CMR-CPET study
Research type
Research Study
Full title
Assessment of Cardiac Function using combined Cardiovascular Magnetic Resonance and Cardiopulmonary Exercise Testing (CMR-CPET) Study\n
IRAS ID
226101
Contact name
Daniel S Knight
Contact email
Sponsor organisation
Royal Free London NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Pulmonary arterial hypertension (PAH) is a debilitating condition that has a poor prognosis. The reference standard method of assessing PAH is invasive measurement of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR). However, focusing on vascular hemodynamics alone neglects the central role the heart plays in determining symptoms and prognosis. \n\nCardiovascular magnetic resonance (CMR) is the most accurate and reliable method of evaluating biventricular systolic function and volumes and is an important adjunct in the assessment of PAH. However, resting CMR metrics do not predict exercise symptoms. A better approach may be exercise CMR with combined respiratory gas analysis (CMR augmented cardio-pulmonary exercise testing - MR-CPET), which has been used to simultaneously evaluate cardiac output, oxygen consumption and oxygen extraction in children at Great Ormond Street Hospital. Using MR-CPET, it has been shown that peak oxygen extraction, but not cardiac output, is significantly reduced in pediatric PAH. MR-CPET has the potential to determine the cause of symptoms in PAH and other multisystem diseases such as scleroderma and amyloidosis. \n\nThe aim of this study is to assess cardiovascular response to exercise in non-ischaemic cardiopulmonary diseases using CMR-CPET. Participants with scleroderma, PAH, amyloidosis and heart failure will undergo comprehensive cardiopulmonary assessment using CMR imaging pre- and post- exercise as well as assessment of tissue oxygen consumption using a specially designed facemask. A group of patients with PAH and amyloidosis will also undergo a repeat scan following initiation of treatment. \n\nOverall, MR-CPET has the potential to improve our understanding of cardiac dysfunction in a variety of conditions that result in chronic breathlessness. Once validated, it is likely to become a useful tool in determining prognosis and tracking response to treatment in a variety of conditions. \n
REC name
London - Hampstead Research Ethics Committee
REC reference
17/LO/1499
Date of REC Opinion
19 Sep 2017
REC opinion
Favourable Opinion