None listed
Conditions
Brief summary
Heart Failure (HF) is a leading cause of heart disease and mortality in developed countries. It is the leading reason for hospital admission among patients over 65 years and the most costly cardiovascular disorder in Western countries. A first hospital admission for HF has been shown to confer a worse prognosis than a first admission for bowel or breast cancer. The burden of HF is expected to increase in Australia due to the ageing population and improved survival from acute cardiac events. New cardiac imaging tools, such as cardiac MRI and novel applications of echocardiography (ultrasound of the heart), now permit an insight into some of the fundamental processes that underlie why some individuals don’t respond to conventional HF treatment. In particular, our research will focus on the scarring within the heart muscle, and the loss of coordination of the heart as it pumps, in perpetuating the vicious HF cycle. Furthermore, we will explore the role of a simple blood test, to measure markers of scarring from the heart, in predicting patient outcomes in the setting of a new diagnosis of HF. An understanding of these elements in the pathogenesis of cardiomyopathy will help clarify the mechanistic cascade of HF, and may thus lead to novel therapies to interrupt such an adverse process. This research may thus change the way cardiomyopathy is viewed and treated.
Interventions
6-minute walk test, Minnesota Living with Heart Failure Questionnaire, NYHA classification, Cardiopulmonary exercise testing, Echocardiogram and CMR will all be performed at baseline, 6 months and 12 months. To complete all these investigations would take approximately 2 hours, at each time point. We will examine the relationship between these parameters and response to conventional heart failure therapy.
Sponsors
Professor Joseph Selvanayagam
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Clinical heart failure (New York Heart Association class II - IV) on first presentation, LV ejection fraction <45% as measured by echocardiography, ventriculography, or cardiac scintigraphy
Exclusion criteria
Standard MRI contraindications, including permanent pacemaker, implantable defibrillator, severe claustrophobia, Significant coronary artery disease, as manifest by >70% stenosis in a major epicardial coronary artery or the presence of a moderate or greater zone of ischaemia/infarction on stress imaging, Concomitant valvular heart disease as a cause or central contributor to the heart failure (excluding functional mitral regurgitation, Hypertrophic obstructive cardiomyopathy, Myocarditis, amyloidosis, sarcoidosis, uncontrolled thyroid disease, post-partum cardiomyopathy, Renal impairment (eGFR <60ml/min) will be an exclusion criterion from the administration of gadolinium, New York Heart Association class IV symptoms (i.e. dyspnoea at rest), and unstable ischaemic heart disease will be exclusion criteria from cardiopulmonary exercise testing
Outcome results
None listed