Left Ventricular Myocardial Work for Predicting Response to CRT
CARE-MW
2 other identifiers
observational
3,240
1 country
82
Brief Summary
This study aims to establish the normal reference values for left ventricular myocardial work in healthy Chinese adults and the influencing factors. Non-invasive myocardial work serves as a new parameter for identifying CRT responders and provides a scoring system for predicting the efficacy of CRT in clinical practice. CRT can improve cardiac function and quality of life, and reduce mortality and hospitalization rates due to heart failure (HF). Currently, the number of CRT treatments is increasing year by year, but even when strictly following the indications, approximately 30% of patients do not respond. Therefore, precise prediction of CRT efficacy is of great clinical significance for improving prognosis. Currently, the indications for CRT mainly rely on clinical, electrocardiogram (CLBBB), and LVEF. By correcting ventricular contraction asynchrony to improve systolic function, however, CLBBB indicates electrical asynchrony, and LVEF improvement depends on mechanical synchrony. If the mechanical asynchrony of the ventricles can be evaluated directly before surgery, it will help predict the efficacy of CRT. Myocardial work is a recently developed non-invasive method that combines LV afterload with the overall longitudinal strain (GLS) analysis of echocardiography. Myocardial work reflects the contraction ability of the heart, stroke work, residual myocardial contraction ability, myocardial oxygen consumption, useless work, useful work, etc., and is represented by the pressure-volume loop analysis, thus having the potential to predict the efficacy of CRT. Therefore, this study intends to adopt the left ventricular myocardial work technique, combined with the current indication criteria, to predict the long-term efficacy of patients with heart failure who are scheduled for CRT treatment, thereby increasing the response rate of CRT and improving the prognosis of patients. Currently, there are no normal reference values for left ventricular myocardial work in healthy Chinese adults. Therefore, our center has initiated this multicenter clinical research project, collaborating with multiple ultrasound centers across the country, aiming to establish the normal ultrasound values for left ventricular myocardial work in healthy Chinese adults, providing new quantitative reference basis for the diagnosis of myocardial function, assessment of the severity of myocardial lesions, and efficacy observation.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started Jan 2026
82 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 21, 2025
CompletedStudy Start
First participant enrolled
January 1, 2026
CompletedFirst Posted
Study publicly available on registry
January 6, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 31, 2026
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 31, 2027
January 6, 2026
December 1, 2025
12 months
December 21, 2025
December 21, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Overall work index（GWI）
The curve area representing the left ventricular PSL from the closure of the mitral valve to its opening, that is, the overall contractile work of the myocardium
At study enrollment (baseline)
Study Arms (4)
Healthy Adults Group
Healthy adults aged 18 to 79 years are planned to be stratified into 6 age groups: 18-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, and ≥70 years. Each age group will include 120 participants of each sex.
Patients with heart failure and left bundle branch block who are scheduled to undergo CRT treatment
Ultrasound machine LVEF ≤ 35%; QRS ≥ 150ms; LBBB; Optimal drug therapy for at least 3 months before implantation 600 participants
Patients with LBBB who have preserved LVEF
LVEF≥53%； LBBB 600 participants
Patients with reduced LVEF but without LBBB
LVEF ≤ 35%, non-LBBB 600 participants
Interventions
Myocardial work is a recently developed non-invasive method that incorporates the LV afterload into the overall longitudinal strain (GLS) analysis of echocardiography. Myocardial work reflects the contractile ability of the heart, stroke work per beat, residual myocardial contractile ability, myocardial oxygen consumption, useless work, and useful work, which is represented by the pressure-volume loop analysis and thus has the potential to predict the efficacy of CRT.
Eligibility Criteria
This study enrolls 4 groups (18-79 years) from clinics/community: Healthy Adults: Han Chinese with normal cardiovascular function (vitals, labs, ECG, echo; no structural heart disease/systemic diseases/poor ultrasound). Heart failure patients with LBBB who are scheduled for CRT treatment： LVEF ≤ 35%,QRS ≥ 150ms; LBBB.At least 3 months of optimal drug therapy before implantation. Patients with LBBB who have preserved LVEF :LVEF≥53%, LBBB. Patients with reduced LVEF but without LBBB :LVEF ≤ 35%,non-LBBB.
You may qualify if:
- Participants must meet all of the following criteria to be enrolled:
- Of Han Chinese ethnicity
- Aged 18-79 years
- Normal blood pressure (\< 140/90 mmHg)
- Normal fasting blood glucose
- Normal blood lipid levels (triglycerides, total cholesterol, low-density lipoprotein, high-density lipoprotein)
- Normal complete blood count results (hemoglobin concentration, white blood cell count, red blood cell count, platelet count)
- Normal liver and renal function (alanine transaminase \< 2× upper limit of normal; normal creatinine and blood urea nitrogen)
- Normal electrocardiogram results (occasional atrial premature beats may be enrolled at the investigator's discretion)
- No structural heart disease and normal cardiac function confirmed by echocardiography
You may not qualify if:
- Participants will be excluded if they meet any of the following criteria:
- Clinically significant cardiac valve regurgitation (≥ mild severity)
- Respiratory diseases: acute or chronic respiratory disorders
- Endocrine diseases: thyroid disease, diabetes mellitus, hyperaldosteronism, pheochromocytoma, etc.
- Abnormal liver function (alanine transaminase \> 2× upper limit of normal), abnormal renal function (elevated creatinine beyond normal range), or dyslipidemia (elevated triglycerides, total cholesterol, low-density lipoprotein, or high-density lipoprotein)
- Other systemic diseases: anemia, malignancy, connective tissue disease, large artery/peripheral vascular diseases (aortic dilation, aortic dissection, coarctation of the aorta, Takayasu arteritis, atherosclerosis), etc.
- Pregnant or lactating women
- Professional athletes
- Poor-quality ultrasound images that cannot support parameter measurement and analysis
- Heart failure patients with LBBB who are scheduled for CRT treatment Group
- LVEF ≤ 35%
- QRS ≥ 150ms; LBBB
- At least 3 months of optimal drug therapy before implantation
- Suffering from connective tissue diseases such as systemic lupus erythematosus, polymyositis, and rheumatoid arthritis;
- Having a history of blood diseases and severe systemic diseases such as infections;
- +13 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (82)
Anhui University of Chinese Medicine First Affiliated Hospital
Hefei, Anhui, China
The First Affiliated Hospital of Anhui Medical University
Hefei, Anhui, China
The First Affiliated Hospital of Wannan Medical College
Wannan, Anhui, China
The Provincial Hospital Affiliated to Fuzhou University
Fuzhou, Fujian, China
Fujian Provincial Geriatric Hospital
Guizhou, Fujian, China
Guizhou Provincial People's Hospital
Guizhou, Fujian, China
Union Hospital Affiliated to Fujian Medical University
Guizhou, Fujian, China
The First Affiliated Hospital of Xiamen University
Xiamen, Fujian, China
Zhongshan Hospital Affiliated to Xiamen University
Xiamen, Fujian, China
Gansu Provincial People's Hospital
Lanzhou, Gansu, China
Jiangmen Central Hospital
Jiangmen, Guangdong, China
The First Hospital of Qinhuangdao City
Qinhuangdao, Hebei, China
The First Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
The Second Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
The Third Hospital of Hebei Medical University
Shijiazhuang, Hebei, China
Longnan Hospital of Daqing Oilfield General Hospital
Daqing, Heilongjiang, China
The First Affiliated Hospital of Harbin Medical University
Harbin, Heilongjiang, China
The Fourth Affiliated Hospital of Harbin Medical University
Harbin, Heilongjiang, China
The First Affiliated Hospital of Zhengzhou University
Zhengzhou, Heinan, China
FuWai Central China Cardiovascular Hospital
Zhengzhou, Henan, China
The First Affiliated Hospital of Henan Medical University (Xinxiang Medical University)
Zhengzhou, Henan, China
The First Affiliated Hospital of Henan University of Chinese Medicine
Zhengzhou, Henan, China
Enshi Central Hospital
Enshi, Hubei, China
Puai Hospital of Wuhan City / The Fourth Hospital of Wuhan City
Wuhan, Hubei, China
Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology
Wuhan, Hubei, China
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, China
Xiangyang Hospital of Traditional Chinese Medicine, Hubei Province
Xiangyang, Hubei, China
Changzhou Second People's Hospital
Changzhou, Jiangsu, China
The First People's Hospital of Lianyungang City
Lianyungang, Jiangsu, China
Jiangsu Provincial People's Hospital
Nanjing, Jiangsu, China
The First People's Hospital of Nantong City
Nantong, Jiangsu, China
The Third People's Hospital of Nantong City
Nantong, Jiangsu, China
Suqian Hospital of Jiangsu Provincial People's Hospital
Suqian, Jiangsu, China
The Hospital of Traditional Chinese Medicine of Suzhou City
Suzhou, Jiangsu, China
The Second Affiliated Hospital of Soochow University
Suzhou, Jiangsu, China
The Affiliated Hospital of Jiangnan University
Wuxi, Jiangsu, China
The People's Hospital of Wuxi City
Wuxi, Jiangsu, China
Su Bei People's Hospital
Yangzhou, Jiangsu, China
The First Affiliated Hospital of Guizhou Medical University
Guizhoucun, Jiangxi, China
The First Affiliated Hospital of Nanchang University
Nanchang, Jiangxi, China
The Second Affiliated Hospital of Nanchang University
Nanchang, Jiangxi, China
The First Hospital of Jilin University
Jilin, Jilin, China
The Second Hospital of Jilin University
Jilin, Jilin, China
Central Hospital of Anshan City
Anshan, Liaoning, China
The First Affiliated Hospital of Dalian Medical University
Dalian, Liaoning, China
The First Hospital of China Medical University
Shenyang, Liaoning, 110000, China
Liaoning Golden Autumn Hospital
Shenyang, Liaoning, China
Shengjing Hospital, China Medical University
Shenyang, Liaoning, China
Chifeng Hospital
Chifeng, Neimenggu, China
The People's Hospital of Ningxia Hui Autonomous Region
Yinchuan, Ningxia, China
Jinan Central Hospital
Jinan, Shandong, China
The First Affiliated Hospital of Shandong First Medical University
Jinan, Shandong, China
The Affiliated Hospital of Qingdao University
Qingdao, Shandong, China
Bethea Hospital of Shanxi Province
Taiyuan, Shanxi, China
Shanxi Cardiovascular Hospital (Shanxi Cardiovascular Hospital Research Institute)
Taiyuan, Shanxi, China
The Cancer Hospital of Shanxi Province
Taiyuan, Shanxi, China
The People's Hospital of Shanxi Province
Taiyuan, Shanxi, China
Tangdu Hospital, Air Force Medical University
Xi’an, Shanxi, China
The Second Affiliated Hospital of Xi'an Jiaotong University
Xi’an, Shanxi, China
The People's Hospital of Sichuan Province
Chengdu, Sichuan, China
Xindu District People's Hospital of Chengdu City
Chengdu, Sichuan, China
Affiliated Hospital of North Sichuan Medical College
Nanchong, Sichuan, China
The People's Hospital of Ya'an City
Ya'an, Sichuan, China
Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine / The Fourth Affiliated Hospital of Xinjiang Medical University
Xinjiang, Xinjiang, China
Dianxi Central Hospital of Yunnan Province
Dingxi, Yunnan, China
The First Affiliated Hospital of Kunming Medical University
Kunming, Yunnan, China
Yan'an Hospital of Kunming City
Kunming, Yunnan, China
Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
Hangzhou, Zhejiang, China
The First Affiliated Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
The Second Affiliated Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
Lihuili Hospital of Ningbo Medical Center
Ningbo, Zhejiang, China
The First Affiliated Hospital of Ningbo University
Ningbo, Zhejiang, China
The Second Hospital of Ningbo City
Ningbo, Zhejiang, China
The Second Hospital of Shaoxing City
Shaoxing, Zhejiang, China
Taizhou Hospital of Zhejiang Province
Taizhou, Zhejiang, China
The First Affiliated Hospital of Wenzhou Medical University
Wenzhou, Zhejiang, China
The People's Hospital of Zhuji City
Zhuji, Zhejiang, China
The First Hospital of Peking University
Beijing, China
The First Affiliated Hospital of Chongqing Medical University
Chongqing, China
The Second Affiliated Hospital of Chongqing Medical University
Chongqing, China
Shanghai Chest Hospital
Shanghai, China
The First Affiliated Hospital of Xinjiang Medical University
Xinjiang, China
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Chunyan Ma, MD
First Hospital of China Medical University
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Chief of Cardiovascular Ultrasound
Study Record Dates
First Submitted
December 21, 2025
First Posted
January 6, 2026
Study Start
January 1, 2026
Primary Completion (Estimated)
December 31, 2026
Study Completion (Estimated)
December 31, 2027
Last Updated
January 6, 2026
Record last verified: 2025-12
Data Sharing
- IPD Sharing
- Will not share