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Zürich Pulmonary Hypertension Outcome Assessment Cohort

Recruiting
Conditions
Pulmonary Hypertension Outcome Assessment
Interventions
Other: PH target therapy according to physician
Registration Number
NCT02249806
Lead Sponsor
University of Zurich
Brief Summary

PH is a serious disease with a dismal prognosis and impaired quality of life when left untreated. Reliable patient centered and prognostically relevant outcome measures are highly warranted in the field of PH. With this prospective cohort study the investigators intend to gain important information on the course of the disease and knowledge on the value of different new and already established outcome parameters.

Detailed Description

PH is a serious disease with a dismal prognosis and impaired quality of life when left untreated. Advances in medical therapy have improved survival according to recent registries, but are associated with high healthcare costs. Most treatment trials and clinical follow-up assessments rely on the 6 minute walk distance as main outcome parameter although submaximal exercise performance reflects only one disease aspect.

Reliable patient centered and prognostically relevant outcome measures are highly warranted in the field of PH. With this prospective cohort study the investigator intend to gain important information on the course of the disease and knowledge on the value of different new and already established outcome parameters. New outcomes to be assessed will be home based activity monitoring, novel physiological measures, namely cerebral and muscle tissue oxygenation at rest and during exercise testing, stair ascent on mechanograph, sit to stand test and several serum markers and micro-RNA. All these assessments will be compared with hard endpoints events (death, lung-transplantation, hospitalization for PH), and with traditional outcome measures such as NYHA functional class, 6 minute walk distance, generic quality of life, cardiopulmonary exercise tests, sleep studies, health preference (utility) and cognitive function.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Patients with precapillary pulmonary hypertension
  • Adult male and female patients of all ages referred to our center for evaluation/treatment of PH
  • Written informed consent by the subject after information about the research project
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Exclusion Criteria
  • Patients with severe concomitant left heart disease (left ventricular ejection fraction <40%).
  • Patients with restrictive lung disease (FVC<60% predicted); obstructive lung disease (forced expiratory volume (FEV) <60% predicted, with FEV 1/FVC<70%).
  • Patients with any other disease limiting their ability to move (skeletal disease, neurological disease, etc.)
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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PH target therapyPH target therapy according to physicianPatients receiving PH target therapy
Primary Outcome Measures
NameTimeMethod
Survival10 years

Transplant free survival will be registered

Change in the 6 minute walk distance10 years

The change in 6 minute walk distance will be registered at 3, 6, 12 months and yearly thereafter

Secondary Outcome Measures
NameTimeMethod
Hemodynamic parameters by echocardiography10 years

The change in echo parameters will be registered at 3, 6, 12 months and yearly thereafter

Hospital days10 years

Days spent in the hospital

Overnight sleep study parameters10 years

The change Overnight sleep study parameters will be registered at 3, 6, 12 months and yearly thereafter

Score in cognitive function tests10 years

The change cognitive function will be registered at 3, 6, 12 months and yearly thereafter

Score in health related Quality of Life (HRQoL) questionnaires10 years

The change in HRQoL class will be registered at 3, 6, 12 months and yearly thereafter

New York Heart association (NYHA) functional class10 years

The change in NYHA class will be registered at 3, 6, 12 months and yearly thereafter

Score on Short-Form-6 D, Euro-Qol 5 D (EQ-5 D), visual analogue scale, time trade-off, standard gamble test10 years

The change in utility will be registered at 3, 6, 12 months and yearly thereafter

Cardiopulmonary exercise test parameters10 years

The change cardiopulmonary exercise test parameters will be registered at 3, 6, 12 months and yearly thereafter

ECG parameters10 years

The change in ECG parameters will be registered at 3, 6, 12 months and yearly thereafter

Motion, step counts, metabolic equivalent10 years

The change in Activity assessment parameters will be registered at 3, 6, 12 months and yearly thereafter with actigraphy

red- and white blood cell counts10 years

The change in blood cell count will be registered at 3, 6, 12 months and yearly thereafter

Partial pressures of oxygen and carbon dioxide, pH, bicarbonate, electrolytes10 years

The change in arterial blood gas parameters taken from radial artery will be registered at 3, 6, 12 months and yearly thereafter, (ABL '90Flex'-blood gas analyzer, Radiometer, Switzerland)

Level of tissue oxygenation and blood volume index of prefrontal and quadriceps muscle tissue10 years

Changes in cerebral and muscle tissue oxygenation will be assessed after 3, 6, 12 months and yearly thereafter by Near-infrared-Spectroscopy

Time, maximal power in stair-ascent test10 years

Changes in performance of stair ascent test will be assessed after 3, 6, 12 months and yearly thereafter

Performance in Sit to stand test10 years

Changes in sit- to stand test will be assessed after 3, 6, 12 months and yearly thereafter

Level of C-reactive protein (CRP)10 years

The change in CRP will be registered at 3, 6, 12 months and yearly thereafter, taken from venous blood sample, measured by immunoassay ('Immulite 2000'; 'DPC'; Los Angeles; USA)

Level of N-terminal brain natriuretic peptide (BNP)10 years

The change in BNP will be registered at 3, 6, 12 months and yearly thereafter, taken from venous blood sample, measured by Roche Modular Systems (Roche; Switzerland)

Trial Locations

Locations (1)

University Hospital Zürich

🇨🇭

Zurich, Switzerland

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