Cardiac Function Under Stress for Early Detection of the Right Ventricular Insufficiency After Repair of Tetralogy of Fallot

This study has been terminated.
Sponsor:
Collaborator:
German Federal Ministry of Education and Research
Information provided by:
Competence Network for Congenital Heart Defects
ClinicalTrials.gov Identifier:
NCT00564993
First received: November 28, 2007
Last updated: June 5, 2012
Last verified: August 2011
  Purpose

Summary:

The investigators aim to identify markers of right ventricular dysfunction in patients with severe pulmonary regurgitation following repair of Tetralogy of Fallot, that allow prediction of the optimal timing of the replacement of the regurgitant valve. The investigators will use MR as a gold-standard reference for measurement of cardiac function during rest and dobutamine stress. The investigators will also evaluate the predictive potential of tissue Doppler imaging in this patient group.

Purpose:

To predict the optimum timing of pulmonary valve replacement for severe regurgitation in repaired Tetralogy of Fallot using Cardiac Magnetic resonance with dobutamine stress testing.


Condition Intervention Phase
Tetralogy of Fallot
Drug: Dobutamin
Phase 3

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Diagnostic
Official Title: Cardiac Imaging Under Exercise Stress Test for Early Assessment of Right Ventricular Function in Patients With Tetralogy of Fallot and Pulmonary Regurgitation

Resource links provided by NLM:


Further study details as provided by Competence Network for Congenital Heart Defects:

Primary Outcome Measures:
  • Identification of predictive parameters of right ventricular insufficiency [ Time Frame: 1 year ]

Secondary Outcome Measures:
  • Evaluation of mortality, morbidity, pulmonary function, objective exercise tolerance, life-quality and prevalence of cardiac arrhythmia after pulmonary valve replacement [ Time Frame: 1 year ]

Enrollment: 53
Study Start Date: November 2007
Study Completion Date: May 2012
Primary Completion Date: May 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: A

necessary re-intervention (pulmonary valve replacement) after repair of Fallot:

2 Visits with cardiac imaging under rest and stress (Dobutamin) before and after pulmonary valve replacement

Drug: Dobutamin
10&20 µg/kg/min
Active Comparator: B

comparison group: with a good result of repair of tetralogy of fallot and good ventricular function:

1 Visit with cardiac imaging under rest and stress (Dobutamin)

Drug: Dobutamin
10&20 µg/kg/min

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   14 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Written informed consent of the patient or patient's legal representatives
  • No participation in another AMG driven study within the past 4 weeks or during the whole duration of this study
  • Patients with Tetralogy of Fallot after corrective surgery

    • group A (n=45): Adolescents ≥ 14 years or adults with Tetralogy of Fallot after corrective surgery and necessary re-intervention (pulmonary valve replacement because of pulmonary insufficiency
    • group B (n=35): Adolescents ≥ 14 years or adults with Tetralogy of Fallot after corrective surgery and good result of repair and good right ventricular function

Exclusion Criteria:

Non-specific

  • pregnancy or lactation
  • women of child-bearing age who are sexually active without practising highly effective methods of contraception (a urine/serum pregnancy test may be requested at the discretion of the investigator)
  • any diseases or impairment that, in the opinion of the investigator, would justify to exclude a subject from participation
  • substance abuse (alcohol, medicines, drugs)
  • other medical, psychological or social circumstances that would adversely affect a patient's ability to participate reliably in the study or increase the risk to themselves or others if they participated
  • insufficient compliance
  • disagreement with storage & transfer of anonymized disease data within this study.
  • Persons who are detained officially or legally to an official institution

Specific

  • contraindication against pharmacological stress testing (ventricular tachycardia or severe arrhythmia, profound pulmonary stenosis and hypertension of the pulmonary artery)
  • coronary heart disease
  • atrial fibrillation or flutter
  • DORV (if there is another VSD than subaortic)
  • associated severe heart defects
  • associated other severe (=hemodynamic significantly) valvular defects except for pulmonary insufficiency
  • Other clinically relevant diseases, such as malignant tumour or florid diseases (as considered by the investigating physician)
  • MRI contraindication, e.g. cardiac pacemaker, implanted neurostimulators and other magnetisable foreign bodies
  • Patient is not able to perform spiroergometry (bicycle/treadmill) or existing contraindications
  • Patients with Type I or II diabetes
  • prohibited concomitant medication: MAO-inhibitors
  • Treatment with beta- or alpha-blocker
  • Treatment with high doses of ACE-inhibitors or inhibitors of the AT- receptor and permanent treatment with nitrates (in the investigating physician's risk assessment)
  • Anticoagulation treatment (risk-benefit decision by the investigating physician, as there may be additional inhibition of platelet aggregation with dobutamine)
  • Treatment with diuretics (risk-benefit decision by the investigating physician, as there may be enhancement of the hypokalemia by administration of dobutamine); if necessary verification of the serum K+ -level before exposure to dobutamine
  • all contraindications against the study medication described in the SMPC
  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: NCT00564993

Locations
Germany
Universitätsklinikum Freiburg, Klinik III Päd. Kardiologie
Freiburg, Baden-Wuerttemberg, Germany, D-79106
Universitätsklinikum Tübingen, Klinik für Kinderheilkunde und Jugendmedizin
Tübingen, Baden-Wuerttemberg, Germany, D-72076
Deutsches Herzzentrum München
Munich, Bavaria, Germany, D-80336
Medizinische Hochschule Hannover, Pädiatrische Kardiologie und Intensivmedizin
Hannover, Lower Saxony, Germany, D-30625
Herz-und Diabeteszentrum Nordrhein-Westfalen
Bad Oeynhausen, North Rhine-Westphalia, Germany, D-32545
Universitätsklinikum Münster, Klinik und Poliklinik für Kinder- und Jugendmedizin, Pädiatrische Kardiologie
Münster, North Rhine-Westphalia, Germany, D-48149
Deutsches Kinderherzzentrum St. Augustin
Sankt Augustin, North Rhine-Westphalia, Germany, D-53757
Universitätsklinikum des Saarlandes
Homburg/Saar, Saarland, Germany, D-66421
Herzzentrum Leipzig, Klinik für Kinderkardiologie
Leipzig, Saxony, Germany, D-04289
Universitätsklinikum Schleswig-Holstein Campus Kiel
Kiel, Schleswig-Holstein, Germany, D-24105
Deutsches Herzzentrum Berlin
Berlin, Germany, D-13353
Sponsors and Collaborators
Competence Network for Congenital Heart Defects
German Federal Ministry of Education and Research
Investigators
Study Chair: Philipp Beerbaum, MD Evelina Children's Hospital, Guy's and St. Thomas Foundation Trust, Interdisciplinary Medical Imaging Group, King's College London
  More Information

Additional Information:
No publications provided

ClinicalTrials.gov Identifier: NCT00564993     History of Changes
Other Study ID Numbers: MP 4.3 Fallot-stress, EudraCT number: 2007-003461-41
Study First Received: November 28, 2007
Last Updated: June 5, 2012
Health Authority: Germany: Federal Institute for Drugs and Medical Devices

Additional relevant MeSH terms:
Tetralogy of Fallot
Cardiovascular Abnormalities
Cardiovascular Diseases
Congenital Abnormalities
Heart Defects, Congenital
Heart Diseases

ClinicalTrials.gov processed this record on October 21, 2014