RecruitingNCT06735521

Cardiac Magnetic Resonance Stress-perfusion Study in Patinets with Fontan Circulation

Att Överleva Och Leva Som Vuxen Med Enkammarhjärta I Sverige


Sponsor

Karolinska Institutet

Enrollment

30 participants

Start Date

Apr 15, 2024

Study Type

OBSERVATIONAL

Conditions

Summary

Univentricular heart (UVH) is a severe congenital heart disease. Accurate advanced non-invasive diagnostic methods is limited. Cardiovascular magnetic resonance (CMR) imaging has evolved as a particularly useful tool for the study of patients with adult congenital heart disease (ACHD) considering its ability to determine detailed anatomy and detect early cardiac dysfunction without the need for radiation exposure. Most of contemporary treatment recommendations are based on consensus opinions/documents and small studies from local, or national registries. Improved knowledge is needed in all these areas to facilitate clinical decisions regarding treatment, monitoring and follow-up. This study seeks to answer if early detection of deterioration in cardiac function, venous pressure and microvascular dysfunction can identify patients before the symptoms progress and thus help to initiate early treatment. The hypothesis is that quantitative myocardial stress-perfusion maps improves the pathophysiological insight in patients with UVH. The overall goal with this research proposal is to implement combined advanced CMR imaging for a comprehensive non-invasive mapping of functional cardiovascular behavior in patients with complex UVH disease. The outcome of this research may benefit this young adult patient population due to early detection of cardiac disease, less hospitalizations because of heart failure, and eventually decrease morbidity and mortality.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is using a special heart MRI scan (cardiac magnetic resonance stress-perfusion imaging) to assess blood flow in the hearts of people who have had Fontan surgery — a procedure done in childhood to reroute blood flow in those born with only one working heart ventricle. **You may be eligible if...** - You are over 18 years old - You have had Fontan circulation surgery (specifically total cavo-pulmonary connection) - Your heart failure symptoms are mild to moderate (NYHA Class I or II) - You are able to give informed consent **You may NOT be eligible if...** - You have a pacemaker or implanted defibrillator (ICD) - Your Fontan is failing (NYHA Class III or IV) - You have severe kidney failure (GFR below 30 mL/h) - You have atrial fibrillation - You are pregnant Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DIAGNOSTIC_TESTCardiac magnetic resonance stress-perfusion

Included patients will be examined at the Karolinska University Hospital in a 1.5T Siemens Sola magnetic resonance camera at rest and during adenosine stress with specific CMR sequences (adenosine stress-perfusion, myocardial velocities, and tissue characterization) for non-invasive determination of macro- and microvascular dysfunction, global myocardial function, pulmonary artery pressure and scarring of the myocardium. Adenosine or Regadenoson will be used as stress medication which is according to clinical routine. Adenosine will be infused over approximately 5 minutes (110-140 μg / kg/min), Regadenoson (5 ml) will be a 10-second injection (400 μg single dosage). Intravenous gadolinium-based contrast agents will be administered, Gadovist (1 mmol/ml, gadobuterol), 0.15 mmol/kg during stress and rest.


Locations(1)

Karolinska University Hospital

Stockholm, Sweden

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NCT06735521


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