Revisit the Value of Imaging in Best Using CArdiac Resynchronization Therapy

NCT ID: NCT02528032

Last Updated: 2023-05-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2018-09-30

Brief Summary

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Many studies have shown the benefits of cardiac resynchronization therapy (CRT) with biventricular pacing in patients with heart failure with left ventricular dysfunction. CRT restores contraction coordination between different regions of the left ventricle, which yields a significant improvement in LV systolic function, symptoms, exercise tolerance and quality of life. In the longer term, treatment with resynchronization induces a reverse remodeling of the left ventricle and a decrease in mortality and morbidity (hospitalization for heart failure). Nevertheless, even if a majority of patients treated with CRT feel the benefit, some (up to 40% depending on the response criteria of CRT) do not experience significant improvement (nonresponders). Echocardiography and imaging have not so far demonstrated their added value to optimize delivery of CRT. Monocentric promising work on limited numbers of patients, however, were carried out. Meanwhile, equipment for delivering CRT evolves and new probes with four poles stimulation of the left ventricle are now used. The objective of this research is to validate new sequences of ultrasound processing estimating the CRT. These tools are based on usual echocardiographic examination of patients

Detailed Description

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Pilot study for testing tools pre and post-treatment images echocardiography but also MRI with a descriptive purpose and identification of the computed parameters should be secondarily test a large multicenter cohort . Patients in the study will be explored in RICART preimplantation as then in the manner used in current clinical routine. The use of data by cons will focus on the study of new tools ever compared in the same patients.

Data echocardiography (as with other techniques) are those used in clinical routine. Then, the data processing to be carried characterized the asynchrony posteriori, regardless of initial clinical data on a dedicated search software. Each quantitative parameter will be compared with others in order to predict the response to resynchronization. Response prediction of threshold values to the resynchronization can be obtained and compared to each of the tools. The value of relative and an addition to another may be tested.

The predictive value of the change (delta) of each parameter between the pre- and post-implantation to predict response to al resynchronization, will be evaluated.

Conditions

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Cardiac Resynchronization Therapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Echocardiographic evaluation

Echocardiographic evaluation of heart function with new processing tools

Group Type OTHER

Echographic evaluation of heart function

Intervention Type OTHER

Echocardiographic data collection and analysis, not fully exploited at present

Interventions

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Echographic evaluation of heart function

Echocardiographic data collection and analysis, not fully exploited at present

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Any patient with sinus rhythm sent to hospital for a cardiac resynchronization according to ESC criteria and implanted with a left ventricular pacing lead quadrupole

Exclusion Criteria

* Patients with an acoustic window is incompatible with the accurate echographic assessment of heart function
* Patients with spontaneous one year prognosis is not dependent on his heart or another disease to the forefront (eg neoplasia)
* Contra-indications to MRI (pacemaker or implantable defibrillator, intracranial ferromagnetic surgical clips, cochlear implants, intraocular metallic foreign body, Starr-Edwards heart valve prosthesis pre 6000, biomedical device type pump insulin or neurostimulator) or against -indications to iodinated contrast injection (severe renal impairment, allergy).
* Patient not giving free and informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rennes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Erwan Donal, MD/PH/Prof

Role: PRINCIPAL_INVESTIGATOR

Rennes UH

Locations

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CHU Pontchaillou

Rennes, , France

Site Status

Countries

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France

References

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Galli E, Le Rolle V, Smiseth OA, Duchenne J, Aalen JM, Larsen CK, Sade EA, Hubert A, Anilkumar S, Penicka M, Linde C, Leclercq C, Hernandez A, Voigt JU, Donal E. Importance of Systematic Right Ventricular Assessment in Cardiac Resynchronization Therapy Candidates: A Machine Learning Approach. J Am Soc Echocardiogr. 2021 May;34(5):494-502. doi: 10.1016/j.echo.2020.12.025. Epub 2021 Jan 7.

Reference Type RESULT
PMID: 33422667 (View on PubMed)

Aalen JM, Donal E, Larsen CK, Duchenne J, Lederlin M, Cvijic M, Hubert A, Voros G, Leclercq C, Bogaert J, Hopp E, Fjeld JG, Penicka M, Linde C, Aalen OO, Kongsgard E, Galli E, Voigt JU, Smiseth OA. Imaging predictors of response to cardiac resynchronization therapy: left ventricular work asymmetry by echocardiography and septal viability by cardiac magnetic resonance. Eur Heart J. 2020 Oct 14;41(39):3813-3823. doi: 10.1093/eurheartj/ehaa603.

Reference Type RESULT
PMID: 32918449 (View on PubMed)

Donal E, Hubert A, Le Rolle V, Leclercq C, Martins R, Mabo P, Galli E, Hernandez A. New Multiparametric Analysis of Cardiac Dyssynchrony: Machine Learning and Prediction of Response to CRT. JACC Cardiovasc Imaging. 2019 Sep;12(9):1887-1888. doi: 10.1016/j.jcmg.2019.03.009. Epub 2019 Apr 17. No abstract available.

Reference Type RESULT
PMID: 31005538 (View on PubMed)

Galli E, Hubert A, Le Rolle V, Hernandez A, Smiseth OA, Mabo P, Leclercq C, Donal E. Myocardial constructive work and cardiac mortality in resynchronization therapy candidates. Am Heart J. 2019 Jun;212:53-63. doi: 10.1016/j.ahj.2019.02.008. Epub 2019 Mar 4.

Reference Type RESULT
PMID: 30951976 (View on PubMed)

Donal E, Galli E, Cosyns B. Twenty years after starting cardiac resynchronization therapy, do we understand the electromechanical coupling? Eur Heart J Cardiovasc Imaging. 2019 Mar 1;20(3):257-259. doi: 10.1093/ehjci/jey152. No abstract available.

Reference Type RESULT
PMID: 30371762 (View on PubMed)

Galli E, Leclercq C, Hubert A, Bernard A, Smiseth OA, Mabo P, Samset E, Hernandez A, Donal E. Role of myocardial constructive work in the identification of responders to CRT. Eur Heart J Cardiovasc Imaging. 2018 Sep 1;19(9):1010-1018. doi: 10.1093/ehjci/jex191.

Reference Type RESULT
PMID: 28954293 (View on PubMed)

Galli E, Leclercq C, Fournet M, Hubert A, Bernard A, Smiseth OA, Mabo P, Samset E, Hernandez A, Donal E. Value of Myocardial Work Estimation in the Prediction of Response to Cardiac Resynchronization Therapy. J Am Soc Echocardiogr. 2018 Feb;31(2):220-230. doi: 10.1016/j.echo.2017.10.009. Epub 2017 Dec 13.

Reference Type RESULT
PMID: 29246513 (View on PubMed)

Other Identifiers

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35RC14-9767

Identifier Type: -

Identifier Source: org_study_id

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