Breath Analysis and Arterial Stiffness in Patients With Respiratory Diseases

Study Overview
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Brief Summary
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Assessment of cardiovascular disorders using echocardiography and arterial stiffness; comparative noninvasive assessment of volatile organic compound (eVOC) exhale breath patterns in patients with different chronic respiratory diseases with age and gender-matched healthy adults in order to identify a disease-specific exhaled eVOCs profiles and markers of respiratory and cardiovascular disorders.

Detailed Description
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Evaluating of eVOCs profiles by proton mass spectrometry with a time-of-flight (PTR-TOF) in patients with different chronic respiratory diseases is of great interest for assessing the prognosis and development of severe ventilation and cardiovascular disorders. The aim of our study is to determine the diagnostic significance of PTR-TOF analysis in patients with chronic respiratory diseases and to identify specific eVOC markers of a severe ventilation and cardiovascular disorders in patients with different chronic respiratory diseases.

Official Title
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Exhaled Breath Proton Mass Spectrometry and Assessment of Endothelial Dysfunction in Patients With Respiratory Diseases

Conditions
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Chronic Respiratory Diseases, Cystic Fibrosis, Lymphangioleiomyomatosis, Hypersensitivity Pneumonitis, Interstitial Lung Diseases, COPD, Bronchial Asthma

Intervention / Treatment
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* Diagnostic Test: Breath test using the Compact PTR-TOF-MS
* Diagnostic Test: Portable cardiac monitor CardioQvark
* Diagnostic Test: Assessment of arterial stiffness using the VaSera VS-1500N


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Written informed consent to participate in the study; Age 18 and over; Clinical diagnosis of one of chronic respiratory diseases (COPD, bronchial asthma, cystic fibrosis, lymphangioleiomyomatosis, hypersensitivity pneumonitis or other interstitial lung disease). Exclusion Criteria: Unable to sign informed consent; Respiratory disease (for controls); Mental illness (severe dementia, schizophrenia, severe depression, manic-depressive psychosis); Acute coronary syndrome, acute cerebrovascular accident, pulmonary embolism within the last 3 months; Oncology; Previous lung transplantation (for patients with respiratory diseases); Diseases and conditions that can change the ECG picture and complicate the analysis of the ECG (conduction disturbance, pacemaker); Inability to use a heart monitor (congenital developmental anomalies, traumatic amputation of the upper limbs, essential tremor, Parkinson's disease); Pregnancy.

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 |
| --- | --- |
| Experimental: patients with chronic respiratory diseases<br>Included patients, aged ≥ 18 years, with chronic respiratory diseases: COPD, bronchial asthma, cystic fibrosis, lymphangioleiomyomatosis, hypersensitivity pneumonitis and other interstitial lung diseases. Intervention: breath analysis using the Compact PTR-MS proton mass spectrometer by Ionicon (Austria); electrocardiogram (ECG) in one lead with an assessment of the pulse wave using a portable cardiac monitor CardioQvark; assessment of arterial stiffness using the VaSera VS-1500N Fukuda Denshi device by non-invasive measurement of blood pressure in four limbs with simultaneous recording of electrocardiogram (ECG), phonocardiogram (PCG) and pulse waves on the carotid, femoral arteries, as well as on the arteries of four limbs. Interventions: Diagnostic Test: Breath analysis using the Compact PTR-MS proton mass spectrometer; Diagnostic Test: Portable cardiac monitor CardioQvark; Diagnostic Test: Assessment of arterial stiffness using the VaSera VS-1500N. | Diagnostic Test: Breath test using the Compact PTR-TOF-MS<br>* Breath samples will be analyzed with a proton-transfer reaction mass spectrometer (Compact PTR-MS, Ionicon, Austria) to obtain eVOCs profiles listed as ions at various mass-to-charge ratios (m/z).<br>Diagnostic Test: Portable cardiac monitor CardioQvark<br>* Record an electrocardiogram (ECG) in one lead with an assessment of the pulse wave using a portable cardiac monitor CardioQvark (Russia, LLC L Card , RU No. RZN 2019/8124 dated February 15, 2019) once. Devices automatically transfer data to the A&D Connect app paired with it (link). When transferring data, they are completely protected. The data obtained using the application must be sent to the specialists of the research group in a depersonalized form.<br>Diagnostic Test: Assessment of arterial stiffness using the VaSera VS-1500N<br>* Assessment of arterial stiffness using the VaSera VS-1500N Fukuda Denshi device by non-invasive measurement of blood pressure in four limbs with simultaneous recording of ECG, PCG and pulse waves on the carotid, femoral arteries, as well as on the arteries of four limbs.<br>|
| Active Comparator: Control<br>Included subjects, aged ≥ 18 years. Intervention: breath analysis using the Compact PTR-MS proton mass spectrometer by Ionicon (Austria); electrocardiogram (ECG) in one lead with an assessment of the pulse wave using a portable cardiac monitor CardioQvark; assessment of arterial stiffness using the VaSera VS-1500N Fukuda Denshi device by non-invasive measurement of blood pressure in four limbs with simultaneous recording of ECG, phonocardiogram (PCG) and pulse waves on the carotid, femoral arteries, as well as on the arteries of four limbs. Interventions: Diagnostic Test: Breath analysis using the Compact PTR-MS proton mass spectrometer; Diagnostic Test: Portable cardiac monitor CardioQvark; Diagnostic Test: Assessment of arterial stiffness using the VaSera VS-1500N. | Diagnostic Test: Breath test using the Compact PTR-TOF-MS<br>* Breath samples will be analyzed with a proton-transfer reaction mass spectrometer (Compact PTR-MS, Ionicon, Austria) to obtain eVOCs profiles listed as ions at various mass-to-charge ratios (m/z).<br>Diagnostic Test: Portable cardiac monitor CardioQvark<br>* Record an electrocardiogram (ECG) in one lead with an assessment of the pulse wave using a portable cardiac monitor CardioQvark (Russia, LLC L Card , RU No. RZN 2019/8124 dated February 15, 2019) once. Devices automatically transfer data to the A&D Connect app paired with it (link). When transferring data, they are completely protected. The data obtained using the application must be sent to the specialists of the research group in a depersonalized form.<br>Diagnostic Test: Assessment of arterial stiffness using the VaSera VS-1500N<br>* Assessment of arterial stiffness using the VaSera VS-1500N Fukuda Denshi device by non-invasive measurement of blood pressure in four limbs with simultaneous recording of ECG, PCG and pulse waves on the carotid, femoral arteries, as well as on the arteries of four limbs.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Molecular composition of exhaled breath analysed by proton-transfer reaction mass spectrometer (Compact PTR-MS, Ionicon, Austria) | Exhaled volatile organic compounds (eVOCs) profiles listed as ions at various mass-to-charge ratios (m/z) | up to 3 years | 
| Results of recording an electrocardiogram (ECG) in one lead with an assessment of the pulse wave | Pulse wave velocity, augmentation index, pulse wave type (A, B or C) analysed by a portable cardiac monitor CardioQvark | up to 3 years | 
| Indicators of arterial stiffness | Cardio-ankle vascular index and ankle-brachial index analysed with using the VaSera VS-1500N | up to 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite of clinical records | Clinical data are assessed via questionaire according to the Modified Medical Research Council (mMRC) Dyspnea Scale, Borg Dyspnea scale, standard examination of respiratory function (spirometry, body plethysmography, diffusion test), echocardiography, CT scan of the chest, if necessary, sputum culture results | up to 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gas exchange disorders, Proton-transfer reaction mass spectrometry (PTR-TOF-MS), Exhaled volatile organic compounds (eVOCs), Endothelial function, Arterial stiffness, Cardiovascular disorders, Ventilation disorders