Assessment of Lesion-Associated Myocardial Ischemia Based on Fusion Coronary CT Imaging
NCT ID: NCT04680689
Last Updated: 2023-02-14
Study Results
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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COMPLETED
100 participants
OBSERVATIONAL
2021-07-30
2023-01-01
Brief Summary
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Moreover the study will investigate the correlation between morphology and composition of atheromatous plaques located in a coronary artery and myocardial ischemia in the territory irrigated by the same coronary artery.
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Detailed Description
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The study will include 100 subjects with coronary lesions depicted by CCTA examination. The study population will consist in: (1) patients with anatomically significant coronary lesions (at least 50% luminal narrowing) on native coronary arteries, or (2) patients surviving an acute myocardial infarction, revascularized or not. In all patients, presence of vulnerability features in the atheromatous plaques will be studied and the vulnerability score will be calculated for each plaque, consisting in one point added for each of the following vulnerability markers: positive remodeling, napkin-rink sign, presence of low density plaque or spotty calcium within the plaque. In addition, following 3D fusion of the images of the coronary tree with the images reflecting wall motion, the correspondence between plaque morphology and composition on one hand, and wall motion in the corresponding distribution territory of that coronary artery, will be studied based on fused models.
The study will be conducted over a period of 2 years, in which patients will be examined at baseline, with a projected recruitment period of 1 year and will be followed-up 1 year for MACE.
Study objectives:
Primary: to investigate the impact of a coronary artery stenosis on myocardial function and viability, based on advanced fusion imaging techniques derived from CCTA.
Secondary: to investigate the correlation between morphology and composition of atheromatous plaques located in a coronary artery and myocardial ischemia in the territory irrigated by the same coronary artery.
Study timeline:
• Baseline (day 0)-Obtain and document consent from participant on study consent form.
Verify inclusion/exclusion criteria. Obtain demographic information, medical history, medication history, alcohol and tobacco use history. Record results of physical examinations and 12-lead ECG.Collect blood specimens (complete blood count, biochemistry and inflammatory biomarkers).Imaging procedures: CCTA-Image processing - quantification of coronary stenosis, characterization of vulnerability markers, 3D reconstruction, extension and characterization of wall motion. Deliver fused 3D images
• Visit 1 (month 1)-Record results of physical examinations, 12-lead ECG, blood pressure, and medical history. MACE assessment Visit 2 (month 3) -Telephone visit with target questions, all the answers recorded in study forms Visit 3 (month 6) - Record results of physical examinations, 12-lead ECG, blood pressure, and medical history. MACE assessment
Final study visit (month 12)- Record results of physical examinations, medical history,12-lead ECG, blood pressure, transthoracic 2-D echocardiography. End-point and MACE evaluation.
Study procedures:
* Medical history, clinical examination, laboratory tests (complete blood count, biochemistry, inflammatory biomarkers: hs-CRP, MMP, IL6 and NT-pro-BNP);
* 12-lead ECG
* 2D transthoracic echocardiography
* CCTA
* Computerized postprocessing and fused images
Data collection:
All the information will be collected in a dedicated database including medical history, medication, imaging features provided by cardiac ultrasound, CCTA and fused images resulting from imaging post-processing.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Fuse-Heart -SG 01
Study subjects with anatomically significant coronary lesions (at least 50% luminal narrowing) on native coronary arteries.
128 Multislice CT coronary angiography
128 Multislice CT coronary angiography with the evaluation of coronary stenosis, the plaque vulnerability markers ( necrotic core, low attenuation plaque, spotty calcifications, napkin ring sign, positive remodeling), asses polar maps of the myocardium
2D Cardiac Transthoracic Echocardiography
2D Cardiac Transthoracic Echocardiography with the evaluation of the cardiac cavity dimensions
Laboratory Blood tests
Laboratory tests for evaluations the level of inflammatory biomarkers ( hs-CRP, MMP, IL6 and NT-pro-BNP), complete blood count, biochemestry
Fuse-Heart -SG 02
Study subjects surviving an acute myocardial infarction, revascularized or not.
128 Multislice CT coronary angiography
128 Multislice CT coronary angiography with the evaluation of coronary stenosis, the plaque vulnerability markers ( necrotic core, low attenuation plaque, spotty calcifications, napkin ring sign, positive remodeling), asses polar maps of the myocardium
2D Cardiac Transthoracic Echocardiography
2D Cardiac Transthoracic Echocardiography with the evaluation of the cardiac cavity dimensions
Laboratory Blood tests
Laboratory tests for evaluations the level of inflammatory biomarkers ( hs-CRP, MMP, IL6 and NT-pro-BNP), complete blood count, biochemestry
Interventions
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128 Multislice CT coronary angiography
128 Multislice CT coronary angiography with the evaluation of coronary stenosis, the plaque vulnerability markers ( necrotic core, low attenuation plaque, spotty calcifications, napkin ring sign, positive remodeling), asses polar maps of the myocardium
2D Cardiac Transthoracic Echocardiography
2D Cardiac Transthoracic Echocardiography with the evaluation of the cardiac cavity dimensions
Laboratory Blood tests
Laboratory tests for evaluations the level of inflammatory biomarkers ( hs-CRP, MMP, IL6 and NT-pro-BNP), complete blood count, biochemestry
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Ability to provide informed consent;
* Patients aged at least 18 years;
Exclusion Criteria
* Allergy to contrast media;
* Absolute or relative contraindications to CCTA imaging;
* Irregular or rapid heart rhythm
* Pregnancy or lactation;
* Women with childbearing potential in absence of any contraceptive treatment;
* Renal insufficiency (creatinine greater than 1.5 mg/dL) or renal failure requiring dialysis;
* Active malignancy or malignancy within the last 5 year prior to enrollment;
* Conditions associated with an estimated life expectancy of under 2 years;
18 Years
90 Years
ALL
No
Sponsors
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George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures
OTHER
Tîrgu Mureș Emergency Clinical County Hospital, Romania
OTHER
Cardio Med Medical Center
INDUSTRY
Responsible Party
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Principal Investigators
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Alexandra Gorea Stanescu, MD
Role: PRINCIPAL_INVESTIGATOR
Cardio Med
Locations
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Cardio Med Medical Center
Târgu Mureş, Mureș County, Romania
Countries
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Other Identifiers
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CM0520-FUSEH
Identifier Type: -
Identifier Source: org_study_id
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