NCT02458703

Brief Summary

Pulmonary arteriovenous malformations (PAVMs) are a rare vascular condition affecting the lungs. PAVMs lead to low blood oxygen levels, yet are very well tolerated by patients. This study will examine the exercise capacity of PAVM patients using formal cardiopulmonary exercise tests performed on a stationary bicycle, and whether this is affected by the presence of concurrent airflow obstruction, such as due to asthma.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started May 2015

Typical duration for not_applicable

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2015

Completed
27 days until next milestone

First Submitted

Initial submission to the registry

May 28, 2015

Completed
4 days until next milestone

First Posted

Study publicly available on registry

June 1, 2015

Completed
2.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2018

Completed
Last Updated

June 1, 2015

Status Verified

April 1, 2015

Enrollment Period

3 years

First QC Date

May 28, 2015

Last Update Submit

May 29, 2015

Conditions

Keywords

workloadoxygen leveloxygen consumptionbreathing reserveventilatory efficiency

Outcome Measures

Primary Outcomes (1)

  • Total body oxygen consumption in mls/min/kg, at peak exercise (VO2 max).

    Of the many measurements and derived indices that can be measured during cardiopulmonary exercise testing, the peak consumption of oxygen (VO2 max) is perhaps the best indicator of integrated cardiorespiratory capacity. The principle research question will therefore test the null hypothesis that "The VO2 max does not differ between PAVM patients with and without airflow obstruction."

    Same day (within 1 hour), at end of exercise study

Secondary Outcomes (2)

  • Breathing reserve

    Same day (within 1 hour), at end of exercise study

  • Ventilatory efficiency

    Same day (within 1 hour), at end of exercise study

Study Arms (2)

Patients with pulmonary AVMs and no airflow obstruction

EXPERIMENTAL

30 patients with pulmonary AVMs and no airflow obstruction will undergo cardiopulmonary exercise testing

Other: Cardiopulmonary exercise test

Patients with pulmonary AVMs and airflow obstruction

EXPERIMENTAL

30 patients with pulmonary AVMs and airflow obstruction will undergo cardiopulmonary exercise testing

Other: Cardiopulmonary exercise test

Interventions

Subjects will have the test in the Exercise Suite of Hammersmith Hospital, London, UK. They will have painless skin probes placed on their fingers, chest, and legs to monitor heart rate, ECG, blood oxygen levels, and oxygen delivery during the test. Subjects will also be shown how to breathe through a mouthpiece with a nose clip on, and how to indicate on a sliding device whether they feel breathless. They will then start cycling against a very low resistance at a steady speed. As long as they feel comfortable, there will be a gradual increase in work load until they feel they cannot keep going at the same speed. They can also stop sooner for any reason. Afterwards, while they are "cooling down", they will fill in a short questionnaire describing how they feel. 20-30mls of blood will be taken for analysis.

Also known as: CPET
Patients with pulmonary AVMs and airflow obstructionPatients with pulmonary AVMs and no airflow obstruction

Eligibility Criteria

Age16 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Ability to provide informed consent
  • Pulmonary AVMs no airflow obstruction: Pulmonary AVMs confirmed by CT scan and no evidence or history of airflow obstruction on clinical grounds, or by spirometric evaluations.
  • Pulmonary AVMs with airflow obstruction: Pulmonary AVMs confirmed by CT scan and evidence or history of airflow obstruction on clinical grounds, and/or by spirometric evaluations (such as FEV1/VC ratio \<80%).

You may not qualify if:

  • Inability to provide informed consent
  • Any known cardiovascular abnormality including a history of syncope (faintness, dizziness, lightheadedness or loss of consciousness due to an abnormality of the cardiovascular system).
  • Current respiratory tract infection (eg a cold).
  • Pregnancy.
  • Claustrophobia or needle phobia

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Howard LSGE, Santhirapala V, Murphy K, Mukherjee B, Busbridge M, Tighe HC, Jackson JE, Hughes JMB, Shovlin CL. Cardiopulmonary exercise testing demonstrates maintenance of exercise capacity in patients with hypoxemia and pulmonary arteriovenous malformations. Chest. 2014 Sep;146(3):709-718. doi: 10.1378/chest.13-2988.

    PMID: 24676541BACKGROUND

MeSH Terms

Conditions

Telangiectasia, Hereditary HemorrhagicAsthmaPulmonary Disease, Chronic Obstructive

Interventions

Exercise TestClostridium perfringens epsilon-toxin

Condition Hierarchy (Ancestors)

Hemostatic DisordersVascular DiseasesCardiovascular DiseasesTelangiectasisHemorrhagic DisordersHematologic DiseasesHemic and Lymphatic DiseasesVascular MalformationsCardiovascular AbnormalitiesCongenital AbnormalitiesCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesBronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesRespiratory HypersensitivityHypersensitivity, ImmediateHypersensitivityImmune System DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Heart Function TestsDiagnostic Techniques, CardiovascularDiagnostic Techniques and ProceduresDiagnosisRespiratory Function TestsDiagnostic Techniques, Respiratory SystemErgometryInvestigative Techniques

Study Officials

  • Claire L Shovlin, PhD FRCP

    Hammersmith Hospital, Du Cane Rd, London, United Kingdom, W12 0NN

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Claire L Shovlin, PhD FRCP

CONTACT

Luke Howard, DPhil FRCP

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 28, 2015

First Posted

June 1, 2015

Study Start

May 1, 2015

Primary Completion

May 1, 2018

Study Completion

May 1, 2018

Last Updated

June 1, 2015

Record last verified: 2015-04