MedPath

Prospective Evaluation of Asians With CRT for Heart Failure

Recruiting
Conditions
Heart Failure
Cardiac Resynchronisation Therapy
Interventions
Device: Cardiac Resynchronization Therapy
Registration Number
NCT02814942
Lead Sponsor
National University Heart Centre, Singapore
Brief Summary

Aim:To determine the baseline characteristics of heart failure patients in Singapore undergoing cardiac resynchronization therapy (CRT); the long term outcome and predictors of response to CRT.

Methodology:Among patients undergoing CRT for severe heart failure according to indications stipulated in international Cardiology guidelines, baseline demographic data is collected. Age, gender, NYHA functional class, co-morbidities, QRS width on ECG, presence of left bundle branch block pattern on ECG, presence of atrial fibrillation, left ventricular ejection fraction (LVEF) on echocardiogram, ventricular dimensions, 6 min walk test distance are collected. In addition, during the CRT implant procedure, blood is drawn from the vascular access and analysed for NT-pro BNP levels and other biomarkers of heart failure.

The echocardiographic and ECG parameters and blood biomarkers are reanalysed at 6 months and 12 months following CRT implant. Response to CRT is defined as a reduction in the iLVESV (left ventricular end-systolic volume index to body surface area) of \>/= 15% and/or an increase in the LVEF of \>/= 10%.

Detailed Description

Among patients undergoing CRT for severe heart failure according to indications stipulated in international Cardiology guidelines, baseline demographic data is collected. Age, gender, NYHA functional class, comorbidities, QRS width on ECG, presence of left bundle branch block pattern on ECG, presence of atrial fibrillation, left ventricular ejection fraction (LVEF) on echocardiogram, ventricular dimensions, 6 min walk test distance are collected. In addition, during the CRT implant procedure, blood is drawn from the vascular access and analysed for NT-pro BNP levels and other biomarkers of heart failure. The echocardiographic and ECG parameters and blood biomarkers are reanalysed at 6 months and 12 months following CRT implant. Response to CRT is defined as a reduction in the iLVESV (left ventricular end-systolic volume index to body surface area) of \>/= 15% and/or an increase in the LVEF of \>/= 10%.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
500
Inclusion Criteria
  • Broad QRS (>120 ms)
  • EF < 40%
  • Symptomatic heart failure
  • Not on optimal medical therapy
Exclusion Criteria
  • Pregnant
  • < 18 years of age
  • Infection
  • Unable to consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Heart Failure receiving CRTCardiac Resynchronization TherapyHeart failure patients with QRS \> 120ms receiving CRT
Primary Outcome Measures
NameTimeMethod
Echocardiographic response to CRT6 months

A subject is considered an echocardiographic responder to CRT if there is:

1. reduction in the iLVESV (left ventricular end-systolic volume index to body surface area) of \>/= 15% OR

2. an increase in the LVEF of \>/= 10% during follow-up echocardiography at 6 months

Secondary Outcome Measures
NameTimeMethod
Hospitalization For Cardiovascular events8 years

Hospitalisation for acute coronary syndrome, heart failure, arrhythmias, ICD shocks or any unplanned admissions for any cardiac interventions or surgery

Mortality8 years

Mortality

Neuroendocrine response to CRT6 months

A subject is considered to have a neuro-endocrine response to CRT if BNP levels at 6 months post CRT implant has fallen more than 30% from baseline

Clinical response to CRT6 months

A subject is considered a positive clinical responder to CRT if:

1. NYHA class has improved by at least 1 class OR

2. 6 minutes walking test has increased by at least 10%

Trial Locations

Locations (1)

National University Hospital

πŸ‡ΈπŸ‡¬

Singapore, Singapore

Β© Copyright 2025. All Rights Reserved by MedPath