Multi-Modality Echocardiographic Techniques in Pathological Left Ventricular Hypertrophy Adults
- Conditions
- Left Ventricular Hypertrophy
- Interventions
- Device: Echocardiography
- Registration Number
- NCT05719337
- Lead Sponsor
- First Hospital of China Medical University
- Brief Summary
This multicenter clinical study aims to evaluate the multi-modality echocardiographic parameters in patients with different pathological left ventricular hypertrophy (LVH) and investigate the correlation between echocardiographic parameters and different etiologies, providing an important theoretical basis for early identification and risk assessment in LVH patients.
- Detailed Description
Left ventricular hypertrophy (LVH) is an abnormal increase in the mass of the left ventricular myocardium, and its presence is associated with poor outcomes and ventricular arrhythmias. It is commonly seen in hypertension and aortic stenosis due to persistent pressure overload. In addition, it can also be found in genetic diseases and metabolic diseases, such as hypertrophic cardiomyopathy, cardiac amyloidosis and Fabry disease. Although patients with the latter type of LVH may often have normal loading conditions, there is significant heterogeneity in phenotypes and prognosis due to etiological variability. Hence for LVH patients, early identification of the underlying causes, effective intervention, follow up and surveillance may reduce mortality and improve survival. Echocardiography is the initial imaging modality for evaluation of cardiovascular diseases. And it plays an important role in the detection of LVH and potential causes in current clinical practice. Nevertheless, the feasibility of discriminatory for different diseases is limited by the fact that overlapping LVH in different conditions can often lead to diagnostic ambiguity. There is an urgent need to find echocardiographic parameters with high specificity to assist in the etiological diagnosis of patients with pathological LVH.
Patients with LVH commonly associate with left ventricular diastolic dysfunction, causing changes in the structure and function of the left atrium prior to abnormal left ventricular ejection fraction. Left atrium function at reservoir, conduit and booster phases can be noninvasively quantify by speckle tracking echocardiography. However, there is incomplete information on left atrium strain characteristics in patients with LV pathological hypertrophy. The myocardial longitudinal strain parameters derived from speckle tracking echocardiography is a sensitive noninvasive method of assessing left ventricular myocardial performance. The relative "apical sparing" can be easily visualized for patients with cardiac amyloidosis. The reduced longitudinal strain in the basal lateral wall could be found at the very early stages of Fabry disease. Hence the specific manifestations derived from longitudinal strain mapping can assist in the differentiate patients from various causes of LVH. And left ventricular volume and mass index assessed by three-dimension echocardiography are independently associated with adverse outcomes of LVH patients. Therefore, appropriate utilization of multi-modality echocardiography techniques is fundamental to accurate diagnosis as well as longitudinal care of pathological LVH patients. However, a great deal of studies were based on small samples and single center. There is lack of defined diagnostic results based on multi-modality echocardiography and comprehensive markers derived from large-scale study.
In this study, we expected to provide a set of parameters for different etiology by including patients with different pathological LVH based on multi-modality echocardiography, so as to assisting in early identification and risk assessment in LVH patients.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 660
- Age ≥ 18 years old;
- A wall thickness ≥ 12mm in one or more LV myocardial segments as measured by 2D echocardiography.
- Patients with definite diagnosis of hypertensive heart disease, hypertrophic cardiomyopathy, cardiac amyloidosis or Fabry disease.
- Patients with severe valvular disease, congenital heart disease, aortic coarctation, multiple Takayasu arteritis, or other cardiovascular diseases that may cause ventricular hypertrophy;
- Hypertrophy of myocardium caused by high intensity exercise;
- Poor ultrasonic image quality, which cannot meet analysis requirement.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Cardiac amyloidosis group Echocardiography Clinical diagnosis of cardiac amyloidosis confirmed by blood tests or tissue biopsy. Hypertensive heart disease group Echocardiography Systolic blood pressure exceeded 140 mmHg and/or diastolic blood pressure exceeded 90 mmHg, or a history of systemic hypertension in the absence of other cardiac or systemic disease was described as hypertension. Hypertrophic cardiomyopathy group Echocardiography Wall thickness≥15 mm in the absence of other causes of hypertrophy in a non-dilated left ventricle (LV) defines HCM. End diastolic wall thickness≥13 mm can be diagnostic if there is a family history of HCM or a known disease-causing genetic mutation. Fabry disease group Echocardiography Clinical diagnosis of Fabray disease confirmed by blood biomarkers or genetic testing.
- Primary Outcome Measures
Name Time Method Conventional echocardiographic parameters in all pathological LVH patients 1 day after admission To evaluate the conventional two-dimensional, color Doppler, spectral Doppler and tissue Doppler echocardiographic parameters in all pathological LVH patients.
- Secondary Outcome Measures
Name Time Method Volume and mass parameters in all pathological LVH patients 1 day after admission To evaluate the three-dimensional volume and mass parameters in all LVH patients.
Strain parameters in all pathological LVH patients 1 day after admission To evaluate the two-dimensional strain parameters of left ventricular and left atrium in all LVH patients.
Trial Locations
- Locations (22)
the Second Hospital of Hebei Medical University
🇨🇳Shijiazhuang, Hebei, China
Ansteel Group General Hospita
🇨🇳Anshan, Liaoning, China
the Second Hospital of Dalian Medical University
🇨🇳Dalian, Liaoning, China
Chaoyang Central Hospital
🇨🇳Chaoyang, Liaoning, China
Dalian Municipal Central Hospital
🇨🇳Dalian, Liaoning, China
Dandong Central Hospital
🇨🇳Dandong, Liaoning, China
Fushun Central Hospital
🇨🇳Fushun, Liaoning, China
the First Affiliated Hospital of Jinzhou Medical University
🇨🇳Jinzhou, Liaoning, China
Affiliated Central Hospital of Shenyang Medical College
🇨🇳Shenyang, Liaoning, China
Dadong Branch of First Affiliated Hospital of China Medical University
🇨🇳Shenyang, Liaoning, China
the First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine
🇨🇳Shenyang, Liaoning, China
the First Hospital of China Medical Univeristy
🇨🇳Shenyang, Liaoning, China
Liaoning Cancer Hospital & Institute
🇨🇳Shenyang, Liaoning, China
Tieling Central Hospital
🇨🇳Tieling, Liaoning, China
the Second Affiliated Hospital of Shenyang Medical College
🇨🇳Shenyang, Liaoning, China
Liao Jian Group Tie Mei General Hospital
🇨🇳Tieling, Liaoning, China
Tianjin Chest Hospital
🇨🇳Tianjin, Tianjin, China
the First Affiliated Hospital of Jiamusi University
🇨🇳Jiamusi, Heilongjiang, China
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
🇨🇳Wuhan, Hubei, China
the Affiliated Hospital of Inner Mongolia Medical University
🇨🇳Hohhot, Inner Mongolia, China
Nanjing Drum Tower Hospital
🇨🇳Nanjing, Jiangsu, China
Benxi Central Hospital
🇨🇳Benxi, Liaoning, China