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Effects of Changes in Fluid Status on Right Ventricular Volumes and Function

Primary Purpose

Tetralogy of Fallot

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Cardiac Magnetic Resonance Imaging (CMRI)
Central venous line placement
Chest X-ray
Fluid administration
Blood Draw
Pregnancy test
Electrocardiogram
Sponsored by
University of Wisconsin, Madison
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Tetralogy of Fallot

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. TOF patients who have had repair using a transannular patch.
  2. Patients that present with free pulmonary insufficiency.
  3. Are older than 18 years.

Exclusion Criteria:

  1. Patients who have lesions predisposing to chronic volume overload (i.e. patients with significant residual postoperative ventricular septal defects (VSD), or large aorto-pulmonary collaterals or more than moderate tricuspid insufficiency) since all these hemodynamic conditions can influence the late function of the right ventricle and potentially affect the response of the right side of the heart in changes in volume status
  2. Patients who had a valve sparing TOF repair and have less than free pulmonary insufficiency.
  3. Patients who have significant residual right-sided obstruction (i.e. patients who have residual RVOT obstruction or significant residual branch pulmonary artery stenosis), as it is shown that residual pulmonary stenosis may protect from RV dilation and from deterioration of the RV function.
  4. Patients who cannot be reconstructed with a transannular patch and/or require a right ventricle to pulmonary artery homograft for reconstruction including:

    • pulmonary atresia and VSD
    • patients with anomalous coronary crossing the right ventricular outflow tract (RVOT) and
    • patients with TOF-absent pulmonary valve syndrome.
  5. Patients with renal failure and renal insufficiency
  6. Patients with uncompensated heart failure
  7. Cancer patients
  8. Latex allergic patients
  9. Patients with diabetes
  10. Pregnant females
  11. Prisoners
  12. Individuals who lack consent capacity

Sites / Locations

  • University of Wisconsin-Madison

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Study Group

Arm Description

Procedures include: Two Cardiac Magnetic Resonance Imaging (CMRIs) A central venous line placement, A chest X-ray Electrocardiogram (ECG) Fluid administration Blood draw Pregnancy test

Outcomes

Primary Outcome Measures

Postload volume status
The following will be measured to define the postload volume status: Left and right ventricle end diastolic volume (milliliters [ml]); Ejection fraction (%); pulmonary regurgitation

Secondary Outcome Measures

Full Information

First Posted
October 27, 2016
Last Updated
April 9, 2021
Sponsor
University of Wisconsin, Madison
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1. Study Identification

Unique Protocol Identification Number
NCT02967315
Brief Title
Effects of Changes in Fluid Status on Right Ventricular Volumes and Function
Official Title
Effects of Changes in Fluid Status on Right Ventricular Volumes and Function
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
June 6, 2014 (Actual)
Primary Completion Date
March 18, 2021 (Actual)
Study Completion Date
March 18, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Wisconsin, Madison

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the correlation between fluid volume status and right ventricular volume and function, in those with free pulmonary valve insufficiency after Tetralogy of Fallot (TOF) repair.
Detailed Description
The purpose of this study is to measure the changes in Right Ventricular size and function with changes in preload, using cardiovascular magnetic resonance (CMR). Based on an intensive research and clinical observations the investigators hypothesize that changes in volume status cause a statistically significant difference in the Cardiovascular magnetic resonance (CMR) measured RV End Diastolic Volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and pulmonary regurgitation (PR). The investigator hypothesizes that smaller changes will occur in left ventricular LV EDV, ESV, and EF. To establish a correlation between the changes in preload volume status and RV size and function in patients with free pulmonary insufficiency (PI) after TOF repair using CMRI. To assess the effects of preload status on the measured severity of pulmonary regurgitation (PR). To assess the effects of preload status on the left ventricular (LV) size This study will be conducted in compliance with this protocol, good clinical practice and the applicable regulatory requirements.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tetralogy of Fallot

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Study Group
Arm Type
Experimental
Arm Description
Procedures include: Two Cardiac Magnetic Resonance Imaging (CMRIs) A central venous line placement, A chest X-ray Electrocardiogram (ECG) Fluid administration Blood draw Pregnancy test
Intervention Type
Procedure
Intervention Name(s)
Cardiac Magnetic Resonance Imaging (CMRI)
Intervention Description
There will be 2 CMRIs. The first one will be patient's routine clinically schedule CMRI after the patient has fasted for 12 hours.This CMRI uses contrast. The second CMRI will be the research CMRI after the fluid administration. This CMRI does not use contrast.
Intervention Type
Procedure
Intervention Name(s)
Central venous line placement
Intervention Description
An ultrasound guided central line catheter will be placed in the internal jugular vein (IJV) under local anesthesia.
Intervention Type
Procedure
Intervention Name(s)
Chest X-ray
Intervention Description
A chest X-ray will be performed for safety reasons to rule out pneumothorax (< 1% risk) after central line placement.
Intervention Type
Procedure
Intervention Name(s)
Fluid administration
Intervention Description
Administration of 15cc/kg of normal saline for fluid hydration through peripheral IV that is placed for the MRI contrast administration.
Intervention Type
Procedure
Intervention Name(s)
Blood Draw
Intervention Description
One to two teaspoons of blood will be drawn for basic metabolic panel.
Intervention Type
Procedure
Intervention Name(s)
Pregnancy test
Intervention Description
A urine pregnancy test will be performed in female subjects.
Intervention Type
Procedure
Intervention Name(s)
Electrocardiogram
Intervention Description
12 lead ECG
Primary Outcome Measure Information:
Title
Postload volume status
Description
The following will be measured to define the postload volume status: Left and right ventricle end diastolic volume (milliliters [ml]); Ejection fraction (%); pulmonary regurgitation
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: TOF patients who have had repair using a transannular patch. Patients that present with free pulmonary insufficiency. Are older than 18 years. Exclusion Criteria: Patients who have lesions predisposing to chronic volume overload (i.e. patients with significant residual postoperative ventricular septal defects (VSD), or large aorto-pulmonary collaterals or more than moderate tricuspid insufficiency) since all these hemodynamic conditions can influence the late function of the right ventricle and potentially affect the response of the right side of the heart in changes in volume status Patients who had a valve sparing TOF repair and have less than free pulmonary insufficiency. Patients who have significant residual right-sided obstruction (i.e. patients who have residual RVOT obstruction or significant residual branch pulmonary artery stenosis), as it is shown that residual pulmonary stenosis may protect from RV dilation and from deterioration of the RV function. Patients who cannot be reconstructed with a transannular patch and/or require a right ventricle to pulmonary artery homograft for reconstruction including: pulmonary atresia and VSD patients with anomalous coronary crossing the right ventricular outflow tract (RVOT) and patients with TOF-absent pulmonary valve syndrome. Patients with renal failure and renal insufficiency Patients with uncompensated heart failure Cancer patients Latex allergic patients Patients with diabetes Pregnant females Prisoners Individuals who lack consent capacity
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Petros V Anagnostopoulos, MD
Organizational Affiliation
University of Wisconsin, Madison
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Wisconsin-Madison
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Effects of Changes in Fluid Status on Right Ventricular Volumes and Function

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