💬In plain words
What the trial is, and whether it could suit you
Pulmonary hypertension (PH) is an uncommon condition and can often be difficult to diagnose. It means elevated blood pressure in the lungs which can rapidly lead to failure of the right side of the heart and is ultimately fatal. Diagnosing PH currently involves a number of scans, breathing tests and often an invasive test called right heart catheterisation \[RHC\] (which involves inserting a tube into a large vein to measure the lung blood pressure from the).
The investigators propose using a scan of the nailbeds called "Nailfold (Video) Capillaroscopy" to see whether this measurements correspond to the pressures that the investigators measure at the time of RHC and whether these measures change with treatment for PH.
The investigators wish to answer the hypotheses that:
1. The measurements of the nailbed blood vessels are correlated with the invasive right heart catheter values acros
Sign in to get the eligibility rules as simple questions to take to your doctor.
📋 Eligibility rules (as published)
Inclusion Criteria:
For inpatient enrolment:
* Suspected diagnosis of group 1,3 or 4 pulmonary hypertension undergoing inpatient assessment at nationally designated centre
* Age \> 18 years
For follow up scanning of those enrolled as an inpatient:
* Confirmed diagnosis of pulmonary hypertension assessed at nationally designated centre fulfilling criteria for group 1, 3 or 4 disease
* Commencing PH targeted therapy, specifically one or more of: a phosphodiesterase 5 inhibitor (PDE5i), an ET receptor antagonist (ERA), parenteral prostanoid therapy, selexipag, riociguat, sotatercept.
For outpatient enrolment
* Confirmed diagnosis of pulmonary hypertension assessed at nationally designated centre fulfilling criteria for group 1, 3 or 4 disease
* Age \> 18 years
* Escalating PH targeted therapy, specifically one or more of: a phosphodiesterase 5 inhibitor (PDE5i), an ET receptor antagonist (ERA), parenteral prostanoid therapy, selexipag, riociguat, sotatercept.
Target of \> 25% of patients recruited at diagnosis and to have an SSc-spectrum disorder fulfilling either ACR/EULAR 2013 or VEDOSS (very early diagnosis of SSc) criteria.
Target of \> 25% of patients recruited at diagnosis and to have non-SSc group 1 (PAH) diagnosis (as determined by national MDT decision).
Exclusion Criteria:
* Patients with confirmed group 2 or group 5 pulmonary hypertension
* Patients \< 18 years of age
* Patients unable to participate in nailbed microscopy (through e.g. amputation, severe contractures or other musculoskeletal issues).
* (From follow up) Patients not being commenced on pulmonary vasodilator therapy at the point of diagnosis.
* Patients already on maximal PH therapy
* Patients lacking capacity to consent to participation
* Patients who are non-fluent English speakers, where suitable translation cannot be found within a time frame that makes the study feasible.
* Patients with a life expectancy \< 4 months
* Patients who have consumed nicotine or caffeine within the last 4 - 6 hours
* Patients wearing nail polish / varnish/ extensions that preclude adequate nailbed visualisation.
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