Coronary Flow Reserve Evaluation in PET and in MRI Scanner in Heart Transplanted Patients : Comparison With Multi-detectors Scanner (RECOPE)
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Purpose
Heart transplantation is the ultimate therapeutic option in patients with end-stage heart failure. Since advances in the treatment of acute rejection has increased early transplant survival, cardiac allograft vasculopathy (CAV) is the main factor limiting long-term survival. The prevalence of angiographically proven CAV is high, documented in 40-50% of transplant recipients 5 years after transplantation. Therefore, annual coronary angiography remains widely used to monitor transplanted patients, although pathologic studies and intravascular ultrasonography have demonstrated that coronary angiography underestimates the severity of CAV. Perfusion SPECT may underestimate allograft vasculopathy in case of diffuse coronary lesions. In this setting, the assessment of coronary reserve by means of Positron Emission Tomography (PET) and perfusion cardiac magnetic resonance imaging (CMR) have not been investigated.
| Condition | Intervention |
|---|---|
|
Heart Disease |
Radiation: 15O-H2O PET - Radiation: MRI |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Coronary Flow Reserve Evaluation in PET and in MRI Scanner in Heart Transplanted Patients : Comparison With Multi-detectors Scanner |
- To compare the coronary flow reserve by a quantitative method (PET ... [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 30 |
| Study Start Date: | November 2010 |
| Estimated Study Completion Date: | June 2014 |
| Estimated Primary Completion Date: | June 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: PET
15O-H2O PET
|
Radiation: 15O-H2O PET -
Assessment of coronary reserve using PET
|
|
Experimental: MRI
MRI
|
Radiation: MRI
Assessment of coronary reserve using MRI
|
Detailed Description:
Aim of the study. The aim of the study is to compare the quantitative (using 15O-H2O PET) and semi-quantitative (using perfusion CMR) assessment of coronary reserve to the presence of coronary artery lesions documented by multidetector CT coronary angiography.
Methods. 30 patients with heart transplantation > 3 yrs will be included in two heart transplantation centers (Caen and Rouen university hospitals)
Expected results.
- To demonstrate that quantitative analysis of coronary reserve using 15O-H2O PET allows the assessment of cardiac allograft vasculopathy
- To establish the feasibility of adenosine stress CMR in this population
- To show a relationship between coronary lesions demonstrated using MDCT and the extent of coronary reserve impairment assessed using cardiac functional imaging (PET and CMR).
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient with heart transplantation > 3 years
- Candidate to a routine coronary angiography
- Age > 18 years old
- signed informed consent
Exclusion Criteria:
- Pregnancy or breast feeding women
- Recent acute coronary syndrome (<4weeks)
- High Blood Pressure ((SBP >=180 mmHg or DBP >=110 mmHg)
- Significant ventricular or supraventricular arrythmia
- Atrioventricular 2nd or 3rd degree blocks, long QT syndrome
- Standard contraindications to MRI including pacemaker/defibrillator, metallic clips on brain aneurysms, metal fragment in the eye etc...
- Congestive heart failure
- Hemodynamic instability
- Intolerance or contraindication to adenosine (history of asthma or bronchoplastic disease).
- Severe and known pulmonary artery hypertension
- Severe hypotension < 90 mmHg
- Contraindication to contrast iodinated media (allergy, patients with chronic renal failure with creatinine clearance < 50 ml/min, multiple myeloma, hyperthyroidism,...)
Contacts and Locations| Contact: Alain MANRIQUE, MD | +33 2 31 47 02 87 | manrique@cyceron.fr |
| Contact: Denis AGOSTINI, PhD | +33 2 31 06 32 46 | agostini-d@chu-caen.fr |
| France | |
| CHU de Caen - GIP Cyceron | Recruiting |
| Caen, France, 14000 | |
| Contact: Alain MANRIQUE, MD +33 2 31 47 02 82 manrique@cyceron.fr | |
| Contact: Cynthia BONDIS +33 2 31 06 57 80 bondis-c@chu-caen.fr | |
| Sub-Investigator: Rémi SABATIER, MD | |
| Sub-Investigator: Annette BELIN, MD | |
| Sub-Investigator: Michèle HAMON, PhD | |
| CHU de Rouen | Recruiting |
| Rouen, France, 76000 | |
| Contact: Michel REDONNET, MD +33 2 32 88 81 97 Michel.Redonnet@chu-rouen.fr | |
| Contact: Catherine NAFEH, MD +33 2 32 88 81 97 catherine.nafeh-bizet@chu-rouen.fr | |
| Sub-Investigator: Jean-Nicolas DACHER, PhD | |
| Principal Investigator: | Alain Manrique, MD | GIP Cyceron - CHU de Caen |
More Information
No publications provided
| Responsible Party: | University Hospital, Caen |
| ClinicalTrials.gov Identifier: | NCT01231815 History of Changes |
| Other Study ID Numbers: | 2008-007746-58 |
| Study First Received: | October 29, 2010 |
| Last Updated: | April 11, 2013 |
| Health Authority: | French Health Authority : AFSSAPS |
Keywords provided by University Hospital, Caen:
|
Heart transplantation |
Additional relevant MeSH terms:
|
Heart Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on May 16, 2013