Phenotyping in Ischaemic Cardiomyopathy
Research type
Research Study
Full title
Deep Phenotyping to Predict Outcome and Treatment Response in Ischaemic Cardiomyopathy
IRAS ID
281825
Contact name
Divaka Perera
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
There are multiple causes of heart failure, one of which is reduced blood supply to the heart from narrowed or blocked coronary arteries. This type of heart failure is termed ischaemic cardiomyopathy (ICM). There is evidence that if we improve the blood flow to the heart using either stents or bypass surgery (termed revascularisation), that in a select group of patients we may be able to improve the pumping strength of the heart.
Patients with ICM often have areas of scarring in the heart related to this reduced blood supply, and from previous heart attacks. This scarred tissue has abnormal electrical conduction and can lead to serious abnormal heart rhythms which are the most common mode of death in these patients. The current medical guidelines recommend that a complex pacemaker which can provide shocks, called an implantable cardiac defibrillator (ICD), is inserted for patients with “severe” ICM (defined as an ejection fraction of less than 40%) to prevent sudden death from abnormal rhythms. This is a very crude cut off which does not consider individual patient differences. It has been shown that many patients who have an ICD inserted never use the device, and conversely others who do not meet the current criteria suffer the same abnormal heart rhythms and are at risk of sudden death.
We aim to carry out a prospective multi-centre cohort analysis, where patients with ICM will undergo cardiac MRI and non-invasive electrical studies before and after they undergo revascularisation. We aim to improve our understanding of how improving the blood supply to the heart muscle alters the scar and rhythm properties. The overall aim of the project is to improve the current risk assessment of patients with ICM, allowing a more personalised and tailored selection of which patients will benefit from revascularisation or an implanted device.REC name
South Central - Hampshire B Research Ethics Committee
REC reference
21/SC/0024
Date of REC Opinion
22 Feb 2021
REC opinion
Further Information Favourable Opinion