Finding Early Predictors of Myocardial Dysfunction in Patients With Hypertension - Pilot Study.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Number of patients with changes in echocardiography during exercise
研究概览
简要总结
The study objective is to clarify the grounds of heart exertional dyspnoea stenocardia in patients with well-controlled stage I or II hypertension according to European Society of Hypertension, without changes in epicardial coronary arteries in CT coronary angiography and normal resting echocardiography result, and to assess of potential early markers of heart hypertrophy and failure in patients with hypertension.
详细描述
The study is to allow for identification of patients with hypertension, in whom an early introduction of pharmacological treatment of heart failure HF should be considered. Evaluation in the detection of asymptomatic myocardial dysfunction will include potential heart failure markers such as: cardiotrophin 1, cystatin C, serum syndecan-4, collagen III N-terminal propeptide [PIIINP], NT-proBNP, IL1RL1 and modern echocardiography methods in order to increase the effectiveness of prevention, diagnosis and treatment optimalization.
Material and study plan about 100 persons (age 30-70 years old) will be included in the study, patients with stage I or II primary hypertension according to the European Society of Hypertension: Group A- 15 patients without symptoms of heart failure Group B- 30 patients with exertional dyspnoea Group C - 40 patients with overt heart failure
In group B (patients with exertional dyspnea/stenocardia) we will include only patients who have undergone CT coronary angiography without any identified changes in the epicardial coronary arteries, which will facilitate answering the presented purpose of research. Patients in groups A and B with normal resting echocardiography and treated with a maximum of 2 antihypertensive drugs (an ACE inhibitor or a sartan as therapy base), according to the following regimen:
ACEI/ARB + diuretic ACEI/ARB + calcium channel antagonist Group C - treatment in accordance with the standards for heart failure. Each patient will be informed about the objectives of the study and give written consent to participate.
After signing informed consent patients will have performed the following tests:
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 30 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •persons (age 30-70 years old) will be included in the study, patients with stage I or II primary hypertension according to the European Society of Hypertension
排除标准
- •with coronary artery disease or a history of coronary artery disease (A, B)
- •with unstable hypertension
- •with a positive stress test
- •with NYHA class III-IV heart failure
- •after percutaneous or surgical revascularization
- •with diabetes
- •with GFR < 60
- •with hyperthyroidism and hypothyroidism
- •active smokers
- •with an implanted pacemaker
- •with obesity level II and III
- •with ECG-arrhythmia
- •pregnant and lactating
- •with congenital heart disease
- •with hemodynamically significant acquired heart defects
- •with cardiomyopathies (A,B)
- •with cancer
- •with anemia
- •abusing alcohol or drugs
- •with chronic inflammatory and other diseases
- •or who have not given their informed consent to participate in the study
结局指标
主要结局
Number of patients with changes in echocardiography during exercise
时间窗: 1 year
Echocardiography at rest and during submaxinal exercise on a bicycle ergometer
次要结局
- Changes in biomarkers levels according to clinical symptoms and echocardiography results(1 year)
研究者
Agata Bielecka-Dabrowa, MD, PhD, Department of Hypertension
MD, PhD, FESC, cardiologist
Medical University of Lodz