Trial Outcomes & Findings for Non-Invasive Diagnosis of Pulmonary Vascular Disease Using Inhaled 129Xe Magnetic Resonance Imaging (NCT NCT03078192)

NCT ID: NCT03078192

Last Updated: 2022-02-22

Results Overview

Determine diagnostic accuracy of XeMRI compared to the gold standard of hemodynamic and clinical criteria of pulmonary arterial hypertension (Hemodynamic criteria: mean pulmonary artery pressure \> 20 mmHg, pulmonary arterial wedge pressure ≤ 15 mmHg, and pulmonary vascular resistance ≥ 3 Wood units; Clinical criteria: absence of significant systolic dysfunction (LVEF \> 40%) or valvular heart disease (moderate or greater mitral or aortic valve disease); absence of significant obstructive or restrictive lung disease; absence of hypoxemic or hypercarbic respiratory failure; absence of chronic thromboembolic disease; absence of sickle cell anemia or other hemolytic anemias; absence of sarcoidosis). We used data from Arm 1 (the training set of patients with known pulmonary vascular disease (PVD), isolated left heart disease and lung disease) to determine thresholds for precapillary pulmonary hypertension used for diagnosis in Arm 2 (the test set of pulmonary vascular disease).

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

62 participants

Primary outcome timeframe

up to 2 weeks

Results posted on

2022-02-22

Participant Flow

Patients with PAH, CTEPH, left heart disease and lung disease will be recruited using inclusion/exclusion criteria. For the first phase of the study, whether patients are receiving approved therapies, enrolled in clinical trials, or receiving no therapy, all will be eligible for inclusion in this study. For the 2nd phase of the study, patients who have PAH and receiving approved therapies, patients who are being evaluated for PVD or other cardiac/pulmonary diseases will be included in the study.

Participant milestones

Participant milestones
Measure
PVD, Left Heart Disease, Lung Disease
The study team recruited 30 subjects. Patients with Pulmonary Vascular Disease (10 subjects), isolated left-sided heart failure (10 subjects), and isolated lung disease(10 subjects) will undergo Xe MRI scans with GE-141, Hyperpolarized 129Xenon gas to develop diagnostic criteria for optimizing the sensitivity and specificity of XeMRI for the diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Pulmonary Vascular Disease
the study team recuited 32 subjects being evaluated for undergoing right heart catheterization for evaluation of PAH or other cardiac or pulmonary disease for testing of diagnostic accuracy of XeMRI for diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Overall Study
STARTED
30
32
Overall Study
COMPLETED
28
28
Overall Study
NOT COMPLETED
2
4

Reasons for withdrawal

Reasons for withdrawal
Measure
PVD, Left Heart Disease, Lung Disease
The study team recruited 30 subjects. Patients with Pulmonary Vascular Disease (10 subjects), isolated left-sided heart failure (10 subjects), and isolated lung disease(10 subjects) will undergo Xe MRI scans with GE-141, Hyperpolarized 129Xenon gas to develop diagnostic criteria for optimizing the sensitivity and specificity of XeMRI for the diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Pulmonary Vascular Disease
the study team recuited 32 subjects being evaluated for undergoing right heart catheterization for evaluation of PAH or other cardiac or pulmonary disease for testing of diagnostic accuracy of XeMRI for diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Overall Study
Withdrawal by Subject
2
1
Overall Study
screen failure
0
3

Baseline Characteristics

Non-Invasive Diagnosis of Pulmonary Vascular Disease Using Inhaled 129Xe Magnetic Resonance Imaging

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
PVD, Left Heart Disease, Lung Disease
n=30 Participants
Patients with Pulmonary Vascular Disease (10 subjects), isolated left-sided heart failure (10 subjects), and isolated lung disease(10 subjects) will undergo Xe MRI scans with GE-141, Hyperpolarized 129Xenon gas to develop diagnostic criteria for optimizing the sensitivity and specificity of XeMRI for the diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Pulmonary Vascular Disease
n=32 Participants
92 subjects being evaluated for undergoing right heart catheterization for evaluation of PAH or other cardiac or pulmonary disease for testing of diagnostic accuracy of XeMRI for diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Total
n=62 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
22 Participants
n=5 Participants
21 Participants
n=7 Participants
43 Participants
n=5 Participants
Age, Categorical
>=65 years
8 Participants
n=5 Participants
11 Participants
n=7 Participants
19 Participants
n=5 Participants
Sex: Female, Male
Female
13 Participants
n=5 Participants
20 Participants
n=7 Participants
33 Participants
n=5 Participants
Sex: Female, Male
Male
17 Participants
n=5 Participants
12 Participants
n=7 Participants
29 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
29 Participants
n=5 Participants
31 Participants
n=7 Participants
60 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 Participants
n=5 Participants
Race (NIH/OMB)
White
24 Participants
n=5 Participants
23 Participants
n=7 Participants
47 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants

PRIMARY outcome

Timeframe: up to 2 weeks

Determine diagnostic accuracy of XeMRI compared to the gold standard of hemodynamic and clinical criteria of pulmonary arterial hypertension (Hemodynamic criteria: mean pulmonary artery pressure \> 20 mmHg, pulmonary arterial wedge pressure ≤ 15 mmHg, and pulmonary vascular resistance ≥ 3 Wood units; Clinical criteria: absence of significant systolic dysfunction (LVEF \> 40%) or valvular heart disease (moderate or greater mitral or aortic valve disease); absence of significant obstructive or restrictive lung disease; absence of hypoxemic or hypercarbic respiratory failure; absence of chronic thromboembolic disease; absence of sickle cell anemia or other hemolytic anemias; absence of sarcoidosis). We used data from Arm 1 (the training set of patients with known pulmonary vascular disease (PVD), isolated left heart disease and lung disease) to determine thresholds for precapillary pulmonary hypertension used for diagnosis in Arm 2 (the test set of pulmonary vascular disease).

Outcome measures

Outcome measures
Measure
Training Set - PVD, Isolated Left Heart Disease, Lung Disease
n=30 Participants
The study recruited 30 subjects being evaluated for undergoing right heart catheterization for evaluation of PAH or other cardiac or pulmonary disease for testing of diagnostic accuracy of XeMRI for diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Test Set - Pulmonary Vascular Disease
n=32 Participants
The study recruited 32 subjects being evaluated for undergoing right heart catheterization for evaluation of PAH or other cardiac or pulmonary disease for testing of diagnostic accuracy of XeMRI for diagnosis of PVD GE-141, Hyperpolarized 129Xenon gas: XeMRI scans will provide 3D images of ventilation and gas exchange. Subjects will inhale HP 129Xe from the dose delivery bags. Then the subject will be moved into the scanner and they will undergo basic 1H localizer and anatomical scans. Once localization is complete, subjects will under-go several MRI scans after inhalation of HPXe MRI: Perform MRI scans with administration of GE-141, Hyperpolarized 129Xenon
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Right Heart Cath · Pre-capillary pulmonary hypertension
10 Participants
15 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Right Heart Cath · Isolated post-capillary pulmonary hypertension
10 Participants
5 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Right Heart Cath · Combined pre- and post-capillary pulmonary hypertension
0 Participants
3 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Right Heart Cath · Pulmonary hypertension (not pre or post)
0 Participants
2 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Right Heart Cath · No pulmonary hypertension
10 Participants
7 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Xenon MRI scan · Pre-capillary pulmonary hypertension
10 Participants
18 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Xenon MRI scan · Isolated post-capillary pulmonary hypertension
10 Participants
8 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Xenon MRI scan · Combined pre- and post-capillary pulmonary hypertension
0 Participants
0 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Xenon MRI scan · Pulmonary hypertension (not pre or post)
0 Participants
0 Participants
Participants Determined to be True Positives for Pulmonary Arterial Hypertension
By Xenon MRI scan · No pulmonary hypertension
10 Participants
6 Participants

Adverse Events

PVD, Left Heart Disease, Lung Disease

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Pulmonary Vascular Disease

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Bastiaan Driehuys

Duke University Medical Center

Phone: 919-684-7786

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place