Fibromuscular Dysplasia

Researchers are creating a registry to study people with early changes in the stomach lining that may lead to gastric cancer. This includes those with gastric atrophy, intestinal metaplasia, and dysplasia. The study also enrolls healthy individuals and people with gastric cancer to compare baseline characteristics and better understand risk factors for disease progression. Participants fall into three groups: those with specific stomach lesions, healthy controls, and people with gastric cancer. The study collects information through questionnaires about clinical history, environmental exposures, lifestyle, and diet. This observational study does not involve any treatment but gathers health data to support future research. Participants will complete questionnaires and provide health information over a period that may last up to 10 years. The main goal is to build a detailed participant registry. Researchers will monitor and analyze the collected data to identify factors related to the progression of stomach lesions to cancer. Participation involves regular data collection but no active treatment, with safety and privacy monitored throughout the study.

Researchers are evaluating new treatment options for Barrett's Esophagus, a condition where the esophageal lining changes and carries a risk of progressing to precancerous stages or cancer. The study compares a new mechanical resection technique using the EndoRotor device against the current standard treatment of thermal destruction by radiofrequency ablation. This comparison aims to find a potentially more effective and cost-efficient method for eradicating Barrett's Esophagus, especially in cases complicated by dysplasia or superficial adenocarcinoma. The study involves two treatment groups: one receiving the EndoRotor procedure, which mechanically removes the entire mucosal surface in a single session, allowing tissue collection for analysis; the other receiving thermal ablation with the HALO system using radiofrequency energy applied after mucosal cleaning. Each technique has specific procedural steps and devices used. The EndoRotor treatment includes submucosal injection to reduce risks, followed by mucosal resection and tissue aspiration. Radiofrequency treatment involves sizing the esophagus and applying energy via specialized probes to destroy the abnormal mucosa. Participants will undergo endoscopic evaluations before and after treatment, with biopsies taken to assess the presence or absence of Barrett's Esophagus and dysplasia at 3 and 12 months. Safety assessments include monitoring discomfort, pain, dysphagia, adverse events, and esophageal narrowing after treatment. Researchers will also evaluate the quality of tissue analysis from EndoRotor samples and economic outcomes such as cost-effectiveness. The study continues through follow-up visits up to 12 months post-treatment to measure treatment success and safety.

Researchers are evaluating how people with Spontaneous Coronary Artery Dissection (SCAD) and/or Fibromuscular Dysplasia (FMD) respond to different types and intensities of aerobic and resistance exercise. This study aims to understand the effects on heart and lung function, blood flow, and symptoms during exercise in this group of patients. The trial is a single-center, single-arm prospective clinical trial sponsored by Mayo Clinic. Participants with a history of SCAD and/or FMD will complete three separate exercise tests spaced at least 48 hours apart. These tests include a symptom-limited cardiopulmonary exercise test on a cycle, two stages of submaximal constant power cycling at moderate and heavy intensity, and a series of six resistance exercises involving chest press, lateral raises, abdominal crunches, planks, leg press, and weighted lunges. The exercises are designed to study different intensities and types of physical activity. During the study visits, researchers will measure changes in blood pressure at multiple time points, assess functional status and physical activity levels using questionnaires like the Dartmouth COOP Functional Assessment Chart, Duke Activity Index Status, and International Physical Activity Questionnaire Short Form. They will also track perceived exertion and blood lactate levels before and during exercise. The study includes careful monitoring of participants' responses to exercise and lasts for the duration of the three test sessions.

Researchers are exploring how microvascular blood flow and blood pressure respond to stress in people with a history of spontaneous coronary artery dissection (SCAD). This observational study uses stress contrast echocardiography to fill existing knowledge gaps about heart function in these patients compared to healthy individuals. The study is sponsored by Mayo Clinic and involves both participants with SCAD and healthy volunteers. The main procedure studied is stress echocardiography with contrast, which evaluates heart function and blood flow changes under stress. Participants are grouped into those with SCAD history and healthy subjects with no significant medical issues. The study measures changes in microvascular function, blood pressure, and heart rate immediately before and after the stress echocardiography. Participants will undergo baseline assessments followed by the stress echocardiography test with contrast. Researchers will monitor changes in heart performance and vital signs during the procedure. The study aims to understand the differences in cardiovascular responses between SCAD patients and healthy individuals. Participation involves a single visit with focused heart imaging and monitoring, with no ongoing treatment or long-term follow-up described.

Researchers are studying the sympathetic nervous system's role and arterial health in people who have had spontaneous coronary artery dissection (SCAD) compared to healthy individuals matched by age and sex. The study aims to understand differences in arterial thickness, stiffness, baroreflex sensitivity, and the sympathetic response to stress between these two groups. This research is led by the Mayo Clinic and involves adults aged 18 and older. Participants with a history of SCAD and healthy controls will undergo diagnostic tests to assess neurovascular function. These tests include arterial tonometry to measure arterial stiffness, echocardiograms for heart ultrasound imaging, carotid ultrasounds, elastography to evaluate artery elasticity, ankle-brachial index to assess blood flow in peripheral arteries, and microneurography with various stress maneuvers to measure sympathetic nerve activity. During the study, participants will complete these diagnostic assessments at baseline. Researchers will measure key outcomes such as arterial thickness, arterial stiffness, baroreflex sensitivity, and sympathetic responses to stress. The study does not involve treatment but focuses on detailed monitoring and evaluation of neurovascular function. Participation is expected to last through the baseline assessments, with no intervention or long-term treatment planned.

Researchers are evaluating the potential of a new technique called Brillouin microscopy to diagnose corneal conditions such as keratoconus and ectasia. The study compares the biomechanical properties of corneas in people with keratoconus, those with post-LASIK ectasia, and individuals with normal corneas. This observational study aims to better understand differences in corneal tissue using this advanced imaging method. Participants include volunteers with normal corneas, patients diagnosed with various stages of keratoconus, individuals who had LASIK surgery with or without complications, people scheduled for PRK or LASIK surgery, and patients with Fuch's endothelial corneal dystrophy. The study involves axial scans of the cornea using Brillouin imaging to assess and compare corneal biomechanics across these groups. Specific inclusion and exclusion criteria apply to each group based on diagnosis, prior surgeries, and other eye health factors. During the study, participants undergo corneal imaging to measure the cornea's elastic modulus, reflecting its biomechanical properties. Researchers monitor these properties over time to evaluate the diagnostic capabilities of Brillouin microscopy. Participants will be assessed for corneal health through topography, pachymetry, and clinical evaluations, with the study lasting several years to gather comprehensive data. The research team also excludes individuals unable to understand imaging instructions or with certain eye conditions to ensure accurate measurements.

Researchers are investigating how minocycline affects blood pressure in adults with treatment-resistant hypertension. The study aims to determine to what degree minocycline lowers blood pressure and whether these effects involve changes in the gut microbiota, gut leakiness, systemic inflammation, neuroinflammation, or a combination of these factors. This phase 4 clinical trial includes a neuroimaging substudy to explore brain-related impacts. Participants will be randomly assigned to receive either minocycline hydrochloride 100 mg twice daily or a matching placebo, both given for 3 months. The study includes three visits: screening, randomization, and a 3-month follow-up. Those in the neuroimaging substudy will undergo PET/MR imaging at each visit. Throughout the study, participants will undergo medical exams, behavioral questionnaires, blood tests for various biomarkers, urine and saliva tests to assess adherence, stool sample analysis for gut microbiota, and blood pressure monitoring including unattended office and 24-hour ambulatory measurements. At the final visit, blood will also be tested for drug concentration to confirm treatment adherence. The main outcomes measured include 24-hour systolic blood pressure, gut microbiome changes, gut inflammation and leakiness, and neuroinflammation.

Researchers are evaluating the baroloop system, a device implanted to stimulate the vagus nerve, for treating adults with hypertension that does not respond well to medication. The study aims to find out if the baroloop is safe, including checking for serious medical problems or death, and if it effectively lowers blood pressure in participants. This is a multicenter clinical trial sponsored by neuroloop GmbH. Participants will have the baroloop device implanted and will attend follow-up visits at 14 days, 3 months, 6 months, 12 months, 18 months, and 24 months after implantation. During these visits, device settings may be adjusted, and various assessments related to the study will be performed. Participants will also answer questions about their quality of life throughout the study period. During the trial, researchers will monitor safety and performance outcomes, especially focusing on safety and blood pressure changes 6 months after stimulation begins. Participants will undergo regular clinical evaluations and provide feedback on their well-being. The total duration of participation includes multiple visits over two years, ensuring close monitoring and adjustment of the device as needed.

Researchers are conducting a large, international observational study called the Canadian SCAD Study to understand spontaneous coronary artery dissection (SCAD), a condition that mainly affects young women without usual heart risk factors and can lead to heart attacks or death. SCAD is often misdiagnosed due to limits of current tests, so this study aims to better understand the condition's natural history, predisposing factors, and treatments over time. The study will enroll about 3,000 patients diagnosed with SCAD from multiple centers in Canada, the United States, and other countries. Participants will be followed for up to 10 years to track cardiovascular events. A genetic sub-study involves a one-time saliva sample collection. The study uses electronic consent for wide geographic participation and collects detailed health history and investigations related to SCAD. Participants will undergo detailed baseline assessments, including history and diagnostic testing, and will be monitored regularly for heart-related outcomes both during hospitalization and over the long term. The main outcomes measured include cardiovascular events during hospital stay and up to 10 years later. Secondary outcomes include arterial healing and success of coronary procedures. This long-term follow-up aims to improve knowledge of SCAD and guide future treatment trials.

Researchers are studying Spontaneous Isolated Superior Mesenteric Artery Dissection (SISMAD), a condition increasingly diagnosed but with limited evidence guiding treatment. This observational study compares the effects of conservative treatment versus endovascular treatment to understand which approach better helps patients with this condition. The study is sponsored by Xiangya Hospital of Central South University and aims to provide real-world evidence to improve clinical decisions for SISMAD. Participants receive either endovascular treatments or conservative care. Conservative treatment includes managing blood pressure, bowel rest, antithrombotic therapy, nutritional support, and pain control. The study observes these treatment groups over time to assess outcomes without altering usual care. There is no randomization or blinding since this is an observational study. Participants will be followed for up to five years with regular monitoring of symptom relief and survival. Researchers will also track reintervention needs, recurrence, disease complications, and artery remodeling. Patients will undergo clinical evaluations and imaging to assess their condition's progress. The study involves long-term observation to gather comprehensive data on treatment effects and safety.