TRAnscranial Doppler CErebral Blood Flow and Cognitive IMPAIRment in Heart Failure

NCT ID: NCT05250349

Last Updated: 2022-02-22

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

RECRUITING

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-09-01

Study Completion Date

2027-09-01

Brief Summary

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TRACE-IMPAIR is a prospective, clinical study of consecutive patients that evaluates the relationship between heart failure (HF) and cognitive impairment in relation to carotid and cerebral flow. The carotid and cerebral flow will be assessed using Doppler ultrasonography, and cognitive function will be estimated during routine neuropsychological tests.

It is an observational, three(natural)-group, single-center study. It is also an Academic Registry - the scientific activity of the Faculty of Medicine, Collegium Medicum, Jagiellonian University, and John Paul II Hospital.

Detailed Description

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Circumstantial evidence suggests that cognitive dysfunction may occur in HF patients as often undiagnosed comorbidity. Cognitive dysfunction may aggravate HF symptoms and influence prognosis. Cognitive dysfunction may be a reason for inadequate self-care and poor symptom control (e.g., weight gain monitoring). In addition, it may affect medication compliance, leading to hospital readmissions and increased mortality. Brain tissue hypoxia, microemboli, silent strokes, and co-existing anemia have been implicated in contributing to cognitive dysfunction in HF. However, the role of cerebral flow impairment in these patients remains unclear. This uncertainty is mainly because previous studies included small patient groups, diverse imaging techniques, and neuropsychological tests. Furthermore, these studies were primarily conducted in the elderly, a potentially important confounder due to the effect of age on cognitive dysfunction. Particularly little data is available for younger patients (\< 60 years).

This study aims to investigate the association of HF, carotid and cerebral flow, and cognitive impairment. Consecutive patients with HF with mildly reduced (HFmrEF) and reduced ejection fraction (HFrEF) will be included in the study. Echocardiography with routine measurements such as ejection fraction and stroke volume will be performed in each patient. The carotid and cerebral flow will be assessed on Doppler ultrasonography. Each patient will undergo cognitive function assessment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The results in the index group (isolated HF) will be compared with those in a group of patients with HF and flow-limiting carotid stenosis (CS) against a control group (no HF, no CS).

Conditions

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Heart Failure Cognitive Impairment Carotid Stenosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Isolated HF Group

Patients with echocardiography - confirmed Heart Failure (HFmrEF and HFrEF) and clinical symptoms (NYHA I-III).

Echocardiography

Intervention Type DIAGNOSTIC_TEST

Transthoracic echocardiography with standard measurements

Doppler sonography

Intervention Type DIAGNOSTIC_TEST

Transcarotid and transcranial Doppler sonography

Neuropsychological tests

Intervention Type DIAGNOSTIC_TEST

Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)

HF + CS group

Patients with echocardiography - confirmed Heart Failure (HFmrEF and HFrEF) with NYHA I-III symptoms, who were diagnosed with flow limiting Carotid Stenosis on carotid Doppler ultrasound.

Echocardiography

Intervention Type DIAGNOSTIC_TEST

Transthoracic echocardiography with standard measurements

Doppler sonography

Intervention Type DIAGNOSTIC_TEST

Transcarotid and transcranial Doppler sonography

Neuropsychological tests

Intervention Type DIAGNOSTIC_TEST

Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)

Control group

A cohort of patients without Heart Failure or other significant cardiac pathology and without Carotid Stenosis (a paired propensity match will be performed).

Echocardiography

Intervention Type DIAGNOSTIC_TEST

Transthoracic echocardiography with standard measurements

Doppler sonography

Intervention Type DIAGNOSTIC_TEST

Transcarotid and transcranial Doppler sonography

Neuropsychological tests

Intervention Type DIAGNOSTIC_TEST

Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)

Interventions

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Echocardiography

Transthoracic echocardiography with standard measurements

Intervention Type DIAGNOSTIC_TEST

Doppler sonography

Transcarotid and transcranial Doppler sonography

Intervention Type DIAGNOSTIC_TEST

Neuropsychological tests

Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Clinically stable patients (NYHA I-III symptoms) with HF (for at least 6 months) either of ischemic or inflammatory etiology as well as genetic cardiomyopathies
* Signed informed consent form
* Consent to imaging studies: echocardiography, carotid and transcranial Doppler sonography and neuropsychological tests (MMSE and MoCA).

Exclusion Criteria

* Co-existing, severe, irreversible disease (e.g. advanced cancer)
* Previously diagnosed dementia (including severe dementia - MMSE and MoCA score \<10)
* Psychiatric condition which may influence cognitive function
* Acute, decompensated HF
* Reversible cause of HF - tachyarrhytmic, peripartum or toxic cardiomyopathy, acute myocarditis, acute myocardial infarction
* Aortic stenosis
* Cerebral stroke in the preceding 3 months
* Lack of transcranial Doppler acoustic window
* Echocardiographic projections precluding adequate measurements
* Anemia with Hemoglobin \< 8 g/dl
* Alcohol or psychoactive agents abuse
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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John Paul II Hospital, Krakow

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Piotr Musialek, MD, DPhil

Role: PRINCIPAL_INVESTIGATOR

John Paul II Hospital

Locations

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Department of Cardiac and Vascular Diseases, The John Paul II Hospital

Krakow, MP, Poland

Site Status RECRUITING

Countries

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Poland

Central Contacts

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Piotr Musialek, MD, DPhil

Role: CONTACT

+48126142287

Karolina Dzierwa, MD, PhD

Role: CONTACT

+48126143158

Facility Contacts

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Piotr Musialek, MD, DPhil

Role: primary

+48126142287

Other Identifiers

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TRACE-IMPAIR

Identifier Type: -

Identifier Source: org_study_id

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