Hyperemic mYocardial Perfusion by adEnosine at diffeRent Doses

Launched by REGION SKANE · Aug 27, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how different doses of adenosine, a medication used during heart tests, affect blood flow in patients with chronic heart conditions like chronic coronary syndrome (CCS). The main goal is to see if a higher dose of adenosine (210 micrograms per kilogram per minute) can provide a better response than the standard dose (140 micrograms per kilogram per minute). This is important because if the medication doesn't work well, it can lead to incorrect diagnoses and treatment decisions, which can affect patient care.

To be eligible for this trial, participants must be adults referred for heart evaluations and able to give consent. The study is looking for a mix of men and women aged 40 and older, including those with known heart conditions and healthy volunteers. Participants will need to avoid caffeine for 24 hours before their test. Throughout the trial, participants can expect to undergo heart imaging tests and may help improve how doctors diagnose and treat heart diseases in the future. It’s important to note that certain health conditions, like severe heart problems or high blood pressure, may exclude someone from participating.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Patients:
• • 1. The subject has given their written consent to participate in the trial.
• • 2. Are referred to Department of Clinical Physiology, Skåne University Hospital, for suspected or known CCS or heart failure
• • 3. Matches the inclusion criteria for sex and age (6 females and 6 males from each group in each age decade from 40 to \>80 years old)
• • 4. Matches the inclusion criteria for no known heart failure (group b) or known heart failure (group c)
• • 5. No caffein intake \<24h prior to the examination
• Healthy volunteers:
• • 1. The subject has given their written consent to participate in the trial.
• • 2. Matches the inclusion criteria for sex and age (6 females and 6 males from each group in each age decade from 40 to \>80 years old)
• • 3. No caffein intake \<24h prior to the examination
• Exclusion Criteria:
• Patients:
• • 1. Acute referral (in-house patients)
• • 2. Clinically unstable
• • 3. Acute chest pain
• • 4. Severe or decompensated heart failure
• • 5. Non sinus rhythm (e.g. atrial fibrillation)
• • 6. Asthma or severe chronic obstructive pulmonary disease
• • 7. Known chronic renal failure (eGFR \<45mL/min/1.73m2)
• • 8. AV-block II or III
• • 9. Left Bundle Branch Block
• • 10. Systolic blood pressure \<90 mmHg or \>230 mmHg at rest
• • 11. Increased intracranial pressure
• • 12. Known allergy or adverse reaction to adenosine or mannitol
• • 13. Known allergy or adverse reaction to gadolinium contrast agents
• • 14. Treatment with medication containing dipyradimol or teofyllamin/teofyllin
• • 15. Claustrophobia
• • 16. Devices contraindicated to CMR imaging (pacemaker, implants, intracranial clips etc)
• • 17. Pregnancy or breast feeding (screened by question only)
• • 18. Inability to give informed consent due to mental state, language difficulties etc
• Healthy volunteers:
• • 1. Any of the exclusion criteria for patients
• • 2. Blood pressure \> 140/90 measured according to clinical routine
• • 3. Known systemic disease
• • 4. Known cardiac disease
• • 5. Cardiovascular medication
• • 6. Medication that might influence cardiovascular health
• • 7. Smoking