Evaluation Cardiac Function With Echo and BNP in Obstetrical Patients With/Without Cardiac Disease
Recruitment status was Not yet recruiting
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Purpose
Maternal cardiac disease complicates approximately 2 percent of pregnancies and is the leading cause of non-obstetrical maternal death. Evaluating cardiac function and dysfunction is a complex process requiring skilled clinicians and technology such as ECG, long-term monitoring, and echocardiography. A fast, easily obtained blood test for B-type natriuretic peptide (BNP) has been developed that can give evidence for heart muscle stretch and dysfunction among adults with suspected congestive heart failure. Preliminary experience indicates that ventricular dysfunction among OB patients with a history of heart disease can be detected with this serum assay. A prospective cohort design consisting of two groups of pregnant patients; one with a history of cardiac disease and one without, will be followed over the course of the pregnancies and cardiac function will be measured using echocardiography and serum BNP. It is hoped that the blood test for BNP will be a reliable way to help evaluate OB patients with suspected abnormal heart function.
| Condition | Intervention |
|---|---|
|
Pregnancy Heart Diseases |
Procedure: echocardiography Procedure: blood draw for serum B-type natriuretic peptide |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Prospective Cohort Evaluation of Cardiac Function With Echocardiography and Serum B-type Natriuretic Peptide (BNP) in Obstetrical Patients With and Without a History of Cardiac Disease |
- Assess cardiac function on echocardiography and with serum B-type natriuretic peptide for women with a history of cardiac disease and for a control group with no history of heart disease over the course of pregnancy and compare the groups [ Time Frame: first, second, third trimesters of a 40-week pregnancy ] [ Designated as safety issue: No ]
- Assess for the presence of cardiac dysfunction in the course of a 40-week pregnancy [ Time Frame: first, second, third trimesters of pregnancy ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | July 2008 |
| Estimated Study Completion Date: | December 2011 |
| Estimated Primary Completion Date: | July 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
1
Pregnant women with a history of cardiac disease (study group)
|
Procedure: echocardiography
A non-invasive assessment of cardiac function using sound waves to create a picture of the pregnant woman's heart. There is no radiation involved.
Other Name: echocardiogram
Procedure: blood draw for serum B-type natriuretic peptide
A simple, minimally invasive standard blood draw for assessment of serum B-type natriuretic peptide, to be measured in a standard hospital laboratory and recorded for research purposes only
Other Name: BNP
|
|
2
Pregnant women with no history of heart disease (control group)
|
Procedure: echocardiography
A non-invasive assessment of cardiac function using sound waves to create a picture of the pregnant woman's heart. There is no radiation involved.
Other Name: echocardiogram
Procedure: blood draw for serum B-type natriuretic peptide
A simple, minimally invasive standard blood draw for assessment of serum B-type natriuretic peptide, to be measured in a standard hospital laboratory and recorded for research purposes only
Other Name: BNP
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 50 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
pregnant women at least 18 years of age with a history of cardiac disease for the study group and a second group of pregnant women at least 18 years of age with no history of heart disease as controls
Inclusion Criteria:
Potential subjects for the cardiac disease in pregnancy cohort:
- At least 18 years of age
- Cardiac disease as per Clark's Maternal Mortality Associated with Pregnancy: Group 1 (mortality less than 1%) atrial septal defect, ventricular septal defect, patent ductus arteriosus, pulmonic or tricuspid valve disease, corrected tetrology of Fallot, bioprosthetic valve, mitral stenosis with NYHA class I and II functional status Group 2 (mortality 5-15%) mitral stenosis with NYHA class III and IV functional status, aortic stenosis, coarctation of aorta without valvular involvement, uncorrected tetrology of Fallot, previous myocardial infarction, Marfan syndrome with normal aorta, mitral stenosis with atrial fibrillation, artificial valve Group 3 (mortality 25-50%) pulmonary hypertension, coarctation of aorta with valvular involvement, Marfan syndrome with aortic involvement (7)
- Other significant cardiac disease not listed above
- Other medical disorders, such as diabetes mellitus, chronic hypertension, asthma, other endocrine disorders, et cetera, will be acceptable
- Diagnosis of a least a single intrauterine pregnancy, multiple gestation acceptable
Potential subjects for pregnancy without cardiac disease cohort:
- At least 18 years of age
- Absence of significant cardiac disease, minor cardiac disorders such as mitral valve prolapse without arrythmia
- Other medical disorders, not directly related to cardiac disease, such as diabetes mellitus, chronic hypertension, asthma, other endocrine disorders et cetera, will be acceptable
- Diagnosis of at least a single intrauterine pregnancy, multiple gestation acceptable
Exclusion Criteria:
- Less than 18 years of age
- Non-viable pregnancy such as a threatened spontaneous miscarriage, or ectopic pregnancy
- Planned termination of pregnancy, either elective or medically indicated based on history
- Inability to complete informed consent process or participate in the study protocol
Contacts and Locations| Contact: John J Folk, MD | 315-464-4736 | folkj@upstate.edu |
| United States, New York | |
| Regional Perinatal Center | Not yet recruiting |
| Syracuse, New York, United States, 13202 | |
| Contact: John J Folk, MD 315-464-4736 folkj@upstate.edu | |
| Contact: Mary P Drexler, RN 315-464-4458 | |
| Principal Investigator: John J Folk, MD | |
| Sub-Investigator: Richard H Aubry, MD MPH | |
| Cardiology Associates Central New York Physician Office Building | Not yet recruiting |
| Syracuse, New York, United States, 13210 | |
| Contact: Martha Castle, RN 315-470-7409 | |
| Sub-Investigator: Raymond J Carlson, MD | |
| Sub-Investigator: Anthony Navone, MD | |
| Principal Investigator: | John J Folk, MD | State University of New York - Upstate Medical University |
More Information
Publications:
| Responsible Party: | John J. Folk, M.D. Associate Professor, SUNY Upstate Medical University Department Obstetrics & Gynecology |
| ClinicalTrials.gov Identifier: | NCT00759733 History of Changes |
| Other Study ID Numbers: | IRBPHS 5123 |
| Study First Received: | September 24, 2008 |
| Last Updated: | August 4, 2010 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by State University of New York - Upstate Medical University:
|
pregnancy heart disease heart function testing |
echocardiography B-type natriuretic peptide obstetrical care |
Additional relevant MeSH terms:
|
Heart Diseases Cardiovascular Diseases Natriuretic Peptide, Brain Natriuretic Agents |
Physiological Effects of Drugs Pharmacologic Actions Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 16, 2013