Sleep-Disordered Breathing in Patients With Severe Valvular Regurgitation Undergoing Clip Procedure

Completed

• Conditions: Sleep Disordered Breathing; Valvular Regurgitation

• Registration Number: NCT03813511
• Lead Sponsor: Heart and Diabetes Center North-Rhine Westfalia

Brief Summary

In a prospective observational study, the investigators investigate the prevalence of sleep disordered breathing in patients with severe valvular regurgitation and the effect of using the minimal invasive Clip technique on sleep disordered breathing.

Detailed Description

The purpose of this study is to analyze the prevalance of sleep disordered breathing in patients with severe valvular regurgitation and the impact of a therapy with the minimal-invasive Clip technique.

Therefore, the investigators want to include consecutive patients with unknown sleep-associated respiratory distress syndrome and, in addition, as a study-specific achievement, the investigators want to obtain the quality of life and specific symptoms of the patients by using established questionnaires. After three month of post-interventional care, the patients will get a post-interventional check-up in our cardiological outpatient clinic, where the course of sleep-associated respiratory distress syndrome and the actual quality of life and specific symptoms will be documented by using a cardiorespiratory polygraphy and the same questionnaires.

The entire hospital stay, including possible post-interventional complications, will be documented for this study from the patients' medical records. The routine examinations (laboratory values, ECG, 6-minute walk test, pulmonary function examinations, spiroergometry, transthoracic / -oesophageal echocardiography, etc.) shall also be recorded in the database of this study.

The plan is to include 100 evaluable patients with complete follow-up and the associated test results. For this purpose, a screening of 150 patients is expected to be required.

Study Timeline

• Study Start: 2018-12-01
• Study First Submitted: 2018-12-19
• Study First Submitted QC: 2019-01-19
• Study First Posted: 2019-01-23
• Primary Completion: 2022-03-14
• Study Completion: 2022-07-31
• Status Verified: 2023-03
• Last Update Submitted: 2023-03-03
• Last Update Posted: 2023-03-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• Patients with severe valvular regurgitation and currently unknown sleep disorder breathing who will be treated with a minimal invasive Clip technique

Exclusion Criteria

• Patients with more then one valvular disease which requires Treatment
• Patients with complex congenital heart disease
• Pregnant women

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Influence of the minimal invasive Clip technique on apnea-hypopnea index	3 month	Changes on the number of apnea and hypopnea events per hour of sleep due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on apnea index	3 month	Changes on the number of apnea events per hour of sleep due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on ventilation length during sleep	3 month	Changes on the ventilation length (in seconds) due to the minimal invasiv Clip technique
Prevalance of Sleep disordered breathing in Patiens with severe valvular regurgitation	3 month	Proportion of of Sleep disordered breathing in Patiens with severe valvular regurgitation in a given time period
Influence of the minimal invasive Clip technique on T90	3 month	Changes on the the percentage of time during which arterial O2 saturation was less than 90% (T90) due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on PISA in tranthoracic echocardiography	3 month	Changes on the proximal isovelocity hemispheric surface area (PISA in square millimeter) in tranthoracic echocardiography due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on the effective regurgitant orifice (ERO) in tranthoracic echocardiography	3 month	Changes on the effective regurgitant orifice (ERO in square millimeter) in tranthoracic echocardiography due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on the peak velocity of the mitral regurgitant jet (mR-Vmax) in tranthoracic echocardiography	3 month	Changes on the peak velocity of the mitral regurgitant jet (mR-Vmax in meter per seconds) in tranthoracic echocardiography due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on the myocardial perfomance index (TEI-index) in tranthoracic echocardiography	3 month	Changes on systolic and diastolic time intervals in expressing global systolic and diastolic ventricular function (without unity) in tranthoracic echocardiography due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on the oxygen desaturation index	3 month	Changes on the number of times per hour of sleep that the blood's oxygen level drop by a certain degree from baseline due to the minimal invasiv Clip technique
Influence of the minimal invasive Clip technique on sleep cycle length	3 month	Changes on the duration of the five stages of sleep (in minutes) due to the minimal invasiv Clip technique

Secondary Outcome Measures

Name	Time	Method
Post-interventional assessment of the sleep quality with and without sleep disordered breathing	3 month	Post-interventional assessment of the sleep quality with and without sleep disordered breathing using the Pittsburgh Sleep Quality Index (PSQI) (From 0 (worst) to 21 (best))
Post-interventional survey of patient health with and without sleep disordered breathing	3 month	Post-interventional survey of patient health with and without sleep disordered breathing measured by the Short Form (36) Health Survey (SF-36).; SF-36 consists of eight scaled score (Vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning and mental health). Total range from 0 to 100 points (from worst to best)
Post-interventional changes in generic health status. with and without sleep disordered breathing	3 month	Post-interventional changes in generic health status. with and without sleep disordered breathing using the EQ-5D questionnaire (grade ranging from 0, the worst possible health status, to 100 ,the best possible health status
Post-interventional assesment of Symptoms, function and quallity of life with and without sleep disordered breathing by patients with heart failure	3 month	Post-interventional assesment of Symptoms, function and quallity of life with and without sleep disordered breathing by patients with heart failure using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) that hat quantifies physical function, symptoms (frequency, severity and recent change), social function, self-efficacy and knowledge, and quality of life. Total range is from 0 to 100 points. 0 denotes the worst and 100 the best possible health status
Post-interventional measurement of the adverse effects of heart failure on patient's life with and without sleep disordered breathing	3 month	Post-interventional measurement of the adverse effects of heart failure on patient's life with and without sleep disordered breathing using the Minnesota Living with Heart Failure Questionnaire. It provides a total score range 0-105, from best to worst
Post-interventional changes aerobic capacity and endurance with and without sleep disordered breathing	3 month	Post-interventional changes on aerobic capacity and endurance with and without sleep disordered breathing using the cardiopulmonary exercise testing (vO2max in milliliter per minute per kilogram
Post-interventional changes functional capacity of cardiopulmonary and musculoskeletal system with and without sleep disordered breathing	3 month	Post-interventional changes on aerobic capacity and endurance with and without sleep disordered breathing using the six minutes walk test (in meters)
Post-interventional changes in daytime sleepiness with and without sleep disordered breathing	3 month	Post-interventional changes in daytime sleepiness with and without sleep disordered breathing measured by the Epworth Sleepinss Scale (ESS) (From 0 to 24 point-scale; A number in the 0-9 range is considered to be normal while a number in the 10-24 range indicates severe daytime sleepiness)
Post-interventional changes on cognitive functions with and without sleep disordered breathing	3 month	Post-interventional changes on cognitive functions with and without sleep disordered breathing using the Montreal Cognitive Assessment Test (MOCA) (From 0 (worst) to 30 (best) point-scale)

Trial Locations

Locations (1)

Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum; 🇩🇪 Bad Oeynhausen, Germany