Mechanisms Of Decompensation Evaluation in Aortic Stenosis (MODE-AS)
Research type
Research Study
Full title
Mechanisms of Left Ventricular Decompensation in Aortic Stenosis
IRAS ID
190134
Contact name
David Newby
Contact email
Sponsor organisation
University of Edinburgh
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Aortic stenosis is the most common heart valve disease in the western world. It is caused by progressive narrowing of the aortic valve which places considerable strain on the heart muscle as it has to pump increasingly hard to squeeze blood out of a narrower valve. This leads to an enlarged heart and finally heart failure although the mechanisms by which this occurs are poorly understood. The only treatment is surgical replacement of the valve and there are no medical treatments available. Scar tissue (also known as fibrosis) is thought to play an important role in damage to the heart muscle caused by the increased strain placed upon it.
In our proposed single-centre study we aim to elucidate the underlying mechanisms of how the heart fails. We plan to recruit 80 patients with severe aortic stenosis due to undergo heart valve surgery at the Royal Infirmary Edinburgh. Participants will attend for a single assessment within the four weeks prior to surgery, which will involve blood and heart imaging tests including echocardiography and MRI. A small sample of heart tissue will then be taken during the heart valve operation which will be analysed later for the presence of scarring. We will also recruit 10 patients having mitral valve surgery and 10 patients having coronary artery bypass surgery with whom we will compare our results.
We hypothesise that scarring detected on tissue samples will correlate closely with MRI measures of scarring such as "T1 mapping" and "late gadolinium enhancement". We also expect that blood test levels of troponin (which are elevated in heart muscle strain or damage) will correlate with scarring detected on tissue samples. We hope this will allow validation of our clinical tests in detecting scarring and may also find novel targets for future medical therapies.REC name
South East Scotland REC 01
REC reference
16/SS/0027
Date of REC Opinion
8 Mar 2016
REC opinion
Further Information Favourable Opinion