Fibrosis in Chronic and Delayed Myocardial Infarction

Launched by UNIVERSITY OF EDINBURGH · Mar 1, 2023

Keywords

ClinConnect Summary

This clinical trial is investigating how fibrosis, a condition where the heart muscle becomes stiff due to injury, affects various heart-related illnesses like aortic stenosis (narrowing of the heart valve), chemotherapy-induced heart damage, and carcinoid syndrome (a type of cancer that can affect the heart). Researchers want to find out how to detect fibrosis early while it is still active, using advanced imaging methods that involve special tracers and scans.

To participate in this study, you need to be over a certain age depending on the group you're in. For example, if you have aortic stenosis, you must be over 50, while those with chemotherapy-induced heart issues should be over 35. The study includes both patients with varying degrees of these conditions and healthy volunteers. Participants will undergo scans to help researchers understand the role of fibrosis in these heart conditions. Before joining, individuals will need to give consent, and there are some exclusions, such as being pregnant or having certain medical issues. Overall, this trial could help improve the understanding and treatment of these heart conditions.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Cohort 1(Aortic stenosis):
• • Male or female above the age of 50 years old
• • Provision of informed consent prior to any study specific procedures
• • 25 patients with symptomatic severe aortic stenosis (peak velocity \>4.0 m/s)
• • 25 patients with moderate aortic stenosis (peak velocity 3.0-4.0 m/s)
• • 10 patients with mild aortic stenosis (peak velocity 2.6-2.9 m/s)
• • 10 patients with aortic sclerosis (tri-leaflet thickened aortic valve with no obstruction of ventricular outflow)
• • 10 healthy volunteers (no other significant co-morbidities, as assessed by the study PI)
• Cohort 2 (Chemotherapy-induced cardiotoxicity):
• • Male or female over the age of 35 years with evidence of cardiotoxicity on cardiac MRI (performed as part of the Cardiac care study), at least 1 year after anthracycline treatment.
• • 10 patients over the age of 35 years (male or females) without evidence of fibrosis on their 1-year scan after anthracycline treatment.
• • 10 healthy volunteers (\>35 years of age) with no significant co-morbidities, as assessed by the study PI.
• • Provision of informed consent prior to any study specific procedures
• Cohort 3 (Carcinoid syndrome):
• • 30 patients with carcinoid syndrome (with or without cardiac involvement), over the age of 35 years, diagnosed as per consensus guidelines
• • Provision of informed consent prior to any study specific procedures
• Exclusion Criteria:
• • Inability or unwilling to give informed consent.
• • History of claustrophobia or feeling of inability to tolerate supine position for the MRI scans.
• • Impaired renal function with eGFR of \<30 mL/min/1.73m2.
• • Women who are pregnant or breastfeeding.
• • Contrast allergy
• • Contraindication to cardiac MRI (e.g. metallic implant or severe claustrophobia)
• • Recent myocardial infarction, other known causes of cardiomyopathy/cardiac fibrosis.