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CompletedNCT03469843Updated Mar 29, 2022

Characterization of the Cardiac Reinnervation of Patients With Transposition of the Great Arteries Long After Repair With the Arterial Switch Operation. Correlation With Electrocardiographic and Exercise Test Parameters

An observational study in Congenital Heart Disease, Congenital Heart Defect and Transposition of the Great Arteries, sponsored by Hospital Universitari Vall d'Hebron Research Institute. Completed at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-03-29.

Sponsored by Hospital Universitari Vall d'Hebron Research Institute · Observational

Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
25
Ages
18 Years and older
Sex
All
01

Study summary

Cardiac denervation is inherent to the arterial switch (ASO) technique for the repair of transposition of the great arteries (TGA) and the long term reinnervation process has not been studied. We sought to describe the reinnervation status of adult patients long after the ASO, to identify areas of myocardial perfusion/innervation mismatch and to assess the relation of innervation status and exercise capacity.

Read the detailed description

Cardiac denervation is inherent to the arterial switch (ASO) technique for the repair of transposition of the great arteries (TGA) and the long term reinnervation process has not been studied. We sought to describe the reinnervation status of adult patients long after the ASO, to identify areas of myocardial perfusion/innervation mismatch and to assess the relation of innervation status and exercise capacity.

02

Conditions studied

  • Congenital Heart Disease
  • Congenital Heart Defect
  • Transposition of the Great Arteries

Keywords

  • Congenital Heart Disease
  • Cardiac denervation
  • 123I-metaiodobenzylguanidine
  • Arterial switch operation
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 aged of more than 18 years-old with transposition of the great arteries repaired with the arterial switch

Inclusion criteria

  • Patients with transposition of the great arteries repaired with the arterial switch.
  • Patients aged of more than 18 years-old.

Exclusion criteria

Exclusion Criteria:

  • Pregnancy or breast-feeding.
  • Denial of informed consent.
04

Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
25 participants (actual)
Patient registry
No

Groups and cohorts

  • Patients

    patients with transposition of the great arteries long after repair with the arterial switch operation

    Other: Non intervention

Interventions

  • OtherNon intervention

    patients without intervention

    Also known as: patients without intervention

05

What researchers measure

Primary outcomes

  1. Myocardial innervation pattern on 123I-mlBG SPECT.

    To describe the myocardial reinnervation pattern of a cohort of patients with TGA long after ASO using cardiac nuclear imaging.

    Time frame: 1 day

Secondary outcomes

  1. Myocardial perfusion defects on cardiac nuclear imaging.

    To identify myocardial perfusion defects using cardiac nuclear imaging.

    Time frame: 1 day

  2. Myocardial innervation perfusion mismatch defects on cardiac nuclear imaging.

    To identify myocardial innervations/perfusion mismatch using cardiac nuclear imaging.

    Time frame: 1 day

  3. Treadmill exercise test.

    To determine exercise capacity (METs and double product) and chronotropic response (Maximal heart rate and heart rate increase pattern). Correlate with myocardial reinnervation pattern and sinus node reinnervation. To determine exercise induced ischeamic ST segment changes. Correlate with myocardial perfusion defects and innervation-perfusion mismatch.

    Time frame: 1 day

  4. 24 hours ECG Holter monitoring .

    To determine sinus node innervation through heart rate variability (HRV) which will be assessed by time domain variables (the standard deviation of normal RR intervals (SDNN) and the square root of the mean of the squared differences between adjacent normal RR intervals (r-MSSD)) and frequency domain variables (variance of all R-R intervals - total power (TP); power in the very low frequency range - very low frequency (VLF, 0.003-0.04 Hz); power in the low frequency range-low frequency (LF, 0.04-0.15Hz); low frequency power in normalized units-normalized low frequency; power in the high frequency range-high frequency (HF, 0.15-0.40 Hz); and high frequency power in normalized units-normalized high frequency and the ratio of low frequency to high frequency (LF/HF)).

    Time frame: 1 day

06

Study locations

1 site
  • Hospital Universitari Vall d'Hebron
    Barcelona, 08035, Spain
07

References and documents

Publications

  • Tobler D, Williams WG, Jegatheeswaran A, Van Arsdell GS, McCrindle BW, Greutmann M, Oechslin EN, Silversides CK. Cardiac outcomes in young adult survivors of the arterial switch operation for transposition of the great arteries. J Am Coll Cardiol. 2010 Jun 29;56(1):58-64. doi: 10.1016/j.jacc.2010.03.031. PubMed 20620718 ↗
  • Khairy P, Clair M, Fernandes SM, Blume ED, Powell AJ, Newburger JW, Landzberg MJ, Mayer JE Jr. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation. 2013 Jan 22;127(3):331-9. doi: 10.1161/CIRCULATIONAHA.112.135046. Epub 2012 Dec 12. PubMed 23239839 ↗
  • Kondo C, Nakazawa M, Momma K, Kusakabe K. Sympathetic denervation and reinnervation after arterial switch operation for complete transposition. Circulation. 1998 Jun 23;97(24):2414-9. doi: 10.1161/01.cir.97.24.2414. PubMed 9641693 ↗
  • Grupper A, Gewirtz H, Kushwaha S. Reinnervation post-heart transplantation. Eur Heart J. 2018 May 21;39(20):1799-1806. doi: 10.1093/eurheartj/ehw604. PubMed 28087606 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03469843
Lead sponsor
Hospital Universitari Vall d'Hebron Research Institute
Responsible party
Sponsor
First posted
Mar 19, 2018
Start date
Apr 19, 2018
Primary completion
Mar 1, 2019
Completion
Sep 1, 2019
Last update
Mar 29, 2022

Study contacts

Laura Dos Subirà, PhD MD
principal investigator · Hospital Universitari Vall d'hebron Barcelona, Spain

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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