Validating Novel, Non-contrast Cardiac MRI Imaging in Haemodialysis Patients
Validating the Accuracy of Novel, Non-contrast, Cardiac Magnetic resOnaNce Imaging in Defining Myocardial FIbRosis in Patients With End-stage Renal Disease on haeModialysis: the CONFIRM Study
University of Leicester
9 participants
Nov 3, 2019
OBSERVATIONAL
Conditions
Summary
There are currently no good ways of measuring levels of scarring in the hearts of patients with advanced kidney disease and patients on dialysis, although recent research has shown a new cardiac MRI technique, called native T1 mapping, may provide a solution to this. To assess the accuracy of this novel technique in dialysis patients, it is essential to undertake a study which compares native T1 mapping to actual levels of scarring in the hearts of patients on dialysis.
Eligibility
Inclusion Criteria5
- Prevalent haemodialysis patient (more than 3 months)
- Active on the supportive care register with anticipated death in the subsequent 12 months
- Able to give informed consent
- Consent to donation of heart for research following death
- Able to understand written and verbal explanations in English
Exclusion Criteria4
- Contraindication to MRI scan (e.g. pacemaker, incompatible metallic implants, claustrophobia)
- Patients with expected or potential infiltrative cardiomyopathy (e.g. amyloidosis)
- Unable to give informed consent
- Unable to understand written and verbal explanations in English
Interventions
A non-contrast cardiac MRI (CMR) scan at 3-Tesla platform (Skyra, Siemens Medical Imaging, Erlangen, Germany). This non-contrast CMR scan will principally determine: Left ventricular (LV) mass and volumes/ejection fraction and; fibrosis using T1 mapping.
Assessments will include: LV size and function as per the American Society of Echocardiography guidelines. In addition specific focus will be paid end-diastolic integrated backscatter measurements.
A limited post-mortem will be performed to retrieve patients' hearts for preparation and storage at St George's University, London where direct comparison will be made between levels of scarring seen directly under the microscope between that on the MRI scans.
Attach continuous Holter monitor (Schiller, medilog®AR12 plus/AR4 plus/FD5 plus, Baar, Switzerland) that will start before dialysis and terminate just before the subsequent dialysis treatment 48h later.
Collect blood samples from the arterial needle before dialysis. Approximately 30 millilitres of blood will be collected and then be pipetted into cryotubes and frozen at -80°C in an electronically monitored freezer for analysis in batches throughout the study. These samples will be used to investigate the relationship between circulating biomarkers of fibrosis, the MRI scans and the histological samples.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT03586518