Non-invasive haemodynamics to probe physiology and echocardiographic dyssynchrony in chronic heart failure

ISRCTN ISRCTN74789510
DOI https://doi.org/10.1186/ISRCTN74789510
Secondary identifying numbers 7356
Submission date
29/04/2010
Registration date
29/04/2010
Last edited
11/08/2014
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Punam Pabari
Scientific

59 North Wharf Road
London
W2 1LA
United Kingdom

Study information

Study designNon-randomised interventional process of care treatment trial
Primary study designInterventional
Secondary study designNon randomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific title
Study acronymDRN 374 (V3E)
Study objectivesPatients with heart failure and pre-existing cardiac resynchronisation therapy (biventricular pacemakers) will be recruited from the pacemaker and heart failure clinics of our institution. Patients will be positioned on the couch. Continuous blood pressure monitoring will be undertaken on a beat by beat basis using the Finapres® device, and electrocardiogram (ECG) recordings will be made simultaneously. Data analysis will occur off line after measurements have been taken.

Hypothesis 1:
The patient will have the pacemaker settings altered while undergoing simultaneous measurements of 3D echo and blood pressure monitoring. These will be taken for 10 consecutive beats before and after the change in the pacemaker setting. The AV delay will be kept constant throughout. Analysis of data will occur offline once measurements are acquired. We will identify whether stroke volume measured in this way provides a reliable method for measuring the best interventricular delay when compared to non-invasive blood pressure.

Hypothesis 2:
We will identify the VV delays (pacemaker settings) giving the smallest amount of intraventricular dyssynchrony, hence allowing the most coordinated contraction by: 2.1. 2-segment TDI echo
2.2. On 12-segment 3D model

2-segment dyssynchrony measurements will be taken using pulse wave Doppler from the septum and lateral wall. 12-segment dyssynchrony measurements will be taken from the septal, lateral, anteroseptal, posterior, anterior and inferior regions at two different levels. The average of 5 measurements for each setting will be used. After offline analysis, the patient will return on a subsequent visit for haemodynamic comparison of the two echocardiographically optimal VV delays, by performing multiple transitions between the two optima while recording non-invasive blood pressure.
Ethics approval(s)MREC approved, ref: 08/H0708/5
Health condition(s) or problem(s) studiedTopic: Diabetes Research Network; Subtopic: Type 2; Disease: Cardiovascular disease
InterventionPatients are recruited and pacemaker settings are changed. Echocardiographic measurements are taken multiple times at each setting and the optimal for each parameter identified.

Study entry: registration only
Intervention typeOther
Primary outcome measureThe optimal pacemaker setting from echo techniques is compared against our gold standard (BP).
Secondary outcome measuresNot provided at time of registration
Overall study start date01/12/2008
Completion date01/12/2011

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 60; UK Sample Size: 60
Key inclusion criteria1. Aged 18 years or above, either sex
2. Ejection fraction less than 40%
3. Biventricular pacemaker in situ
Key exclusion criteria1. Poor lead position
2. Pure diastolic dysfunction in the absence of systolic dysfunction
3. Decompensated heart failure
Date of first enrolment01/12/2008
Date of final enrolment01/12/2011

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

59 North Wharf Road
London
W2 1LA
United Kingdom

Sponsor information

Imperial College Healthcare NHS Trust (UK)
Hospital/treatment centre

International Centre for Circulatory Health
59 North Wharf Road
London
W2 1LA
England
United Kingdom

Website http://www.imperial.nhs.uk/
ROR logo "ROR" https://ror.org/056ffv270

Funders

Funder type

Charity

British Heart Foundation (BHF) (UK)
Private sector organisation / Trusts, charities, foundations (both public and private)
Alternative name(s)
the_bhf, The British Heart Foundation, BHF
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan