Cardiovascular Magnetic Resonance Imaging study assessing myocardial ischemia in patients with end-stage renal disease and renal transplant - post renal transplant cohort
Study of myocardial ischemia post renal transplant as assessed by Cardiac MRI in patients with end-stage renal disease
Professor Joseph Selvanayagam
80 participants
Jul 7, 2011
Interventional
Conditions
Summary
This project is designed to assess myocardial ischemia in various populations of patients with renal disease. These cohorts of patients have significant cardiovascular morbidity and mortality. It is believed that apart from epicardial coronary disease, they also have microvascular or small vessel ischemia. Dialysis is thought to be a major contributor in acceleration of their cardiovascular disease, however even after renal transplantation, there cardiovascular morbidity and mortality does not mirror the general population. We are going to assess myocardial ischemia using cardiac MRI and blood oxygen level dependent imaging. This uses intrinsic contrast of deoxy-hemoglobin to assess ischemia. We are going to assess it in patients on dialysis regardless of their cardiovascular symptoms as this group of patients have significant disease despite lack of traditional cardiac symptoms. We are also going to look at patients being evaluated for renal transplant. In this population, we can directly compare this relatively new technique with traditional method of ischemia assessment. We believe this technique will provided added information to already existing imaging modalities as it looks at oxygenation of the myocardium, which precedes development of ischemia. Our third cohort, evaluates patients after their renal transplant, examining markers that may predict cardiovascular morbidity and mortality in this group. This trial is the post transplant cohort and is linked to trial ACTRN12611000786998 and ACTRN12611000785909
Eligibility
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Interventions
Framingham's risk score at baseline (race, age, smoking history, family history of cardiac disease, cardiac risk factors) Blood tests at baseline - biochemical markers (hsCRP); markers of fibrosis (MMP); troponin T, BNP and homocysteine levels. Cardiac MRI at baseline - cine images; Blood oxygen level dependent MRI (BOLD) rest and stress using adenosine 140mcg/kg/min for 3-6 minutes; 1st pass perfusion imaging after rapid bolus Gd-DTPA 0.045 mmol/kg body weight, then after 15 minutes a further 0.045 mmol/kg Gd-DTPA would be given to obtain resting perfusion; finally delayed enhancement CMR. Follow up via phone call at 6, 12 and 24 months for Major Adverse Cardiac Events - including angina, myocardial infarction, rehospitalisation with cardiac event, cerebrovascular event, heart failure and death.
Locations(1)
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ACTRN12611000783921