Right ventricular stroke work in PHLHD
Research type
Research Study
Full title
Right ventricular stroke work in pulmonary hypertension due to left heart disease (PHLHD)
IRAS ID
239949
Contact name
Sern Lim
Contact email
Sponsor organisation
University Hospital Birmingham
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
In patients with heart failure (HF) and left ventricular (LV) dysfunction, an increase in filling pressure increases atrial and pulmonary venous pressure, which results in ‘passive’ rise in pulmonary arterial pressure within a closed hAemodynamic system. Pulmonary artery pressure (PAP) is further increased by vasoconstriction and remodelling of the pulmonary vasculature. Pulmonary hypertension due to left heart disease (PHLHD) is thus defined by elevation in PAP due to raised left-sided filling pressures. The right ventricle (RV) responds to the increased PAP by adopting hetero- and homeometric mechanisms. However, these adaptive mechanisms fail overtime and lead to right heart failure. Right heart failure is independently associated with exercise intolerance and mortality in patients with HF. Hence, there is a need to identify a clinically applicable measure of RV function to identify the turning point in the progression of right heart failure; and understand the effect of PHLHD on the RV to guide therapeutic interventions.
We aim to recruit 20 patients from the advanced HF service undergoing routine right heart catheter study as part of their HF assessment in Queen Elizabeth Hospital Birmingham. Right heart catheter studies are routinely performed via the right internal jugular vein using a standard pulmonary artery catheter. Following standard pulmonary haemodynamic measurements, a combined dual-tipped pressure and Doppler wire will be positioned in the RV then at the main pulmonary artery, via the pulmonary artery catheter. Data collected will be analysed offline. No additional invasive procedure or radiation required to conduct this study.
This study will validate the empirical formula described by Chemla et al in patients with PHLHD and HF. This will allow us to assess RV function in HF patients more accurately in clinical practice. In addition, this study will provide mechanistic information on the progression of RV failure in patients with PHLHD.
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
18/EM/0122
Date of REC Opinion
29 May 2018
REC opinion
Further Information Favourable Opinion