Chronic Mesenteric Ischemia
Conditions
Keywords
breath test, chronic mesenteric ischemie, calcium scoring
Brief summary
CMI is an incapacitating disease and timely diagnosis remains problematic. Despite the substantial compensatory capacity of the mesenteric circulation CMI is relatively common, its incidence being comparable to other well-known diseases like Crohn's disease. Diagnostic tools are needed for two purposes since the exclusion of CMI currently requires a cumbersome complication-prone diagnostic workup and since a definitive diagnosis is mainly established per exclusionem. First, a sensitive test is desirable to rule out CMI and avoid excessive diagnostic investigations. Quantification of mesenteric arterial calcification on computed tomography (CT) seems suitable for this purpose, synonymous with the coronary artery calcium score. Second, a specific test is required confirming CMI by detection of mucosal ischemia during a meal, when oxygen demand peaks. A breath test, based on the requirement of oxygen to absorb and metabolize 13C-butyrate in the enterocyte, could detect mucosal ischemia Objective: Facilitating diagnosis of chronic mesenteric ischemia (CMI) using 1) the mesenteric artery calcium score (MACS) and 2) mucosal ischemia detection by butyrate breath testing Study design: Multicentre prospective cohort studies.
Interventions
DIAGNOSTIC_TEST13C-butyrate breath test
breath test
Sponsors
Maag Lever Darm Stichting
Erasmus Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with a clinical suspicion of CMI referred to Maagdarm Ischemie Centrum Rotterdam (MICR), MST or UMCG. * Patients ≥ 18 years
Exclusion criteria
* Patients who are unable to give informed consent * Patients with previous mesenteric artery revascularization * No available CT imaging and contraindications for CT imaging (e.g. pregnancy) * Common origin of the celiac artery and superior mesenteric artery * Known delayed gastric emptying * Known and untreated small intestinal bacterial overgrowth
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Breath test | 2023-2025 | \- To validate the butyrate breath test as a specific functional test with a high positive predictive value to rightfully diagnose and select patients who will benefit from invasive treatment. |
| calcium scores | 2023-2035 | To validate the mesenteric artery calcium score as a readily available, easy, and sensitive test with a high negative predictive value to either rule out CMI or select patients for further investigations. |
Countries
Netherlands
Contacts
Primary ContactEva Karina Bocharewicz, MD, PhD Candidate
Backup ContactDesirée Leemreis - van Noord, MD, PhD
Outcome results
None listed