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Trial registered on ANZCTR
Registration number
ACTRN12621000936820
Ethics application status
Approved
Date submitted
15/03/2021
Date registered
16/07/2021
Date last updated
16/07/2021
Date data sharing statement initially provided
16/07/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Assessment of subclinical right ventricular dysfunction in Systemic Sclerosis (SSc) using blood oxygen level dependent (BOLD) myocardial resonance imaging and strain echocardiography
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Scientific title
Assessment of subclinical right ventricular dysfunction in Systemic Sclerosis (SSc) using blood oxygen level dependent (BOLD) myocardial resonance imaging and strain echocardiography
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Secondary ID [1]
303662
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
BOLD-SSc
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Systemic sclerosis
321048
0
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Cardiovascular - right ventricular dysfunction
321049
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Skin
321537
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Condition category
Condition code
Inflammatory and Immune System
318850
318850
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0
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Autoimmune diseases
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Cardiovascular
318851
318851
0
0
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Other cardiovascular diseases
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Skin
319286
319286
0
0
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All participants will undergo BOLD and Parametric T1/T2 mapping Cardiac Magnetic Resonance (CMR) of their RV and Speckle tracking Echocardiography (Echo).
Both patient population and normal volunteers will have CMR and echo assessments. Echo assessment will apart of the patient populations annual routine follow up with their rheumatologist. CMR assessment will be done within 3 months of this echo.
CMR will be carried out in the presence of radiographer and cardiologist. Echo will be performed by sonographer.
During CMR scan, participants will be administered with adenosine and gadolinium. Adenosine is a drug that mimics the effect of exercise on your heart. Cardiac images will be taken both at rest and at adenosine stress. There will be no designated time between rest and stress periods however if the patient's conditions requires this, adequate time will be given.
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Intervention code [1]
319962
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Early detection / Screening
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Comparator / control treatment
Normal healthy controls will be recruited and have the same assessments
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Control group
Active
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Outcomes
Primary outcome [1]
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Right ventricular myocardial oxygenation during rest and stress (OS-CMR delta SI) in SSc patients
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Assessment method [1]
326803
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Timepoint [1]
326803
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The primary end-point of OS-CMR is one variable. The OS-CMR will be assessed in the CMR, at single session.
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Secondary outcome [1]
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Diffuse interstitial RV myocardial fibrosis in SSc patients
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Assessment method [1]
392716
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Timepoint [1]
392716
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At single assessment session
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Secondary outcome [2]
392717
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RV strain in SSc and healthy participants using echocardiography speckle tracking
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Assessment method [2]
392717
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Timepoint [2]
392717
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At single assessment session
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Eligibility
Key inclusion criteria
Patient population:
-Male and female aged greater than/ equal to 18 years
-Confirmed diagnosis of systemic sclerosis
-Screen negative for PAH based on Australian Scleroderma Interest Group (ASIG) algorithm or normal mean PAP (8-20 mmHg; assessed by right heart catheterisation). (Screen negative implies NT-proBNP < 210 pg/ml and pulmonary function test demonstrating DLCO > 70% predicted with FVC/DLCO <1.8)
-Normal echocardiography.
-No history of cardiac disease (myocardial infarction, angina, cardiomyopathy/heart failure, pulmonary thromboembolism and significant valvular heart disease).
Normal healthy controls:
-Male and female aged greater than/ equal to 18 years
-No history of cardiac disease
-Normal screening echocardiogram (post consent) which includes assessment of left and right ventricular function, diastolic function and pulmonary artery pressures
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
-Inability to provide informed consent
-Prior documented LV/RV systolic dysfunction.
-Presence of significant coronary artery disease (>50% stenosis).
-Contraindications of CMR, including:
o Extreme claustrophobia
o Implantable cardiac devices and other contra-indications to CMR (metal in eyes, intracranial clips)
o Inability to lie flat for one hour
-Contraindication to gadolinium, including:
o Estimated Glomerular Filtration Rate (eGFR) of <45mL/min/1.73m2
-Contraindications to adenosine, including:
o second or third degree atrioventricular block
o obstructive pulmonary disease
o dipyridamole use
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
This is a prospective case-control study with a study population of male and female, consists of 71 SSc patients and 17 normal volunteers (NV) matched for age and gender will be recruited.
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
19/07/2021
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Actual
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Date of last participant enrolment
Anticipated
31/05/2022
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Actual
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Date of last data collection
Anticipated
31/12/2022
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Actual
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Sample size
Target
88
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [2]
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
33389
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5042 - Bedford Park
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Recruitment postcode(s) [2]
33390
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
308075
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Other
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Name [1]
308075
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SAHMRI
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Address [1]
308075
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SAHMRI
North Terrace
Adelaide SA 5000
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Country [1]
308075
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Australia
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Primary sponsor type
Other
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Name
Flinders Medical Centre
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Address
1, Flinders Drive
Bedford Park
SA 5042
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Country
Australia
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Secondary sponsor category [1]
308818
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None
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Name [1]
308818
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Address [1]
308818
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Country [1]
308818
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308064
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
308064
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1, Flinders Drive Bedford Park SA 5042
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Ethics committee country [1]
308064
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Australia
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Date submitted for ethics approval [1]
308064
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23/11/2020
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Approval date [1]
308064
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17/03/2021
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Ethics approval number [1]
308064
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Summary
Brief summary
Systemic Sclerosis (SSc) is an autoimmune disorder in which normal tissue is replaced with scar tissue. Normally, the immune system helps to defend the body against various infections and diseases. In SSc, the immune system stimulates the cells to produce excess collagen (protein). The excess collagen is deposited in skin and other organs (heart muscle, lungs, blood vessels, skeletal muscles and joints) causing hardening and thickening of normal tissues (similar to scar formation). The prevalence of SSc is 443 per million population, and women are more commonly affected. One of the major causes of SSc-related death is right heart (right ventricle, RV) failure, and thus assessment of its function is important in determining survival. The RV is affected through primary heart muscle involvement and/or due to involvement of blood vessels supplying the heart. RV dysfunction is silent until advanced and routine investigations do not detect it at an early stage. Hence, there is a need for a safe and sensitive non-invasive technique for early detection of RV dysfunction. Advanced imaging techniques like cardiac magnetic resonance imaging show potential in detecting early abnormalities in the RV, before symptoms present. We propose to utilize this technique to detect early RV abnormalities in patients with SSc. This will identify those at an increased risk and allow initiation of disease modifying therapy, thereby improving outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Joseph Selvanayagam
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Address
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Flinders Medical Centre - Cardiology
1, Fliinders Drive
Bedford Park
SA 5042
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Country
109398
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Australia
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Phone
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+61 8 8204 5619
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Fax
109398
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+ 61 8 8204 5625
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Email
109398
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[email protected]
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Contact person for public queries
Name
109399
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Joseph Selvanayagam
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Address
109399
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Flinders Medical Centre - Cardiology
1, Fliinders Drive
Bedford Park
SA 5042
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Country
109399
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Australia
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Phone
109399
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+61 8 8204 5619
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Fax
109399
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+ 61 8 8204 5625
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Email
109399
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[email protected]
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Contact person for scientific queries
Name
109400
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Joseph Selvanayagam
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Address
109400
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Flinders Medical Centre - Cardiology
1, Fliinders Drive
Bedford Park
SA 5042
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Country
109400
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Australia
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Phone
109400
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+61 8 8204 5619
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Fax
109400
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+ 61 8 8204 5625
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Email
109400
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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