The Evolution of Systemic Microvascular Reactivity in Heart Transplant Patients
概览
- 阶段
- 不适用
- 干预措施
- skin microvascular reactivity
- 疾病 / 适应症
- Heart Transplantation
- 发起方
- National Institute of Cardiology, Laranjeiras, Brazil
- 入组人数
- 31
- 试验地点
- 2
- 主要终点
- Baseline and post-iontophoresis of acetylcholine endothelium-dependent skin microvascular reactivity
- 状态
- 招募中
- 最后更新
- 19天前
概览
简要总结
The evolution of systemic microvascular reactivity may aid in the comprehension of cardiovascular physiology in heart transplantation patients, and possibly suggest the non-invasive evaluation of skin microcirculation as an ancillary tool in the clinical evaluation of these patients.
详细描述
Introduction: Systemic microvascular reactivity (MR) is an essential component of cardiovascular physiology, being studied through non-invasive techniques in readily accessible body regions, such as the skin surface. Heart transplant (HT) is a treatment considered to selected patients, with advanced heart failure. The main cause of long-term mortality after HT is graft vascular disease (GVD), a condition which starts with endothelial dysfunction. To know the evolution of systemic MR in patients subjected to HT can help to find prognostic factors. Objective: The present study aims to perform the prospective evaluation of systemic MR in adult patients, before and two years after HT, at a quaternary hospital, correlating the findings with clinical variables. Methods: Systemic MR will be evaluated in the skin of the forearm using laser speckle contrast imaging with acetylcholine (ACh) iontophoresis, followed by postocclusive reactive hyperemia (PORH), before and after HT. Measurements will be correlated to patient clinical profile, hemodynamic and echocardiographic data. Expected results: The evolution of systemic MR may aid in the comprehension of cardiovascular physiology in HT patients, and possibly suggest the non-invasive evaluation of skin microcirculation as an ancillary tool in the clinical evaluation of these patients.
研究者
Eduardo Tibirica, MD, PhD
Principal Investigator
National Institute of Cardiology, Laranjeiras, Brazil
入排标准
入选标准
- •capability to understand the objectives of the research and to fulfill the Term of Consent
排除标准
- •Pregnancy, acute infection diagnosis, use of circulatory assistance devices
研究组 & 干预措施
heart transplantation
干预措施: skin microvascular reactivity
结局指标
主要结局
Baseline and post-iontophoresis of acetylcholine endothelium-dependent skin microvascular reactivity
时间窗: Microvascular reactivity will be evaluated 20-minute rest in the supine position in a temperature-controlled room.
Evaluation of systemic microvascular reactivity induced by endothelium-dependent agents. Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging, coupled with skin iontophoresis of vasodilator agents. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance.