EXERT: Exercise physiology after thrombosis
Research type
Research Study
Full title
Exercise Physiology after Thrombosis (EXERT): a prospective single centre cohort study of cardiovascular and exercise physiology in patients with extensive venous thrombosis in the inferior vena cava and iliofemoral veins.
IRAS ID
254956
Contact name
Stephen Black
Contact email
Sponsor organisation
Guy's and St Thomas' NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Post thrombotic syndrome (PTS) is a collection of symptoms that can occur after damage to a vein from deep vein thrombosis (DVT). Patients may develop leg swelling, pain, changes to the skin, and venous ulcers. This can lead to difficulties with exercise, walking and carrying out daily activities. There is a higher probability of developing severe PTS after DVT in the veins in the groin (iliofemoral) and abdomen (inferior vena cava). These patients are sometimes treated surgically with nitinol stents to re-open the veins and relieve PTS symptoms. In our clinical practice we have noticed that a number of patients with PTS are also affected by shortness of breath when they try to exercise, despite not having any known heart or lung disease. The primary aim of this study is to investigate whether these symptoms are due to problems with venous blood flow from the legs back to the heart, and whether stenting can improve venous return, exercise tolerance and quality of life.
This will be a pilot study of 16 participants recruited to 4 groups; 1) Patients with previous DVT involving the IVC who have symptoms of breathlessness on exertion, 2) Patients with IVC involvement who do not have symptoms of breathlessness, 3) Patients with previous iliofemoral DVT not involving the IVC, 4) control group. Participants will undergo cardiopulmonary exercise testing and the 6 minute walk test to determine exercise capacity. They will also have imaging of the heart (cardiac MRI and echocardiogram) and the venous system before and after exercise (MR venogram), and complete quality of life questionnaires. Groups 1 and 3 will be recruited from those who are on the waiting list for stenting. During intervention they will have monitoring of cardiac output, and 6 weeks after surgery they will repeat all of the previous assessments.
REC name
London - London Bridge Research Ethics Committee
REC reference
19/LO/0753
Date of REC Opinion
4 Jun 2019
REC opinion
Favourable Opinion