Wave intensity analysis in the pulmonary artery
Research type
Research Study
Full title
Clinical application of wave intensity analysis in advanced heart failure
IRAS ID
268644
Contact name
Sern Lim
Contact email
Sponsor organisation
University Hospitals Birmingham NHS Foundation Trust
Duration of Study in the UK
1 years, 11 months, 26 days
Research summary
Left ventricular assist devices (LVADs) are mechanical heart pumps that are designed to support a weak and failing left side of the heart. However, the right side of the heart must work well for LVAD to work successfully. Unfortunately, there are major problems with the techniques that are currently used to assess the function of the right side of the heart. As a result, it is difficult for clinicians to assess how well the right heart is working, which makes it difficult to select patients who would do well with LVAD, or diagnose and treat right heart failure before it is too late.
The heart is directly connected to blood vessels. When the heart beats, it generates a wave that propels blood into the bloods vessels. Wave intensity analysis (WIA) is a technique that measures the pressure and flow characteristics of these waves. By analysing these waves, we can work out how well the heart is pumping and how the heart interacts with the blood vessels, which is a major strength of WIA compared to other methods of assessing heart function. So far, WIA has only been used in research, but the technology is now matured enough to be developed for use.
The aim of this research study is to develop WIA into a tool for clinicians to assess the right heart function. To achieve this aim, we would firstly demonstrate that WIA can measure the effects of medications on the right side of the heart; and secondly, show that WIA can be used to identify the best pump speed settings for LVAD.
This study will include 20 patients with heart failure undergoing assessment for heart transplantation or LVAD. All patients will undergo a right heart catheter study (a procedure to measure blood pressure in the lungs and right side of the heart using a flexible plastic tube inserted into a vein), as part of the routine assessment. Patients with high pressure in the lungs will be treated with a combination of drugs to see if the high pressures can be lowered. For this study, we will insert a wire that can simultaneously measure pressure and blood flow (Combowire) into the plastic tube at the time of right heart catheter study to collect data for WIA.
The first part of this study will assess the effects of drug treatment on WIA in patients with advanced heart failure before LVAD implant. We propose that WIA will be able to detect the changes in heart function and blood flow due to the drug treatment. The second part of the study will assess the effect of changing LVAD pump speed on the right heart. High pump speeds can worsen right heart function, and pump speeds that are too low may not be sufficient to support the left side of the heart. We propose that WIA can be used to identify the best LVAD pump speed for each patient, and will compare WIA to the currently method to assess LVAD pump speed using heart scan.
The findings of this study will show that WIA can be used to assess the right heart. Improved assessment of the right heart with this technique can benefit patients with a range of heart diseases. Scientifically, this study will build on the work that has been done so far and improved our understanding of how the circulation works in our body.REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
20/WM/0022
Date of REC Opinion
5 Feb 2020
REC opinion
Favourable Opinion