Lymphatic Function in Patients With Secondary Tricuspid Valve Regurgitation

Study Overview
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Brief Summary
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The study will examine the lymphatic functional and morphological status in patients with moderate tricuspid valve regurgitation compared to healthy age and gender-matched controls. The study will use t2 weighted MRI, Near-infrared fluorescence imaging, and plethysmography to examine the above-mentioned question.

Detailed Description
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The study will examine the lymphatic functional and morphological status in patients with moderate tricuspid valve regurgitation compared to healthy age and gender-matched controls. Subjects will be examined at one occasion using t2-weighted MRIs to evaluated lymphatic anatomy and Near-infrared fluorescence imaging for evaluation of superficial peripheral lymphatic function. Finally, the capillary filtration rate will be estimated using plethysmography.

Official Title
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Lymphatic Function in Patients With Secondary Tricuspid Valve Regurgitation - An Unknown Collaborator in a System Under Pressure

Conditions
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Lymphatic Insufficiency, Heart Failure, Edema

Participation Criteria
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Eligibility Criteria
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Patients: Inclusion criteria: Patients with moderate to severe tricuspid regurgitation Age ≥18 years Informed consent Exclusion criteria: Reduced ejection fraction (<50%) Congenital heart disease Left sided valve disease MRI contraindications (All metal implants, cochlear implants, pacemakers etc.) Claustrophobia Peripheral edema BMI>30 Age<18. Controls: Inclusion criteria: Healthy Age ≥18 years Age, gender and weight matched with included patients. Exclusion criteria: Cardiovascular disease MRI contraindications (All metal implants, cochlear implants, pacemakers etc.) Claustrophobia Peripheral edema BMI>30 Age<18.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>Patients suffering from moderate tricuspid valve regurgitation | |
| Controls<br>Cardiovascular healthy, age, gender and weight matched controls. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thoracic duct tortuosity (centimeters/centimeters) | Based on MRI, the thoracic duct will be rendered and measured with regards to tortuosity (full length/straight length) | 20 minutes | 
| Thoracic duct volume (cubic centimetres) | Based on MRI, the thoracic duct will be rendered and measured with regards to volume. | 30 minutes | 
| Excess fluid (yes/no) | Based on MRI, the existence of excess fluid in the pericardial, thoracic and abdominal cavity will be accessed. | 40 minutes | 
| Peripheral lymphatic velocity (centimeters/second) | Peripheral lymphatic fluid velocity (centimeters/second) will be calculated based upon NIRF sequences. | 1 hour | 
| Peripheral lymphatic frequency (contractions/minute) | Peripheral lymphatic contraction frequency (contractions/minute) will be calculated based upon NIRF sequences. | 1 hour 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Capillary filtration | Evaluation of capillary filtration rate estimated using plethysmography | 2 hours |