NCT03094910

Brief Summary

Patients with Raynaud's disease have an increased tendency of chest pain and migraine, and studies indicate that the disease might be associated with increased cardiovascular morbidity and mortality. Furthermore, a certain hyperactivity of the sympathetic nervous system has been demonstrated in these patients. Hyperactivity of the sympathetic nervous system is known to cause decreasing heart function, regardless of the underlying disease. The cardiac autonomic nervous function and thermographic parameters will be assessed in patients with primary and secondary Raynaud's phenomenon and glaucoma as well as in patients diagnosed with autonomic dysfunction such as diabetics and patients with Parkinson's disease in order to compare the function of the cardiac autonomic nervous system and the peripheral response to cold exposure. Potentially, this will lead to a better understanding of the cardiac autonomic nervous function in Raynaud's phenomenon. Moreover, it might give rise to a new perception of the condition and its association to cardiovascular disease. At the Department of Clinical Physiology, the current method of detecting Raynaud's phenomenon is time-consuming and unpleasant to the patient due to cooling for several minutes. Another aim of the PhD study is to implement infrared thermography as a gentler and possibly more sensitive method to replace the currently applied method. The project will also include an epidemiological study based on data obtained from the National Patient Registry, among others. Raynaud's phenomenon will be paired with diagnostic codes of conditions such as diabetes mellitus, Parkinson's disease, glaucoma, and cardiovascular disease.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
174

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2017

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

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

January 1, 2017

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

March 8, 2017

Completed
21 days until next milestone

First Posted

Study publicly available on registry

March 29, 2017

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 28, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 28, 2019

Completed
Last Updated

February 28, 2019

Status Verified

February 1, 2019

Enrollment Period

2.2 years

First QC Date

March 8, 2017

Last Update Submit

February 27, 2019

Conditions

Keywords

Raynaud PhenomenonHand and Arm Vibration SyndromeAutonomic ImbalanceThermography

Outcome Measures

Primary Outcomes (2)

  • Thermography of the hands after cooling - a composite evaluation of the rewarming ability

    Determination of which variables are able to distinguish the participants with Raynaud's phenomenon from the healthy participants. Temperature (degrees celsius), time (minutes), degrees/min, acceleration of temperature change (degrees/min\^2), recovery index (percent). All measurements will be evaluated in terms of ability to diagnose Raynaud's phenomenon. Finally, the most prominent variables are aggregated to determine whether or not the participant has Raynaud's phenomenon or not.

    Participant is examined once for a maximum of 1 hour.

  • Heart rate variability (HRV)

    Determination of HRV from participants with Raynaud's phenomenon, with diagnosed autonomic neuropathy, and healthy participants. All measurements will be aggregated to determine whether HRV differs among the different groups of participants.

    Participant is examined once for 1,5 hours.

Study Arms (2)

123I-MIBG

OTHER

Only the group of participants with primary Raynaud's phenomenon (Raynaud's disease) is also scheduled for this intervention, the 123I-MIBG.

Diagnostic Test: Examination of vibration perception threshold in fingertipsDiagnostic Test: Ewing's testsDiagnostic Test: Tilt table testDiagnostic Test: ThermographyDiagnostic Test: 123I-MIBGDiagnostic Test: Blood samples

All participants

OTHER

Examination of vibration perception threshold in fingertips, thermography, Ewing's test, tilt table test, blood samples.

Diagnostic Test: Examination of vibration perception threshold in fingertipsDiagnostic Test: Ewing's testsDiagnostic Test: Tilt table testDiagnostic Test: ThermographyDiagnostic Test: Blood samples

Interventions

Vibration perception threshold is examined for 7 different frequences. All fingers are examined except for the thumbs.

123I-MIBGAll participants
Ewing's testsDIAGNOSTIC_TEST

A battery of tests invented to diagnose the cardiac autonomic neuropathy in diabetics. Heart rate and blood pressure are measured during Valsalva maneuver, deep breathing, active standing and prolonged handgrip.

123I-MIBGAll participants
Tilt table testDIAGNOSTIC_TEST

Blood pressure and heart rate are measured continuously while the participant is brought to a 60 degree position and held there for 15 minutes.

123I-MIBGAll participants
ThermographyDIAGNOSTIC_TEST

An infrared thermographic camera is applied to record temperature of the fingers of the participant before and after cooling in 10 degree water for 1 min.

123I-MIBGAll participants
123I-MIBGDIAGNOSTIC_TEST

123I-MIBG is injected into a vein, and an early and a late scan is performed. Regions Of Interest are selected for the heart and mediastinum, and the ratio as well as well as the Washout Rate can be determined. MIBG is a noradrenaline analogue and the examination is performed to visualize a potential imbalance of the autonomic nervous system of the heart.

123I-MIBG
Blood samplesDIAGNOSTIC_TEST

The blood samples will be assayed for hemoglobin, long-term blood sugar, C-reactive protein, sodium, potassium, magnesium, albumin, TSH, vitamin B and D, and ionized calcium. Patients with suspected Raynaud's disease will be tested for anti-nuclear antibodies (ANA) to screen for underlying rheumatic illness. Blood samples will also be drawn during tilt table testing and assayed for plasma catecholamines.

123I-MIBGAll participants

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • \- Attacks of demarcated pallor of the skin of the fingers provoked by exposure to cold

You may not qualify if:

  • Positive Anti-Nuclear Antibodies
  • Connective tissue disease
  • Current smoker
  • Current treatment with beta blocker
  • Other predisposing factors for developing Raynaud's phenomenon
  • Pacemaker
  • Cardiac arrhythmia
  • Pregnancy
  • Diabetes mellitus
  • Parkinson's disease
  • Glaucoma

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital

Herlev, Capital Region, 2730, Denmark

Location

Related Publications (1)

  • Lindberg L, Kristensen B, Thomsen JF, Eldrup E, Jensen LT. Characteristic Features of Infrared Thermographic Imaging in Primary Raynaud's Phenomenon. Diagnostics (Basel). 2021 Mar 20;11(3):558. doi: 10.3390/diagnostics11030558.

MeSH Terms

Conditions

Raynaud DiseaseHand-Arm Vibration SyndromeDiabetes MellitusParkinson DiseaseGlaucoma

Interventions

Tilt-Table TestThermographyBlood Specimen Collection

Condition Hierarchy (Ancestors)

Livedoid VasculopathyThrombosisEmbolism and ThrombosisVascular DiseasesCardiovascular DiseasesPeripheral Vascular DiseasesSkin Diseases, VascularSkin DiseasesSkin and Connective Tissue DiseasesPeripheral Nervous System DiseasesNeuromuscular DiseasesNervous System DiseasesOccupational DiseasesGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesParkinsonian DisordersBasal Ganglia DiseasesBrain DiseasesCentral Nervous System DiseasesMovement DisordersSynucleinopathiesNeurodegenerative DiseasesOcular HypertensionEye Diseases

Intervention Hierarchy (Ancestors)

Diagnostic Techniques, CardiovascularDiagnostic Techniques and ProceduresDiagnosisDiagnostic ImagingThermometryInvestigative TechniquesSpecimen HandlingClinical Laboratory TechniquesPuncturesSurgical Procedures, Operative

Study Officials

  • Lars T Jensen, DMSc

    Department of Clinical Physiology, Herlev Hospital

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal investigator

Study Record Dates

First Submitted

March 8, 2017

First Posted

March 29, 2017

Study Start

January 1, 2017

Primary Completion

February 28, 2019

Study Completion

February 28, 2019

Last Updated

February 28, 2019

Record last verified: 2019-02

Data Sharing

IPD Sharing
Will not share

Locations