Right Ventricular FailureRVEFNCT03341208
Quantitative Assessment of RV Strain Using cMRI Following Catheter Intervention on PE
An observational study of Right Ventricular Failure and Pulmonary Embolism, run by University of Arizona.
Trial summary
Acute pulmonary embolism (PE) is a condition in which the vessels carrying blood to the lungs become suddenly blocked, usually by a blood clot. There are a number of adverse consequences that result, with one of the most significant being strain on the right side of the heart (which must push blood through the blocked… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Right Ventricular Failure, Pulmonary Embolism
- What is being tested?
- Cardiac Magnetic Resonance Imaging
- How many people
- 10 participants
- Where
- No sites listed yet
- Study dates
- 1 Dec 2017to 1 Dec 2019
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Approximately 10 patients will be recruited for the study. Participants will be patients who present to the emergency department or are inpatients in the hospital, who are found to have a diagnosis of acute pulmonary embolism (confirmed by computed tomography pulmonary angiography), and who have been referred to Interventional Radiology for evaluation for CDT. Patients appropriate for recruitment into this study will have large PEs involving lobar branches or more central segments of the pulmonary arteries. However, patients with massive PE (resulting in hemodynamic instability) will not be appropriate participants for this study.
Who may be able to join
- Participants will be patients who present to the emergency department or are inpatients in the hospital, who are found to have a diagnosis of acute pulmonary embolism (confirmed by computed tomography pulmonary angiography), and who have been referred to Interventional Radiology for evaluation for CDT. Patients appropriate for recruitment into this study will have large PEs involving lobar branches or more central segments of the pulmonary arteries.
Who cannot join
- Exclusion criteria will be limited to prisoners, pregnant women, patients for whom English or Spanish is not a first language, severe claustrophobia, and other routine contraindications for MRI. Patients with massive PE (resulting in hemodynamic instability) will not be appropriate participants for this study.
Trial locations and contacts
No sites are listed yet.
About this study
Official title: Quantitative Assessment of Right Ventricular Strain Utilizing Cardiac Magnetic Resonance Imaging: Development of an Optimal Measure of Treatment Response Following Catheter-directed Interventions on Sub-massive Pulmonary Embolism.
Acute pulmonary embolism (PE) is a condition in which the vessels carrying blood to the lungs become suddenly blocked, usually by a blood clot. There are a number of adverse consequences that result, with one of the most significant being strain on the right side of the heart (which must push blood through the blocked arteries to the lungs). Although this strain on the right heart is very important, current methods for measuring it are flawed. The standard practice is to obtain an echocardiogram (ultrasound of the heart), from which indirect measurements of the size of the heart are used to make inferences about right heart strain. This method can help guide management in some patients, but it in not a sensitive test and does not provide detailed information.
Patients with PE are treated with blood thinning medications. Some patients may be referred to the Interventional Radiology (IR) team for endovascular intervention, in which catheters are placed into the patient's vessels under radiologic guidance and advanced to the lungs to remove the clot entirely.
Read more
Cardiac magnetic resonance imaging (MRI) is a well-established imaging technique that produces highly detailed images of the heart's structure and function, with no risks to patients of ionizing radiation or intravenous contrast. Cardiac MRI is far superior to echocardiogram in evaluation of the right side of the heart, however it has not been widely used in the evaluation of patients with PE. We propose that by using a fast MRI protocol, we will be able to detect right heart strain with more accuracy than echocardiogram. Furthermore, we hypothesize that MRI images obtained before and after IR catheter-directed therapy will demonstrate the degree to which strain is relieved with this treatment. Finally, we believe that using MRI may help to guide management of patients with PE by detecting early or mild heart strain before it progresses.
In order to test these hypotheses, we plan to image PE patients who have been referred to the IR team with MRI. Patients recruited for this study will undergo two short MRI scans - one immediately before treatment, and one after completion of IR treatment (which lasts approximately 12-24 hours).
Read the detailed description
Pulmonary embolism occurs when embolic material (usually clot in the venous system) travels to the heart and lodges in the pulmonary vasculature. This obstruction, if significant, can lead to pulmonary arterial hypertension, which places increased demand on the right ventricle (RV), which must pump against the blockage. This can manifest as right ventricular dysfunction (RVD), which is characterized by dilatation of the RV, wall motion abnormalities and other structural and functional changes. There is a significant body of data demonstrating that function of the RV is an important prognostic indicator in patients with acute PE. In these studies, RVD allowed identification of patients who, although clinically stable on presentation, were at risk for hemodynamic instability and high morbidity/mortality. As a result, many authors have suggested that RVD represents an important indication for more aggressive therapy in patients with submassive PE.
Currently, echocardiography is the most commonly used method for evaluating the RV in acute PE. However, obtaining quality imaging of the RV using echocardiography is technically difficult, and determining a reliable indicator of RV function has proved challenging. A number of markers of right ventricular function have been described, including size criteria, ejection fraction, wall motion, tricuspid regurgitation, paradoxical septal motion, and others. However, there is no general consensus on which methodology or measurements produce the most clinically meaningful data. The American Heart Association guidelines for submassive pulmonary embolism use the ratio of the right ventricle to left ventricle at end diastole (RV:LV ratio), which is defined as greater than 0.9 in patients with RVD. However, there is a large degree of heterogeneity in echocardiographic criteria for RVD used in the literature.
Additionally, the quantitative data provided by echocardiography is suspect, as they show only modest correlation with cardiac magnetic resonance imaging (cMRI) or computed tomography (CT) in evaluation of the RV. Even when specifically utilizing the American Society of Echocardiography guidelines, echocardiography proves to be significantly less accurate than cMRI for evaluation of the RV, especially in patients with a dilated ventricle.
Cardiac magnetic resonance imaging is considered the reference standard for accurate evaluation of ventricular structure and function. It has proven its accuracy, reliability, and prognostic value in the setting of other pathologies that result in RV dysfunction, such as pulmonary hypertension. However, to date, this modality has not been used to provide detailed information about the structure and function of the RV in patients with acute PE.
Recently, new therapies for acute PE have come into use that allow more precise treatment of the embolus itself through the use of endovascular catheters. These catheter-directed therapies (CDTs) deliver thrombolytic medication or other treatment strategies directly to the pulmonary circulation. There is a strong body of evidence supporting the use of these therapies, and some devices have been FDA-approved for this indication. Despite this, there is a lack of definitive markers for the patients who would benefit most from this therapy. Additionally, techniques currently used to attempt to quantify response to therapy (such as RV:LV ratio) are not ideal. There remains a need for a quantitative method for evaluating the structure and function of the RV in patients with acute PE in order to determine their risk for hemodynamic compromise, the need for CDT, and response after therapy is completed.
- Conditions
- Right Ventricular Failure, Pulmonary Embolism
- Being tested
- Cardiac Magnetic Resonance Imaging
- Medical subject headings
- Heart Failure, Pulmonary Embolism
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cardiac Magnetic Resonance ImagingDiagnostic test
Cardiac MRI will be performed before and after subject has undergone catheter directed therapy
What is being measured
The primary outcome is the main question the study is designed to answer.
Measure RVEF prior to and after catheter directed therapy to remove pulmonary thromboembolus
Will predict severity of PE and identify patients that would most benefit from catheter therapy
Measured: 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Nov 2017
- Study start1 Dec 2017 (estimated)
- Primary completion1 Dec 2019 (estimated)
- Study completion1 Dec 2019 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for Right Ventricular FailureStudies of the same condition, open and under way.
- More trials run by University of ArizonaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Prospective
- Enrolment
- 10 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Arizona
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Charles Hennemeyer, University of Arizona
- Investigators
- Charles Hennemeyer, MD, Principal investigator, University of Arizona
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03341208
- Sponsor's protocol ID
- UArizonaIR
- Acronym
- RVEF
- Status last verified
- Nov 2017
- First submitted
- 7 Nov 2017
- Last updated
- 14 Nov 2017
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lualdi JC, Goldhaber SZ. Right ventricular dysfunction after acute pulmonary embolism: pathophysiologic factors, detection, and therapeutic implications. Am Heart J. 1995 Dec;130(6):1276-82. doi: 10.1016/0002-8703(95)90155-8.
PubMed 7484782Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, Conti A, Agnelli G, Berni G. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation. 2000 Jun 20;101(24):2817-22. doi: 10.1161/01.cir.101.24.2817.
PubMed 10859287Fremont B, Pacouret G, Jacobi D, Puglisi R, Charbonnier B, de Labriolle A. Prognostic value of echocardiographic right/left ventricular end-diastolic diameter ratio in patients with acute pulmonary embolism: results from a monocenter registry of 1,416 patients. Chest. 2008 Feb;133(2):358-62. doi: 10.1378/chest.07-1231. Epub 2007 Oct 20.
PubMed 17951624Cho JH, Kutti Sridharan G, Kim SH, Kaw R, Abburi T, Irfan A, Kocheril AG. Right ventricular dysfunction as an echocardiographic prognostic factor in hemodynamically stable patients with acute pulmonary embolism: a meta-analysis. BMC Cardiovasc Disord. 2014 May 6;14:64. doi: 10.1186/1471-2261-14-64.
PubMed 24884693Jurcut R, Giusca S, La Gerche A, Vasile S, Ginghina C, Voigt JU. The echocardiographic assessment of the right ventricle: what to do in 2010? Eur J Echocardiogr. 2010 Mar;11(2):81-96. doi: 10.1093/ejechocard/jep234. Epub 2010 Feb 2.
PubMed 20124362Wake N, Kumamaru KK, George E, Bedayat A, Ghosh N, Gonzalez Quesada C, Rybicki FJ, Gerhard-Herman M. Computed tomography and echocardiography in patients with acute pulmonary embolism: part 1: correlation of findings of right ventricular enlargement. J Thorac Imaging. 2014 Jan;29(1):W1-6. doi: 10.1097/RTI.0000000000000047.
PubMed 24157621Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, Kline JA, Michaels AD, Thistlethwaite P, Vedantham S, White RJ, Zierler BK; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; American Heart Association Council on Peripheral Vascular Disease; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011 Apr 26;123(16):1788-830. doi: 10.1161/CIR.0b013e318214914f. Epub 2011 Mar 21.
PubMed 21422387Pruszczyk P, Goliszek S, Lichodziejewska B, Kostrubiec M, Ciurzynski M, Kurnicka K, Dzikowska-Diduch O, Palczewski P, Wyzgal A. Prognostic value of echocardiography in normotensive patients with acute pulmonary embolism. JACC Cardiovasc Imaging. 2014 Jun;7(6):553-60. doi: 10.1016/j.jcmg.2013.11.004. Epub 2014 Jan 8.
PubMed 24412192Kjaergaard J, Petersen CL, Kjaer A, Schaadt BK, Oh JK, Hassager C. Evaluation of right ventricular volume and function by 2D and 3D echocardiography compared to MRI. Eur J Echocardiogr. 2006 Dec;7(6):430-8. doi: 10.1016/j.euje.2005.10.009. Epub 2005 Dec 9.
PubMed 16338173Lai WW, Gauvreau K, Rivera ES, Saleeb S, Powell AJ, Geva T. Accuracy of guideline recommendations for two-dimensional quantification of the right ventricle by echocardiography. Int J Cardiovasc Imaging. 2008 Oct;24(7):691-8. doi: 10.1007/s10554-008-9314-4. Epub 2008 Apr 28.
PubMed 18438737Mooij CF, de Wit CJ, Graham DA, Powell AJ, Geva T. Reproducibility of MRI measurements of right ventricular size and function in patients with normal and dilated ventricles. J Magn Reson Imaging. 2008 Jul;28(1):67-73. doi: 10.1002/jmri.21407.
PubMed 18581357van Wolferen SA, Marcus JT, Boonstra A, Marques KM, Bronzwaer JG, Spreeuwenberg MD, Postmus PE, Vonk-Noordegraaf A. Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension. Eur Heart J. 2007 May;28(10):1250-7. doi: 10.1093/eurheartj/ehl477. Epub 2007 Jan 22.
PubMed 17242010Benza R, Biederman R, Murali S, Gupta H. Role of cardiac magnetic resonance imaging in the management of patients with pulmonary arterial hypertension. J Am Coll Cardiol. 2008 Nov 18;52(21):1683-92. doi: 10.1016/j.jacc.2008.08.033.
PubMed 19007687Alunni JP, Degano B, Arnaud C, Tetu L, Blot-Souletie N, Didier A, Otal P, Rousseau H, Chabbert V. Cardiac MRI in pulmonary artery hypertension: correlations between morphological and functional parameters and invasive measurements. Eur Radiol. 2010 May;20(5):1149-59. doi: 10.1007/s00330-009-1664-3. Epub 2010 Jan 22.
PubMed 20094890Sista AK, Kearon C. Catheter-Directed Thrombolysis for Pulmonary Embolism: Where Do We Stand? JACC Cardiovasc Interv. 2015 Aug 24;8(10):1393-1395. doi: 10.1016/j.jcin.2015.06.009. No abstract available.
PubMed 26315744
Study at a glance
From the registry record, last updated by the sponsor on 14 Nov 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Quantitative Assessment of Right Ventricular Strain Utilizing Cardiac Magnetic Resonance Imaging: Development of an Optimal Measure of Treatment Response Following Catheter-directed Interventions on Sub-massive Pulmonary Embolism.
- ClinicalTrials.gov ID
- NCT03341208
- Acronym / sponsor ID
- RVEF / UArizonaIR
- Conditions
- Right Ventricular Failure, Pulmonary Embolism
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 10 participants (estimated)
- Lead sponsor
- University of ArizonaUniversity, hospital or other
- Study start
- 1 Dec 2017 (estimated)
- Primary completion
- 1 Dec 2019 (estimated)
- Study completion
- 1 Dec 2019 (estimated)
- First posted
- 14 Nov 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Acute pulmonary embolism (PE) is a condition in which the vessels carrying blood to the lungs become suddenly blocked, usually by a blood clot. There are a number of adverse consequences that result, with one of the most significant being strain on the right side of the heart (which must push blood through the blocked arteries to the lungs). Although this strain on the right heart is very important, current methods for measuring it are flawed. The standard practice is to obtain an echocardiogram (ultrasound of the heart), from which indirect measurements of the size of the heart are used to make inferences about right heart strain. This method can help guide management in some patients, but it in not a sensitive test and does not provide detailed information.
Patients with PE are treated with blood thinning medications. Some patients may be referred to the Interventional Radiology (IR) team for endovascular intervention, in which catheters are placed into the patient's vessels under radiologic guidance and advanced to the lungs to remove the clot entirely.
Cardiac magnetic resonance imaging (MRI) is a well-established imaging technique that produces highly detailed images of the heart's structure and function, with no risks to patients of ionizing radiation or intravenous contrast. Cardiac MRI is far superior to echocardiogram in evaluation of the right side of the heart, however it has not been widely used in the evaluation of patients with PE. We propose that by using a fast MRI protocol, we will be able to detect right heart strain with more accuracy than echocardiogram. Furthermore, we hypothesize that MRI images obtained before and after IR catheter-directed therapy will demonstrate the degree to which strain is relieved with this treatment. Finally, we believe that using MRI may help to guide management of patients with PE by detecting early or mild heart strain before it progresses.
In order to test these hypotheses, we plan to image PE patients who have been referred to the IR team with MRI. Patients recruited for this study will undergo two short MRI scans - one immediately before treatment, and one after completion of IR treatment (which lasts approximately 12-24 hours).
Detailed description
Pulmonary embolism occurs when embolic material (usually clot in the venous system) travels to the heart and lodges in the pulmonary vasculature. This obstruction, if significant, can lead to pulmonary arterial hypertension, which places increased demand on the right ventricle (RV), which must pump against the blockage. This can manifest as right ventricular dysfunction (RVD), which is characterized by dilatation of the RV, wall motion abnormalities and other structural and functional changes. There is a significant body of data demonstrating that function of the RV is an important prognostic indicator in patients with acute PE. In these studies, RVD allowed identification of patients who, although clinically stable on presentation, were at risk for hemodynamic instability and high morbidity/mortality. As a result, many authors have suggested that RVD represents an important indication for more aggressive therapy in patients with submassive PE.
Currently, echocardiography is the most commonly used method for evaluating the RV in acute PE. However, obtaining quality imaging of the RV using echocardiography is technically difficult, and determining a reliable indicator of RV function has proved challenging. A number of markers of right ventricular function have been described, including size criteria, ejection fraction, wall motion, tricuspid regurgitation, paradoxical septal motion, and others. However, there is no general consensus on which methodology or measurements produce the most clinically meaningful data. The American Heart Association guidelines for submassive pulmonary embolism use the ratio of the right ventricle to left ventricle at end diastole (RV:LV ratio), which is defined as greater than 0.9 in patients with RVD. However, there is a large degree of heterogeneity in echocardiographic criteria for RVD used in the literature.
Additionally, the quantitative data provided by echocardiography is suspect, as they show only modest correlation with cardiac magnetic resonance imaging (cMRI) or computed tomography (CT) in evaluation of the RV. Even when specifically utilizing the American Society of Echocardiography guidelines, echocardiography proves to be significantly less accurate than cMRI for evaluation of the RV, especially in patients with a dilated ventricle.
Cardiac magnetic resonance imaging is considered the reference standard for accurate evaluation of ventricular structure and function. It has proven its accuracy, reliability, and prognostic value in the setting of other pathologies that result in RV dysfunction, such as pulmonary hypertension. However, to date, this modality has not been used to provide detailed information about the structure and function of the RV in patients with acute PE.
Recently, new therapies for acute PE have come into use that allow more precise treatment of the embolus itself through the use of endovascular catheters. These catheter-directed therapies (CDTs) deliver thrombolytic medication or other treatment strategies directly to the pulmonary circulation. There is a strong body of evidence supporting the use of these therapies, and some devices have been FDA-approved for this indication. Despite this, there is a lack of definitive markers for the patients who would benefit most from this therapy. Additionally, techniques currently used to attempt to quantify response to therapy (such as RV:LV ratio) are not ideal. There remains a need for a quantitative method for evaluating the structure and function of the RV in patients with acute PE in order to determine their risk for hemodynamic compromise, the need for CDT, and response after therapy is completed.
Study design
- Observational model
- Case only
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Approximately 10 patients will be recruited for the study. Participants will be patients who present to the emergency department or are inpatients in the hospital, who are found to have a diagnosis of acute pulmonary embolism (confirmed by computed tomography pulmonary angiography), and who have been referred to Interventional Radiology for evaluation for CDT. Patients appropriate for recruitment into this study will have large PEs involving lobar branches or more central segments of the pulmonary arteries. However, patients with massive PE (resulting in hemodynamic instability) will not be appropriate participants for this study.
Key inclusion criteria (1 listed)
- Participants will be patients who present to the emergency department or are inpatients in the hospital, who are found to have a diagnosis of acute pulmonary embolism (confirmed by computed tomography pulmonary angiography), and who have been referred to Interventional Radiology for evaluation for CDT. Patients appropriate for recruitment into this study will have large PEs involving lobar branches or more central segments of the pulmonary arteries.
Key exclusion criteria (1 listed)
- Exclusion criteria will be limited to prisoners, pregnant women, patients for whom English or Spanish is not a first language, severe claustrophobia, and other routine contraindications for MRI. Patients with massive PE (resulting in hemodynamic instability) will not be appropriate participants for this study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cardiac Magnetic Resonance ImagingCardiac MRI will be performed before and after subject has undergone catheter directed therapy | Diagnostic test | – |
Primary outcome
Measure RVEF prior to and after catheter directed therapy to remove pulmonary thromboembolus
Time frame: 2 years
Will predict severity of PE and identify patients that would most benefit from catheter therapy
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Nov 2017.
- Background: PubMed 7484782Lualdi JC, Goldhaber SZ. Right ventricular dysfunction after acute pulmonary embolism: pathophysiologic factors, detection, and therapeutic implications. Am Heart J. 1995 Dec;130(6):1276-82. doi: 10.1016/0002-8703(95)90155-8.
- Background: PubMed 10859287Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, Conti A, Agnelli G, Berni G. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation. 2000 Jun 20;101(24):2817-22. doi: 10.1161/01.cir.101.24.2817.
- Background: PubMed 17951624Fremont B, Pacouret G, Jacobi D, Puglisi R, Charbonnier B, de Labriolle A. Prognostic value of echocardiographic right/left ventricular end-diastolic diameter ratio in patients with acute pulmonary embolism: results from a monocenter registry of 1,416 patients. Chest. 2008 Feb;133(2):358-62. doi: 10.1378/chest.07-1231. Epub 2007 Oct 20.
- Background: PubMed 24884693Cho JH, Kutti Sridharan G, Kim SH, Kaw R, Abburi T, Irfan A, Kocheril AG. Right ventricular dysfunction as an echocardiographic prognostic factor in hemodynamically stable patients with acute pulmonary embolism: a meta-analysis. BMC Cardiovasc Disord. 2014 May 6;14:64. doi: 10.1186/1471-2261-14-64.
- Background: PubMed 20124362Jurcut R, Giusca S, La Gerche A, Vasile S, Ginghina C, Voigt JU. The echocardiographic assessment of the right ventricle: what to do in 2010? Eur J Echocardiogr. 2010 Mar;11(2):81-96. doi: 10.1093/ejechocard/jep234. Epub 2010 Feb 2.
- Background: PubMed 24157621Wake N, Kumamaru KK, George E, Bedayat A, Ghosh N, Gonzalez Quesada C, Rybicki FJ, Gerhard-Herman M. Computed tomography and echocardiography in patients with acute pulmonary embolism: part 1: correlation of findings of right ventricular enlargement. J Thorac Imaging. 2014 Jan;29(1):W1-6. doi: 10.1097/RTI.0000000000000047.
- Background: PubMed 21422387Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, Kline JA, Michaels AD, Thistlethwaite P, Vedantham S, White RJ, Zierler BK; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; American Heart Association Council on Peripheral Vascular Disease; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011 Apr 26;123(16):1788-830. doi: 10.1161/CIR.0b013e318214914f. Epub 2011 Mar 21.
- Background: PubMed 24412192Pruszczyk P, Goliszek S, Lichodziejewska B, Kostrubiec M, Ciurzynski M, Kurnicka K, Dzikowska-Diduch O, Palczewski P, Wyzgal A. Prognostic value of echocardiography in normotensive patients with acute pulmonary embolism. JACC Cardiovasc Imaging. 2014 Jun;7(6):553-60. doi: 10.1016/j.jcmg.2013.11.004. Epub 2014 Jan 8.
- Background: PubMed 16338173Kjaergaard J, Petersen CL, Kjaer A, Schaadt BK, Oh JK, Hassager C. Evaluation of right ventricular volume and function by 2D and 3D echocardiography compared to MRI. Eur J Echocardiogr. 2006 Dec;7(6):430-8. doi: 10.1016/j.euje.2005.10.009. Epub 2005 Dec 9.
- Background: PubMed 18438737Lai WW, Gauvreau K, Rivera ES, Saleeb S, Powell AJ, Geva T. Accuracy of guideline recommendations for two-dimensional quantification of the right ventricle by echocardiography. Int J Cardiovasc Imaging. 2008 Oct;24(7):691-8. doi: 10.1007/s10554-008-9314-4. Epub 2008 Apr 28.
- Background: PubMed 18581357Mooij CF, de Wit CJ, Graham DA, Powell AJ, Geva T. Reproducibility of MRI measurements of right ventricular size and function in patients with normal and dilated ventricles. J Magn Reson Imaging. 2008 Jul;28(1):67-73. doi: 10.1002/jmri.21407.
- Background: PubMed 17242010van Wolferen SA, Marcus JT, Boonstra A, Marques KM, Bronzwaer JG, Spreeuwenberg MD, Postmus PE, Vonk-Noordegraaf A. Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension. Eur Heart J. 2007 May;28(10):1250-7. doi: 10.1093/eurheartj/ehl477. Epub 2007 Jan 22.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Charles Hennemeyer, MD principal investigator
University of Arizona
Questions about this trial
What is this clinical trial studying?
An observational study of Right Ventricular Failure and Pulmonary Embolism, run by University of Arizona.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 14 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Shannon Urbina, BS (520-626-7500, Shannon.Urbina@bannerhealth.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Measure RVEF prior to and after catheter directed therapy to remove pulmonary thromboembolus (time frame: 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03341208, which also lists 18 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Nov 2017.