CClinicalTrials.gg
CompletedNCT03430102Updated Jun 17, 2020

Indicor Validation

An observational study in Heart Failure, sponsored by Vixiar Medical, Inc.. Completed at 4 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-06-17.

Sponsored by Vixiar Medical, Inc. · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
289
Ages
18 Years and older
Sex
All
01

Study summary

The study is designed to repeat an initial training set study conducted at Johns Hopkins Medical Center, comparing a new investigational device, Indicor, a non-invasive tool for estimating left ventricular end diastolic pressure (LVEDP), to the gold standard, invasively measured LVEDP via direct measurement via left heart catheterization. The study is divided into an initial training set, followed by the validation set which is designed to support an FDA 510(k) submission and validate the final algorithm. Patients will be enrolled who are scheduled to undergo a cardiac catheterization and will be asked to perform three tests with the Indicor.

Read the detailed description

Patients who are scheduled to undergo a left heart cardiac catheterization for direct measure of left ventricular end diastolic pressure (LVEDP) as part of routine care will be asked to participate. Investigators will take non-invasive measures of LVEDP using the Indicor device, repeated at three time points before and after the catheterization procedure. The Indicor indirectly measures LVEDP by calculating a value from finger photoplethysmography (PPG) waveforms that will be recorded while the patient performs a Valsalva maneuver.

Participants baseline characteristics will be gathered from the electronic medical record, including history of coronary artery disease, heart failure, hypertension, diabetes, or lung disease; list of blood pressure medications; serum markers of kidney function; and echocardiogram measurements including ejection fraction. These parameters will be used to assess relevance to the calculation of LVEDP by Indicor.

The first Indicor measure will be conducted before the catheterization procedure. PPG probes will be attached to participants' first or second finger. Participants will be asked to strain as if having a bowel movement (Valsalva maneuver) for 10 seconds. Participants will blow into a pressure transducer that measures and displays the pressure of their effort. The Indicor device will acquire 3 successful efforts.

During the cardiac catheterization, while the pressure transducer used by the clinical team to measure LVEDP is in the aorta, the Valsalva testing will be repeated. The device will again acquire 3 successful efforts. This will allow investigators to determine how well the amplitude changes of the PPG signal during Valsalva maneuver reflect the amplitude changes of central arterial pressure during the Valsalva maneuver. According to experienced catheterization cardiologists, this set of tests will not add significant risk to the procedure. This second set of tests may not be performed in all participants.

Immediately after the cardiac catheterization, while the patient is still on the catheterization table, the Valsalva testing will be repeated. The device will again acquire 3 successful efforts.

02

Conditions studied

  • Heart Failure

Browse trials for

03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients scheduled to undergo cardiac catheterization as part of their routine care and clinically indicated

Inclusion criteria

-Adult patients scheduled to undergo a left-heart catheterization that will include the measurement of left ventricular end-diastolic pressure (LVEDP)

Exclusion criteria

Exclusion Criteria:

  • Weight \<88 pounds (40 kilograms)
  • Atrial flutter or atrial fibrillation with an irregular ventricular response
  • Significant atrial or ventricular ectopy
  • History of paradoxical emboli
  • Hypertrophic obstructive cardiomyopathy
  • History of paradoxical emboli
  • Known intracardiac shunt
  • Known severe aortic valve stenosis or known severe mitral valve stenosis
  • History of embolic cerebrovascular accident
  • Clinically unstable
  • Uncontrolled hypertension (systolic BP >160 mmHg or diastolic BP> 100 mmHg)
  • Hypotension (systolic BP \<90 mmHg)
  • Symptomatic bradycardia
  • Known cholesterol emboli
  • Poor LV function with known LV thrombus
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
289 participants (actual)
Patient registry
No

Groups and cohorts

  • LeftHeartCath

    Patients scheduled for LV catheterization for direct measurement of LVEDP

    Diagnostic Test: Indicor

Interventions

  • Diagnostic testIndicor

    Calculation of LVEDP via analysis of PPG waveform with Valsalva

05

What researchers measure

Primary outcomes

  1. C-LVEDP

    Specificity of Calculated LVEDP (C-LVEDP) in identifying invasively Measured LVEDP (M-LVEDP) \> 20 mmHg

    Time frame: During patients scheduled left heart cardiac catheterization

06

Study locations

4 sites
  • Christiana Care
    Newark, Delaware 19713, United States
  • Deborah Heart and Lung Center
    Browns Mills, New Jersey 08015, United States
  • Stony Brook Medicine
    Stony Brook, New York 11794, United States
  • Lancaster General Health
    Lancaster, Pennsylvania 17603, United States
07

References and documents

Publications

  • Gilotra NA, Tedford RJ, Wittstein IS, Yenokyan G, Sharma K, Russell SD, Silber HA. Usefulness of Pulse Amplitude Changes During the Valsalva Maneuver Measured Using Finger Photoplethysmography to Identify Elevated Pulmonary Capillary Wedge Pressure in Patients With Heart Failure. Am J Cardiol. 2017 Sep 15;120(6):966-972. doi: 10.1016/j.amjcard.2017.06.029. Epub 2017 Jun 28. PubMed 28754567 ↗
  • Galiatsatos P, Win TT, Monti J, Johnston PV, Herzog W, Trost JC, Hwang CW, Fridman GY, Wang NY, Silber HA. Usefulness of a Noninvasive Device to Identify Elevated Left Ventricular Filling Pressure Using Finger Photoplethysmography During a Valsalva Maneuver. Am J Cardiol. 2017 Apr 1;119(7):1053-1060. doi: 10.1016/j.amjcard.2016.11.063. Epub 2017 Jan 5. PubMed 28185634 ↗
  • Silber HA, Trost JC, Johnston PV, Maughan WL, Wang NY, Kasper EK, Aversano TR, Bush DE. Finger photoplethysmography during the Valsalva maneuver reflects left ventricular filling pressure. Am J Physiol Heart Circ Physiol. 2012 May 15;302(10):H2043-7. doi: 10.1152/ajpheart.00609.2011. Epub 2012 Mar 2. PubMed 22389389 ↗
  • Sharma GV, Woods PA, Lambrew CT, Berg CM, Pietro DA, Rocco TP, Welt FW, Sacchetti P, McIntyre KM. Evaluation of a noninvasive system for determining left ventricular filling pressure. Arch Intern Med. 2002 Oct 14;162(18):2084-8. doi: 10.1001/archinte.162.18.2084. PubMed 12374516 ↗
  • Gillard C, Henuzet C, Lallemand J, Moscariello A, Guillaume M, Van Meerhaeghe A. Operating characteristics of the Finapress system to predict elevated left ventricular filling pressure. Clin Cardiol. 2006 Mar;29(3):107-11. doi: 10.1002/clc.4960290305. PubMed 16596832 ↗
  • Zema MJ. Bedside assessment of cardiac hemodynamics: role of the simple Valsalva maneuver. Am J Med. 2012 Aug;125(8):e13; author reply e15-6. doi: 10.1016/j.amjmed.2011.12.020. No abstract available. PubMed 22840672 ↗
  • Felker GM, Cuculich PS, Gheorghiade M. The Valsalva maneuver: a bedside "biomarker" for heart failure. Am J Med. 2006 Feb;119(2):117-22. doi: 10.1016/j.amjmed.2005.06.059. PubMed 16443410 ↗
  • Stevenson LW, Perloff JK. The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA. 1989 Feb 10;261(6):884-8. PubMed 2913385 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03430102
Lead sponsor
Vixiar Medical, Inc.
Responsible party
Sponsor
First posted
Feb 12, 2018
Start date
Feb 14, 2018
Primary completion
Mar 12, 2020
Completion
Mar 12, 2020
Last update
Jun 17, 2020

Study contacts

Harry Silber, MD, PhD
principal investigator · Johns Hopkins Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2020. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion