AzTrials
AzTrials

Myocardial DeformationNCT04830787

Correlation Between Myocardial Deformation and Coronary Artery Tortuosity in Patients With Hypertrophic Cardiomyopathy

An observational study of Myocardial Deformation and Coronary Artery Anomaly, run by Henan Provincial People's Hospital at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Correlation between Myocardial Deformation and Coronary Tortuosity and Analysis of Genetic Factors Among Hypertrophic Cardiomyopathy Patients Read more about this study

Who is it for?
Ages 18 to 85 yearsHealthy volunteers can take part
How many people
302 participants
Where
1 siteChina
Study dates
1 Dec 2017to 1 Aug 2022
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 to 85 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Patients with hypertrophic cardiomyopathy and without hypertrophic cardiomyopathy undergoing coronary angiography and echocardiography

Who may be able to join

  • Subjects must meet all the following inclusion criteria to be eligible for participation in this study
  • 18<age≤85;
  • Patients with hypertrophic cardiomyopathy and without hypertrophic cardiomyopathy undergoing coronary angiography and echocardiography;
  • Willing to sign informed consent.

Who cannot join

  • Subjects who meet any of the following exclusion criteria are not to be enrolled in this study
  • All coronary arteries can not be shown clearly in coronary angiography
  • Prior coronary artery bypass surgery, valve prosthesis
  • Connective tissue disease
  • Cardiac dilatation(left ventricular end diastolic diameter, ≥55mm male,≥50mm female )
  • Congenital heart failure, LVEF<35%
  • Coronary total occlusion, changes in coronary morphology, such as long stents implantation(≥12mm)

Trial locations and contacts

1 site in 1 country.

China1 site
  • Central China Fuwai Hospital, Heart Center of Henan Provincal People's Hospital

    Zhengzhou, Henan, 450000

Other trials in China

About this study

Official title: Correlation Between Myocardial Deformation and Coronary Artery Morphology in Patients With Hypertrophic Cardiomyopathy and Analysis of Genetic Factors:A Prospective, Single-center, Case-control Study

Correlation between Myocardial Deformation and Coronary Tortuosity and Analysis of Genetic Factors Among Hypertrophic Cardiomyopathy Patients

Read the detailed description

Excessive tortuosity of the coronary arteries (TCA) is a somewhat common finding in patients referred for coronary angiography, reported in 14-40% of patients referred for angiography. The presence of TCA has been associated with chest pain and myocardial perfusion abnormalities during stress in the absence of obstructive coronary artery disease. Fluid dynamic modeling suggests that stress-induced ischemia may be attributable to a reduction in distal coronary artery perfusion pressure from viscous and turbulence energy losses. The physiologic reasons for TCA are unclear. The roles of TCA on prognosis of HCM are also needed to explore. Pre-clinical studies where elastases and collagenases were used to alter arterial morphology together with genetic and pathologic analysis of rare clinical disorders such as arterial tortuosity syndrome have indicated that arterial tortuosity arises from abnormalities in arterial elastin fibers and extracellular matrix. Apart from inherited disorders, some but not all studies have linked TCA with hypertension and female sex, and with increased left ventricular (LV) mass from pressure but not volume overload and smaller heart size.

Hypertrophic cardiomyopathy (HCM) is associated with an increased left ventricular (LV) wall thickness. HCM is the most common genetic heart disease, characterized by marked clinical and morphologic heterogeneity. Diagnosis is usually based on the echocardiographic finding of unexplained left ventricular (LV) hypertrophy, defined by increased wall thickness in 1 or more LV segments. LV mass is generally assumed to be increased in patients with phenotypically expressed HCM, based largely on early pathological studies. TCA among HCM patients have not been studied. So, firstly, we choose HCM and non-HCM patients to investigate the relationship between TCA and HCM, and further explore the potential roles of TCA for prognosis in HCM.

In HCM patients, disruption of the ordered arrangement of myofibers alters normal cardiac mechanical function, resulting in temporal and spatial heterogeneity in regional myocardial contractility. Although global LV function is generally unaltered, asynchrony and asynergy in regional function lead to delayed diastolic relaxation and impaired diastolic filling. Whilst LV ejection fraction is frequently normal in both, LV strain assessment could differentiate, compared to normal person. Cardiovascular magnetic resonance (CMR), by virtue of its high-resolution volumetric reconstruction of the LV chamber, currently affords a highly accurate and reproducible quantitative assessment of mass . So secondly, we sought to establish if cardiovascular magnetic resonance myocardial feature tracking (CMR-FT), an emerging method allowing accurate assessment of myocardial deformation, differentiates between HCM with or without TCA. Additionally, we want to explore the potential genetic factor on TCA in HCM.

This is a single-center, retrospective, case control study that will evaluate the difference of TCA between HCM and non-HCM, and explore the prognostic roles of TCA in the first part. In the second part, we will use CMR-FT to compare the myocardial strain between HCM with or without TCA and analyze the relationship of strain and TCA. In the third part, we choose HCM patients and non-HCM to investigate potential genetic factors for TCA in HCM.

Being tested
no intervention
Keywords
hypertrophic cardiomyopathy, tortuosity of coronary arteries, myocardial strain, prognosis, genetic mutation
Medical subject headings
Cardiomyopathy, Hypertrophic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • no interventionOther

    there is no intervention, we just chose patients diagnosed with hypertrophic cardiomyopathy and underwent CAG, and patients without hypertrophic cardiomyopathy as control ,the two groups are matched with age, gender and hypertension.

Study groups in NCT04830787
Study groupRoleWhat they receive
hypertrophic cardiomyopathypatients with hypertrophic cardiomyopathy
Receives: Other: no intervention
control without hypertrophic cardiomyopathycontrols without hypertrophic cardiomyopathy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. coronary artery tortuosity and tortuosity score in hypertrophic cardiomyopathy patients

    Severe tortuosity was defined as ≥2 consecutive curvatures of ≥180° in a major epicardial coronary artery ≥2 mm in diameter . Mild tortuosity was defined as either ≥3 consecutive curvatures of 45° to 90° in a major epicardial coronary artery, or ≥3 consecutive curvatures of 90° to 180° in an artery <2 mm in diameter. The tortuosity score was calculated as a sum of scores for each major epicardial coronary artery (left anterior descending, left circumflex, right coronary artery) with 0=no tortuosity, 1=mild tortuosity,2=tortuosity, 3=severe tortuosity. We will evaluate if the patients have coronary artery tortuosity and assess the number of tortuosity score for every coronary artery and add the score up for every patients.

    Measured: six months

  2. prognostic roles of coronary artery tortuosity in hypertrophic cardiomyopathy

    retrospectively included HCM patients with echocardiography and coronary angiography (CAG), in Fuwai Central China Cardiovascular Hospital from 1st Dec 2017 to 10th Jun 2021. All patients were followed up until the censoring day of 1st July 2022. The primary outcomes were composite of all-cause death, maglinant arrhythmia, ischemic stroke. Death was documented according to medical records, death certificates, or follow-up questionnaires by family members. Arrhythmia included ventricular fibrillation, sustained ventricular tachycardia, second-degree type II and third-degree atrioventricular block.

    Measured: 2017/12/01-2022/07/01

  3. prognostic roles of coronary artery tortuosity in hypertrophic cardiomyopathy

    etrospectively included HCM patients with echocardiography and coronary angiography (CAG), in Fuwai Central China Cardiovascular Hospital from 1st Dec 2017 to 10th Jun 2021. All patients were followed up until the censoring day of 1st July 2022. The secondary outcomes were composite of primary outcomes and rehospitalization.

    Measured: 2017/12/01-2022/07/01

Secondary outcomes (2)
  1. myocardial strain and strain rate in hypertrophic cardiomyopathy patients with coronary artery tortuosity

    observe the difference of myocardial strain between hypertrophic cardiomyopathy with and without coronary artery tortuosity, Global longitudinal strain (GLS), global longitudinal strain rate (GLSR), global circumferential strain (GCS), global circumferential strain rate (GCSR), global radial strain (GRS), and global radial strain rate (GRSR) of the LV and RV will be calculated and segmental strain and strain rate will also be assessed respectively

    Measured: six months

  2. genetic factors(such as genetic mutation site for HCM(MYBPC3,MYH7,ACTC1,TNNI3)) for hypertrophic cardiomyopathy patients with coronary artery tortuosity

    do genetic testing, observe the difference for genetic factors such as gene mutation for hypertrophic cardiomyopathy with and without coronary artery tortuosity, all the 40 genes which has been found to be implicated in HCM will be tested, such as MYBPC3, MYH7, TPM1,TNNT2 and TNNI3.

    Measured: two months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Apr 2021
  2. Study start1 Dec 2017
  3. Primary completion1 Jul 2022
  4. Study completion1 Aug 2022

Resources

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-control
Time perspective
Retrospective
Enrolment
302 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04830787
Sponsor's protocol ID
TCAHCM
Status last verified
Aug 2022
First submitted
28 Mar 2021
Last updated
19 Aug 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: It will be decided by patients , hospital and Chinese health authority.

Publications

  • Li Y, Shen C, Ji Y, Feng Y, Ma G, Liu N. Clinical implication of coronary tortuosity in patients with coronary artery disease. PLoS One. 2011;6(8):e24232. doi: 10.1371/journal.pone.0024232. Epub 2011 Aug 31.

    PubMed 21904618
  • Eleid MF, Guddeti RR, Tweet MS, Lerman A, Singh M, Best PJ, Vrtiska TJ, Prasad M, Rihal CS, Hayes SN, Gulati R. Coronary artery tortuosity in spontaneous coronary artery dissection: angiographic characteristics and clinical implications. Circ Cardiovasc Interv. 2014 Oct;7(5):656-62. doi: 10.1161/CIRCINTERVENTIONS.114.001676. Epub 2014 Aug 19.

    PubMed 25138034
  • Barilla F, Romeo F, Rosano GM, Valente A, Reale A. Coronary artery loops and myocardial ischemia. Am Heart J. 1991 Jul;122(1 Pt 1):225-6. doi: 10.1016/0002-8703(91)90781-c. No abstract available.

    PubMed 2063741
  • Vorobtsova N, Chiastra C, Stremler MA, Sane DC, Migliavacca F, Vlachos P. Effects of Vessel Tortuosity on Coronary Hemodynamics: An Idealized and Patient-Specific Computational Study. Ann Biomed Eng. 2016 Jul;44(7):2228-39. doi: 10.1007/s10439-015-1492-3. Epub 2015 Oct 23.

    PubMed 26498931
  • Maron BJ, McKenna WJ, Danielson GK, Kappenberger LJ, Kuhn HJ, Seidman CE, Shah PM, Spencer WH 3rd, Spirito P, Ten Cate FJ, Wigle ED; Task Force on Clinical Expert Consensus Documents. American College of Cardiology; Committee for Practice Guidelines. European Society of Cardiology. American College of Cardiology/European Society of Cardiology clinical expert consensus document on hypertrophic cardiomyopathy. A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol. 2003 Nov 5;42(9):1687-713. doi: 10.1016/s0735-1097(03)00941-0. No abstract available.

    PubMed 14607462
  • Weidemann F, Mertens L, Gewillig M, Sutherland GR. Quantitation of localized abnormal deformation in asymmetric nonobstructive hypertrophic cardiomyopathy: a velocity, strain rate, and strain Doppler myocardial imaging study. Pediatr Cardiol. 2001 Nov-Dec;22(6):534-7. doi: 10.1007/s002460010293. Epub 2001 Dec 4.

    PubMed 11894166
  • Salton CJ, Chuang ML, O'Donnell CJ, Kupka MJ, Larson MG, Kissinger KV, Edelman RR, Levy D, Manning WJ. Gender differences and normal left ventricular anatomy in an adult population free of hypertension. A cardiovascular magnetic resonance study of the Framingham Heart Study Offspring cohort. J Am Coll Cardiol. 2002 Mar 20;39(6):1055-60. doi: 10.1016/s0735-1097(02)01712-6.

    PubMed 11897450

Questions about this trial

What is this clinical trial studying?

An observational study of Myocardial Deformation and Coronary Artery Anomaly, run by Henan Provincial People's Hospital at 1 site in China.

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 4 inclusion and 7 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: finished, as of the sponsor's last update on 19 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

coronary artery tortuosity and tortuosity score in hypertrophic cardiomyopathy patients (time frame: six months). The study lists 3 primary outcomes in all. 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 NCT04830787, which also lists 7 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 19 Aug 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in