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Prevalence and Determinants of Subclinical Cardiovascular Dysfunction in Adults With Type 2 Diabetes Mellitus

Sponsor: University of Leicester

NCT ID: NCT03132129

View on ClinicalTrials.gov ↗

At a glance

What the study gets you
Health checks and monitoring — no treatment given
Type of study
Observational (no treatment given)
Time in hospital
In-person visits at study sites — visit count not specified by the sponsor
Drug or intervention
Cardiovascular magnetic resonance (CMR) imaging and magnetic resonance spectroscopy (diagnostic test), Transthoracic echocardiography (diagnostic test), Computed tomography coronary artery calcium scoring (diagnostic test), Cardiopulmonary exercise testing (diagnostic test)
How long the study runs
Study runs about 144 months (dates as stated)
About the drug or intervention
Cardiovascular magnetic resonance (CMR) imaging and magnetic resonance spectroscopy — diagnostic test: CMR scanning performed on a 3T MRI scanner. · Transthoracic echocardiography — diagnostic test: Comprehensive transthoracic echocardiography, including: tissue Doppler indices of diastolic filling and speckle tracking for systolic and diastolic strain/strain rate, exclusion of valvular abnormalities, assessment of LV size and function. · Computed tomography coronary artery calcium scoring — diagnostic test: Computed Tomography coronary calcium scoring to assess the presence of subclinical atherosclerosis and allow an estimate of atheroma burden in addition to epicardial adipose tissue characterisation and systolic strain. · Cardiopulmonary exercise testing — diagnostic test: Physician supervised incremental symptom limited cardiopulmonary exercise tolerance test with ECG and haemodynamic monitoring. · Manganese-enhanced magnetic resonance imaging (MEMRI) — diagnostic test: A subset of the participants will have cardiac MRI scanning with manganese-based contrast agent, lasting approximately 45-50 minutes. · Ambulatory blood pressure monitoring — diagnostic test: A 24-hour blood pressure monitor will be worn at the end of the visit to the following day. · Accelerometer watch — diagnostic test: Watch worn to collect free living physical activity data for 7 days. · Blood tests — diagnostic test: Collection of blood samples from each participant to characterise the participant's health status and to develop a proteomic signature of early heart failure.
Patient visit burden
Not specified by the sponsor
Type of study
Observing health over time
Ages
50 Years to 75 Years
Who
All
Number of participants
593
Started
2017-10-24
Last checked
2024-01

Plain English Summary

What is this study?

  • • Testing a new treatment for diabetes mellitus, type 2
  • • Clinical study - 593 participants
  • • Background: Heart failure is a major cause of morbidity and mortality in diabetes mellitus, but its pathophysiology is poorly understood

Who can take part?

  • • Ages 50 Years to 75 Years
  • • Diagnosed with diabetes mellitus, type 2

Where?

  • • Leicester - University of Leicester

This is a simplified summary. Always discuss with your doctor before making any decisions.

About This Trial

Background: Heart failure is a major cause of morbidity and mortality in diabetes mellitus, but its pathophysiology is poorly understood. Aim: To determine the prevalence and determinants of subclinical cardiovascular dysfunction in adults with type 2 diabetes (T2D). Plan: 518 asymptomatic adults (aged 18-75 years) with T2D will undergo comprehensive evaluation of cardiac structure and function using cardiac MRI (CMR) and spectroscopy, echocardiography, CT coronary calcium scoring, exercise tolerance testing and blood sampling. 75 controls will undergo the same evaluation. Primary hypothesis: myocardial steatosis is an independent predictor of left ventricular global longitudinal strain. Secondary hypotheses: will assess whether CMR is more sensitive to detect early cardiac dysfunction than echocardiography and BNP, and whether cardiac dysfunction is related to peak oxygen consumption. Expected value of results: This study will reveal the prevalence and determinants of cardiac dysfunction in T2D, and could provide targets for novel therapies.

Diabetes Mellitus, Type 2Diabetic Cardiomyopathies

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What we know so far

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Preliminary match based on your answers. Full eligibility requires on-site assessment including medical history, physical exam, and lab tests. This does not guarantee enrolment.

Eligibility at a Glance

Key info

  • Age: 50 Years - 75 Years
  • Who can join: All genders

What the study is looking for

  • ✓Participant is willing and able to give agreement to take part for participation in the study.
  • ✓Male or Female, aged ≥18 and ≤75 years.
  • ✓Diagnosed with Stable type 2 diabetes (determined by: i) formal diagnosis in GP case records, ii) a record of...

Who cannot take part

  • ✗Angina pectoris or limiting dyspnoea (\>NYHA II),
  • ✗Major atherosclerotic disease: causing symptoms CAD, history of myocardial infarction, previous revascularisation,...
  • ✗Atrial fibrillation or flutter.
  • ✗Moderate or severe valvular heart disease.
  • ✗History of heart failure or cardiomyopathy.
See the full criteria
Inclusion Criteria: * Participant is willing and able to give informed consent for participation in the study. * Male or Female, aged ≥18 and ≤75 years. * Diagnosed with Stable type 2 diabetes (determined by: i) formal diagnosis in GP case records, ii) a record of diagnostic oral glucose tolerance test OR glycated haemoglobin level ≥6.5%). Exclusion Criteria: * Angina pectoris or limiting dyspnoea (\>NYHA II), * Major atherosclerotic disease: Symptomatic CAD, history of myocardial infarction, previous revascularisation, stroke/transient ischaemic attack or symptomatic peripheral vascular disease. * Atrial fibrillation or flutter. * Moderate or severe valvular heart disease. * History of heart failure or cardiomyopathy. * Type 1 diabetes mellitus (T1DM). * Low fasting C-peptide levels suggestive of adult-onset T1DM. * Stage III-V renal disease (estimated glomerular filtration rate ≤30ml/min/1.73m2). * Absolute contraindications to CMR. Importantly, patients with subclinical CAD, and other common comorbidities such as obesity and hypertension, will not be excluded from this study. This will enable us to evaluate the contribution of CAD to myocardial dysfunction in diabetes and ensures our study group is representative of the general population with diabetes. Similarly, as mild dyspnoea is extremely common and non-specific participants with mild dyspnoea will be included.

Where Is This Study? (1 UK site)

University of Leicester

Leicester, United Kingdom

Recruiting
Hospital R&D contact (matched)

Carolyn Maloney

uhl-tr.researchandinnovationadminmailbox@nhs.net0116 258 8351

How to Get in Touch

Gerry P McCann, MD

Sponsor contact

CONTACT

01162583402 gpm12@le.ac.uk

Gaurav S Gulsin, MBChB(Hons)

Sponsor contact

CONTACT

01162583244 gg149@leicester.ac.uk
Data sourced from ClinicalTrials.gov · Last verified: 2024-01