Trial record 4 of 130 for:    heart attack OR myocardial infarction OR acute coronary syndrome | Open Studies | NIH, U.S. Fed

Technical Development of Cardiovascular Magnetic Resonance Imaging

This study is currently recruiting participants. (see Contacts and Locations)
Verified May 2014 by National Institutes of Health Clinical Center (CC)
Sponsor:
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) )
ClinicalTrials.gov Identifier:
NCT00027170
First received: November 27, 2001
Last updated: May 22, 2014
Last verified: May 2014
  Purpose

This study will explore new ways of using magnetic resonance imaging (MRI) to evaluate the heart and blood vessels of patients with cardiovascular disease, including better detection of myocardial infarction (heart attack) and blockage of heart and leg arteries.

Patients 21 years of age and older with cardiovascular disease may be eligible for this study.

All participants will have magnetic resonance imaging of the heart. MRI uses a magnetic field and radio waves to show structural and chemical changes in tissues. For the procedure, the patient lies on a table surrounded by a metal cylinder (the scanner). A 'gadolinium contrast' material may be injected into the patient s vein during part of the study to brighten the images. Patients wear earplugs during the scan to muffle loud knocking sounds caused by the electrical switching of the magnetic fields. They will be asked to hold their breath intermittently for 5 to 20 seconds during the scan. They will be monitored with an electrocardiogram (EKG) during the procedure and will be in contact by intercom at all times with the person performing the scan. Patients can request to stop the study and come out of the scanner at any time. The procedure may last from 30 to 90 minutes. An echocardiogram a test that uses sound waves to produce pictures of the heart and blood vessels may be done to confirm the MRI findings. In addition, patients may undergo one or more of the following optional studies:

  • Dobutamine stress MRI This test uses dobutamine a medicine that simulates exercise by increasing heart rate and heart function to detect blockages in the coronary arteries (vessels that supply oxygen and nutrients to the heart) and locate areas of the heart that are permanently damaged, perhaps by a previous heart attack. For this test, MRI pictures of the heart are taken before, during and after administration of dobutamine. Gadolinium may be injected during part of the study to brighten the images. An EKG will be used to monitor the heart during the procedure.
  • Vasodilator MRI The procedure and objectives of this test are the same as those described for dobutamine stress MRI, except that this study uses dipyridamole or adenosine. These drugs dilate blood vessels, causing increased blood flow to the heart.
  • Plethysmography MRI This test determines the presence and severity of narrowing in arteries that supply blood to the leg. Blockage of these vessels often causes pain while walking. This study will compare plethysmography MRI with venous occlusion plethysmography, an older method of measuring blood flow in the legs. For venous occlusion plethysmography, a large blood pressure cuff is placed around the upper leg and a strain gauge (thin elastic band) is placed around the calf. The pressure cuff is inflated very tightly for 5 minutes to block blood flow to the leg, and another pressure cuff over the ankle is also inflated. When the large cuff is deflated, blood rushes to the leg, a smaller cuff is inflated to a low pressure, and the strain gauge measures the maximum blood flow to the leg for 1 or 2 more minutes. This procedure is done once or twice outside the MRI scanner and once or twice inside the scanner. The scans are performed as described above for the dobutamine and vasodilator studies. The strain gauge is not used for plethysmography MRI the MRI pictures are used to measure flow.

Condition
Cardiovascular Disease

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Technical Development of Cardiovascular Magnetic Resonance Imaging

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • The overall objective of this protocol is to test and develop innovative new noninvasive MRI techniques suitable for evaluating patients with cardiovascular disease. [ Time Frame: ongoing ]

Secondary Outcome Measures:
  • Technical Development of Multiecho MRI Methods [ Time Frame: ongoing ]
  • Technical Developments Related to Distinguishing Fat and Water by MRI [ Time Frame: ongoing ]

Estimated Enrollment: 7560
Study Start Date: November 2001
Detailed Description:

The purpose of this protocol is to allow development and testing of new MRI techniques suitable for evaluating patients with cardiovascular disease. Since such technical development work often depends on preliminary studies in healthy volunteers, the protocol also recruits healthy subjects. This protocol will provide the framework for technical development scans in patients with cardiovascular disease.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

-INCLUSION CRITERIA:

  1. Inclusion Criteria for All Arms of the Protocol:

    • Subjects 18 years of age or older
    • Written informed consent

    EXCLUSION CRITERIA:

  2. Exclusion Criteria for All Arms of the Protocol:

    • Patients with a contraindication to MRI scanning will be excluded. These contraindications include patients with the following devices:

      • Central nervous system aneurysm clips;
      • Implanted neural stimulator;
      • Implanted cardiac pacemaker or defibrillator;
      • Cochlear implant;
      • Ocular foreign body (e.g. metal shavings);
      • Implanted Insulin pump;
      • Metal shrapnel or bullet.
  3. In addition, the following patient groups will be excluded:

    • Pregnant women (Patients who are uncertain as to whether they are pregnant will be required to have a screening urine or blood pregnancy test)
    • Patients with symptoms of myocardial ischemia occurring despite maximally tolerated doses of oral antianginal therapy and intravenous nitroglycerin
  4. Furthermore, the following patient groups will be excluded from studies involving the administration of MRI contrast agents:

    • lactating women unless they are willing to discard breast milk for 24 hours after receiving gadolinium
    • renal disease (estimated glomerular filtration rate (eGFR) less than 30 ml/min/1.73 m(2) body surface area)

    The eGFR will be used to estimate renal function if reported by the laboratory. Otherwise, estimated glomerular filtration rate (eGFR) can be based on the Modification of Diet in Renal Disease (MDRD) study equation (see below) in subjects with stable renal function. This formula is not applicable to patients with acute renal insufficiency:

    eGFR (ml/min/1.73 m(2)) equal to 175 times (serum creatinine)-1.154 times (age)-0.203 times 0.742 (if the subject is female) times1.212 (if the subject is black)

  5. Additional Exclusion Criteria for Dobutamine, Bicycle, or Vasodilator Stress MRI:

    • Myocardial infarction within 48 hours
    • Uncontrolled congestive heart failure
    • Severe hypertension (SBP greater than 200, DBP greater than 110) (exclusion only for dobutamine and bicycle)
    • Atrial fibrillation. This exclusion only applies to Dobutamine stress.
    • Frequent PVC s (more than 1 every 10 heart beats or nonsustained ventricular tachycardia (greater than 4 beat runs) or ongoing sustained ventricular tachycardia. This exclusion only applies to Dobutamine and Bicycle stress
    • Patients with narrow angle glaucoma and known or suspected prostatic obstruction will not receive atropine
  6. Additional Exclusion Criteria for PET/MR perfusion scans

    • Pregnant patients
    • Patients that are breast feeding
  7. Additional Exclusion Criteria for Plethysmography:

    • Patients with patent bypass grafts at or distal to the level of occlusion
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00027170

Contacts
Contact: Marsha Block, R.N. (301) 496-0211 blockma@mail.nih.gov
Contact: Andrew E Arai, M.D. (301) 496-3658 araia@nih.gov

Locations
United States, Maryland
Suburban Hospital Recruiting
Bethesda, Maryland, United States, 20814
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Contact: For more information at the NIH Clinical Center contact Patient Recruitment and Public Liaison Office (PRPL)    800-411-1222 ext TTY8664111010    prpl@mail.cc.nih.gov   
Sponsors and Collaborators
Investigators
Principal Investigator: Andrew E Arai, M.D. National Heart, Lung, and Blood Institute (NHLBI)
  More Information

Additional Information:
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) )
ClinicalTrials.gov Identifier: NCT00027170     History of Changes
Other Study ID Numbers: 020050, 02-H-0050
Study First Received: November 27, 2001
Last Updated: May 22, 2014
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Myocardial Infarction
Myocardial Viability
Myocardial Perfusion
Myocardial Ischemia
Atherosclerosis
Cardiovascular Disease
Coronary Artery Disease

Additional relevant MeSH terms:
Cardiovascular Diseases

ClinicalTrials.gov processed this record on July 28, 2014