Trial record 8 of 65 for:    sickle cell anemia OR sickle cell disease OR hemoglobin S disease OR hemoglobin SS disease | Open Studies | NIH, U.S. Fed

Microvessels and Heart Problems in Sickle Cell Disease

This study is currently recruiting participants. (see Contacts and Locations)
Verified February 2014 by National Institutes of Health Clinical Center (CC)
Sponsor:
Information provided by:
National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:
NCT01602809
First received: May 18, 2012
Last updated: March 14, 2014
Last verified: February 2014
  Purpose

Background:

- Small blood vessels (microvessels) in many different organs are affected by diseases such as diabetes and atherosclerosis. These microvessels may also be abnormal in people who have sickle cell disease. Stiffness of the red blood cells leads to problems in the microvessels of the heart and kidneys. However, these problems may not be detected until these organs are severely affected. Researchers want to study problems with microvessels in people with and without sickle cell disease.

Objectives:

- To study how microvessels in the heart and other organs are affected by sickle cell disease.

Eligibility:

  • Individuals at least 18 years of age who have sickle cell disease.
  • Healthy volunteers at least 18 years of age.

Design:

  • Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected.
  • All participants will have about 3 to 4 hours of testing for the study. Participants with sickle cell disease who are having a pain crisis at the time they enter the study may be asked to have the testing again when the crisis is over. The repeat testing will occur at least 4 weeks after the pain crisis ends.
  • All participants will have the following tests:
  • Blood draws to check kidney and liver function, and other blood tests
  • Measure of blood flow in the brachial (upper arm) artery
  • Heart ultrasound
  • Ultrasound scans of arm muscles to study blood flow
  • Ultrasound scans after taking vasodilators to increase blood flow
  • Healthy volunteers will also have a magnetic resonance imaging scan. It will show blood flow in the heart. This scan will involve another dose of a vasodilator.

Condition
Sickle Cell Disease

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Microvascular and Cardiac Dysfunction in Sickle Cell Disease

Resource links provided by NLM:


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

Primary Outcome Measures:
  • To use contrast-enhanced ultrasound to evaluate microvascular blood flow (MBF) and capillary RBC velocity (CBV) in skeletal muscle and the heart (at rest and during vasodilator stress) in patients with SCD in comparison to normal control patient...

Secondary Outcome Measures:
  • To determine whether MBF and CBV worsen during pain crisis in patients with SCD
  • To determine the relation between MBF and CBV and brachial artery flow or LV dysfunction.

Estimated Enrollment: 85
Study Start Date: April 2012
Detailed Description:

Sickle cell disease is the most common genetic disease affecting African-Americans. It is characterized by an abnormal hemoglobin S, which polymerizes when deoxygenated leading to red cell rigidity and microvascular flow obstruction. Recurrent episodes of ischemia and a chronic inflammatory state lead to ischemia-reperfusion injury in multiple vital organ systems. Endothelial dysfunction has been demonstrated in patients with sickle cell disease and new therapies are targeted specifically towards the endothelium. Contrast ultrasound is a non-invasive technique that has been used to assess microvascular flow in coronary artery disease, diabetes, and other disease states. We propose to use this technique in sickle cell patients to compare their myocardial and skeletal muscle flow with that of normal controls, to detect changes during pain crisis, and to compare flow abnormalities with cardiac functional abnormalities.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria
  • INCLUSION CRITERIA:
  • Adult subject age greater than or equal to 18 years
  • Able to give written informed consent
  • For SCD groups, must have confirmed diagnosis of sickle cell disease

EXCLUSION CRITERIA:

  • Atrial fibrillation or other irregular rhythm that would preclude adequate image acquisition
  • Subjects with a contraindication for the ultrasound contrast agent.
  • Pregnant or lactating women
  • Known obstructive coronary or peripheral vascular disease
  • SCD subjects at steady-state must not have acute pain crisis requiring intravenous analgesics within the prior 4 weeks
  • SCD subjects in crisis must be within 72 hours of hospital admission
  • Subjects with contraindications to MRI scanning will complete all other procedures but will not undergo the MRI scan. Subjects with an estimated glomerular filtration rate of < 30 ml/min/1.73 m(2) will not receive gadolinium as per 2011 NHLBI gadolinium administration policy.
  • Subjects with a contraindication to regadenson
  • Any condition that in the clinical opinion of the investigators renders study procedures inadvisable.

Diagnosis of acute chest syndrome is not an exclusion criteria for this protocol. Subjects may be concurrently enrolled in any other protocols with the exception of investigational new drug studies.

  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: NCT01602809

Contacts
Contact: Cynthia L Brenneman, R.N. (301) 451-3799 brennemc@nhlbi.nih.gov
Contact: Vandana Sachdev, M.D. (301) 496-3015 vs74y@nih.gov

Locations
United States, Maryland
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: Vandana Sachdev, M.D. National Heart, Lung, and Blood Institute (NHLBI)
  More Information

Additional Information:
Publications:
ClinicalTrials.gov Identifier: NCT01602809     History of Changes
Other Study ID Numbers: 120124, 12-H-0124
Study First Received: May 18, 2012
Last Updated: March 14, 2014
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Perfusion
Microvessels
Ultrasound
Sickle Cell Disease

Additional relevant MeSH terms:
Anemia, Sickle Cell
Anemia, Hemolytic, Congenital
Anemia, Hemolytic
Anemia
Hematologic Diseases
Hemoglobinopathies
Genetic Diseases, Inborn

ClinicalTrials.gov processed this record on September 18, 2014