Hepatic Effects of Right Heart Lesions in ACHD
Research type
Research Study
Full title
The Hepatic Effects of Right Heart Lesions in Adults with Congenital Heart Disease
IRAS ID
189485
Contact name
Dilip Abraham
Contact email
Sponsor organisation
University of East Anglia
Duration of Study in the UK
1 years, 6 months, 2 days
Research summary
Congenital defects effecting the right side of the heart are the particular focus in this study. Pulmonary regurgitation (PR, leaking pulmonary valve) is a common sequelae of surgery that patients have had as young children to fix congenital heart defects, including the tetralogy of fallot and pulmonary stenosis. The optimal timing of replacing this valve is currently based on size of the right ventricle (it dilates as the blood flows back through the pulmonary valve), symptoms, objective evidence of exercise intolerance, or abnormal heart rhythms. In ebstein's anomaly a faulty tricuspid valve causes leaking. There is a recognition amongst physicians that problems affecting the right heart can cause liver dysfunction too as they are directly connected. The pressure generated within the right heart causes back pressure onto the liver which can damage it. As a group we are interested in assessing the liver in this group of patients to see whether there are early changes that signify that the right heart is under pressure. We will organise blood tests, and three scans of the liver (Magnetic resonance elastography, ultrasound of the liver and fibroscan - a type of ultrasound), and in addition use the results of tests that are routinely done in clinical practice. We will assess:
1. Whether right heart lesions are associated with subclinical abnormality of hepatic structure and/or function
2. If so, whether the presence of hepatic abnormality correlates with right ventricular function (as assessed by echocardiography and cardiac MRI)
3. For participants with PR, whether any hepatic abnormality correlates with established prognostic markers such as degree of RV dilatation and peak oxygen uptake on exercise. As such may this contribute to definition of the optimal timing of pulmonary valve replacement?The study is expected to last 12-18 months and will be performed at the Norfolk and Norwich Hospital.
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
15/EE/0440
Date of REC Opinion
20 Jan 2016
REC opinion
Further Information Favourable Opinion