patients that might bring more insight into chamber interaction and cardiac function. This study hypothesizes the following:
- Atrial enlargement is a marker of chronic increase in filling pressures and 3D echo might be the best method for follow-up.
- Cardiac remodeling associated with chronic loading results in changes in diastolic properties related to changes in cardiac mass and volume. This is related to changes in cardiac mechanics influencing diastolic parameters. Especially the influence on twisting and untwisting will be studied.
- Regional myocardial fibrosis and scarring may account for regional systolic and diastolic dysfunction with possible prognostic impact
| Condition | Intervention | Phase |
|---|---|---|
|
Congenital Heart Disease |
Procedure: Echocardiograph Procedure: Magnetic Resonance Imaging (MRI) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | Combined Echocardiographic and MRI Assessment of Diastolic Function in Patients With Congenital Heart Disease |
- Atrial Volumes [ Time Frame: Day 1 ] [ Designated as safety issue: No ]Measure right and left atrial volumes by 2D and 3D echo and correlate the different echocardiographic measurements with MRI. This will allow identifying the most accurate measurement which can be used in clinical practice.
- Assess Ventricular Volumes [ Time Frame: Day 1 ] [ Designated as safety issue: No ]Assess ventricular volumes and mass and calculate mass/volume ratio. Study the effect of ventricular remodeling on myocardial mechanics especially twisting and untwisting. Relate these changes to evaluation of diastolic function.
- Myocardial Scarring [ Time Frame: Day 1 ] [ Designated as safety issue: No ]Assess the presence of myocardial scarring in specific populations with congenital heart disease and correlate the findings with regional and global systolic and diastolic dysfunction.
| Estimated Enrollment: | 200 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | December 2015 |
| Estimated Primary Completion Date: | December 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Magnetic Resonance Imaging (MRI)
Subjects with congenital heart disease will undergo an echocardiograph, as well as an MRI.
|
Procedure: Echocardiograph Procedure: Magnetic Resonance Imaging (MRI) |
|
Experimental: Echocardiograph
Subjects with congenital heart disease will undergo an echocardiograph, as well as an MRI.
|
Procedure: Echocardiograph Procedure: Magnetic Resonance Imaging (MRI) |
Eligibility| Ages Eligible for Study: | up to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- All patients with tetralogy of Fallot post repair, transposition of great arteries after arterial switch operation, aortic valvulopathy (aortic stenosis and aortic regurgitation), coarctation of the aorta and cardiomyopathy, who are planned to undergo a cardiac MRI will be eligible.
- Informed consent
Exclusion Criteria:
- Lack of informed consent
- Need for general anesthesia
- Similar contraindications as for a clinical MRI study apply.
Contacts and Locations| Contact: Luc Mertens, MD | (416)813-7418 | luc.mertens@sickkids.ca |
| Canada, Ontario | |
| The Hospital for Sick Children | Recruiting |
| Toronto, Ontario, Canada, M5G 1X8 | |
| Contact: Luc Mertens, MD (416)813-7418 luc.mertens@sickkids.ca | |
| Principal Investigator: Luc Mertens, MD | |
| Sub-Investigator: Andreea Dragulescu, MD | |
| Sub-Investigator: Lars Grosse-Wortmann, MD | |
| Sub-Investigator: Shi-Joon Yoo, MD | |
| Sub-Investigator: Edgar Jaeggi, MD | |
| Sub-Investigator: Mark Friedberg, MD | |
| Principal Investigator: | Luc Mertens, MD | The Hospital for Sick Children |
More Information
No publications provided
| Responsible Party: | The Hospital for Sick Children |
| ClinicalTrials.gov Identifier: | NCT01668264 History of Changes |
| Other Study ID Numbers: | 1000017963 |
| Study First Received: | August 13, 2012 |
| Last Updated: | August 14, 2012 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by The Hospital for Sick Children:
|
Pediatrics Congenital Heart Disease Diastolic Function Echocardiograph MRI |
Additional relevant MeSH terms:
|
Heart Diseases Heart Defects, Congenital Cardiovascular Diseases Cardiovascular Abnormalities Congenital Abnormalities |
ClinicalTrials.gov processed this record on May 16, 2013