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A 10-Minute Cardiovascular Magnetic Resonance Protocol for Cardiac Disease

Recruiting
Conditions
Coronary Artery Disease
Myocarditis
Infiltrative Cardiomyopathy
Dilated Cardiomyopathy
Aortic Valve Stenosis
Congenital Heart Disease
Aortic Valve Regurgitation
Pericardial Effusion
Vascular Anomaly
Hypertrophic Cardiomyopathy
Registration Number
NCT04464655
Lead Sponsor
McGill University Health Centre/Research Institute of the McGill University Health Centre
Brief Summary

This study aims to identify and assess new CMR techniques that can improve current CMR protocols.

Detailed Description

The aim of this study is to develop a comprehensive 10-minute protocol based on function and myocardial tissue characterization without the need for contrast injection, which can be standardized for 70% of cardiac patients.

To test this 10-minute CMR protocol for its ability to significantly improve diagnostic decision-making and to reduce cost.

To test its clinical feasibility, performance and cost-effectiveness in different populations including: Non-ischemic cardiomyopathies (-)OS-CMR and Ischemic Heart Disease and CAD (+)OS-CMR

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
2130
Inclusion Criteria
  • Age: > 18y, Informed consent No known current or pre-existing significant medical conditions that would affect the cardiovascular or respiratory system
Exclusion Criteria
  • General MRI contraindications: MR- incompatible devices such as pacemakers, defibrillators, or implanted material or foreign bodies. Consumption of caffeinated drinks or foods (including cocoa and chocolate) during the 12 hours prior to the exam.Regular nicotine consumption during the last 6 months

Patients

Inclusion Criteria:

  • Age: >18 y, Informed consent, Clinically indicated CMR exam

Exclusion Criteria:

  • General MRI contraindications: MR- incompatible devices such as pacemakers, defibrillators, or implanted material or foreign bodies Vasoactive medication (e.g. nitro) during the 12 hours prior to the exam. Consumption of caffeinated drinks or foods (including cocoa and chocolate) during the 12 hours prior to the exam.

Regular nicotine consumption during the last 6 months

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main finding comparison between SMART CMR and standard CMR in patients with suspected coronary artery disease2019-2025

(Patients with suspected coronary artery disease:) Agreement of the main finding regarding the presence of a coronary territory at risk for inducible myocardial ischemia myocardial derived from OS-CMR, compared with standard first-pass perfusion CMR, using the coronary angiography report as a standard of truth. If the latter is not available, the conclusions based on the results of the standard CMR first pass perfusion scan will be used as the standard of truth.

Primary diagnosis comparison between SMART CMR and standard CMR2019-2025

(All patients) Agreement of the suggested primary diagnosis derived from SMART CMR, compared with the diagnosis established from standard CMR protocols, using the final clinical diagnosis as established by the treating physician, as a standard of truth. If the latter is not available, the conclusions based on the results of the standard CMR protocol will be used as the standard of truth.

Secondary Outcome Measures
NameTimeMethod
SMART CMR scan completion percentage2019-2025

Proportion of SMART CMR scans that could be completed according to the protocol

Adverse event monitoring during SMART CMR sequences2019-2025

Number and proportion of reported adverse events effects during SMART CMR

Adverse event monitoring during OS-CMR sequence2019-2025

Number and proportion of reported adverse events during OS-CMR

OS-CMR scan completion percentage2019-2025

Proportion of OS-CMR scans that could be completed according to the protocol

SMART CMR sequence times vs standard protocol sequence times2019-2025

Observed scan time for SMART CMR compared with the standard CMR protocol

Septal myocardial T2 vs standard myocardial T22019-2025

Septal myocardial T2 as estimated from SMART CMR, compared with results from standard myocardial mapping

OS-CMR sequence times vs standard protocol sequence times2019-2025

Observed scan time for for OS-CMR during breathing maneuvers compared with the standard CMR first-pass perfusion protocol

Cost comparison of OS-CMR vs standard CMR protocol2019-2025

Total cost of OS-CMR with breathing maneuvers (based on scan time) vs the standard CMR first-pass perfusion protocol (calculated from the scan time plus any other material such as contrast agents or pharmacological vasodilators)

Septal myocardial T1 vs standard myocardial T12019-2025

Septal myocardial T1 as estimated from SMART CMR, compared with results from standard myocardial mapping

SMART-CMR post-stenotic peak flow vs standard CMR flow images2019-2025

Post-stenotic peak flow velocity in patients with suspected valvular disease measured in SMART CMR images, compared with results from standard CMR flow images

Inter- and intra-scanner variability2019-2025

Inter- and intra- scanner variability as assessed by ICC and kappa

Cost comparison of SMART CMR vs standard CMR protocol2019-2025

Total estimated cost of SMART CMR compared with the standard CMR protocol

Intra- and inter-reader reproducibility2019-2025

Correlation coefficients will be obtained to evaluate the intra- and inter-reader reproducibility of all quantitative markers.

Quantitative parameter comparison between SMART CMR and CINE images2019-2025

Quantitative parameters relevant to the diagnosis (see Appendix: CanSCMR Recommendations for reporting CMR) measured in SMART CMR images, compared with results from standard CMR cine images

Strain measurements vs standard cine image measurements2019-2025

Longitudinal and circumferential strain measurements measured in SMART CMR images, compared with results from standard CMR cine images

Trial Locations

Locations (1)

McGill University Health Center

🇨🇦

Montreal, Quebec, Canada

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