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Trial registered on ANZCTR
Registration number
ACTRN12624000868583
Ethics application status
Approved
Date submitted
11/07/2022
Date registered
16/07/2024
Date last updated
16/07/2024
Date data sharing statement initially provided
16/07/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of weight loss surgery on cardiovascular haemodynamics in adults with obesity
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Scientific title
The effect of weight loss surgery on cardiovascular haemodynamics in adults with obesity
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Secondary ID [1]
307390
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obesity
326705
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Condition category
Condition code
Diet and Nutrition
323948
323948
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0
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Obesity
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
We will assess the impact of bariatric surgery on adults with obesity. Participants will be followed up 12 months after their surgery.
Participants will be assessed before and 12 months after their bariatric surgery. Each face-to-face visit is estimated to take approximately three hours to complete. This will include a cardiac MRI (~1hr); echocardiogram and 6-minute walk test (~1hr); anthropometric measurements, quality of life questionnaires, and blood collection (~10 tubes for cholesterol, glucose, other biomarkers) to take the remaining time. The MRI and echocardiogram will be performed by trained imaging technicians supervised by a cardiologist. Blood samples will be taken by a qualified blood collector. Other assessments will be performed by trained research staff.
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Intervention code [1]
323823
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Diagnosis / Prognosis
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
331745
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Change in cardiac output from MRI scan
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Assessment method [1]
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Timepoint [1]
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At baseline and 12 months post-surgery
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Primary outcome [2]
335356
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Change in cardiac output from echocardiogram
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Assessment method [2]
335356
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Timepoint [2]
335356
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At baseline and 12 months post-surgery
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Secondary outcome [1]
410986
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Change in epicardial fat volume from MRI scan
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Assessment method [1]
410986
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Timepoint [1]
410986
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At baseline and 12 months post-surgery
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Secondary outcome [2]
411776
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Change in global longitudinal strain from echocardiogram
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Assessment method [2]
411776
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Timepoint [2]
411776
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At baseline and 12 months post-surgery
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Secondary outcome [3]
411777
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Change in atrial strain from echocardiogram
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Assessment method [3]
411777
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Timepoint [3]
411777
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At baseline and 12 months post-surgery
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Secondary outcome [4]
411778
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Change in T1 mapping from MRI scan
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Assessment method [4]
411778
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Timepoint [4]
411778
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At baseline and 12 months post-surgery
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Secondary outcome [5]
424047
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Exercise capacity measured by the 6-minute walk test
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Assessment method [5]
424047
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Timepoint [5]
424047
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At baseline and 12 months post-surgery
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Secondary outcome [6]
424048
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Quality of life questionnaire using the EQ-5D-5L
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Assessment method [6]
424048
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Timepoint [6]
424048
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At baseline and 12 months post-surgery
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Secondary outcome [7]
424050
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Measures of cholesterol in the blood
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Assessment method [7]
424050
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Timepoint [7]
424050
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At baseline and 12 months post-surgery
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Secondary outcome [8]
437355
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Sleep quality assessed using the Pittsburgh Sleep Questionnaire
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Assessment method [8]
437355
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Timepoint [8]
437355
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At baseline and 12 months post-surgery
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Secondary outcome [9]
437356
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Measures of triglycerides in the blood
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Assessment method [9]
437356
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Timepoint [9]
437356
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At baseline and 12 months post-surgery
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Secondary outcome [10]
437357
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Measures of glucose in the blood
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Assessment method [10]
437357
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Timepoint [10]
437357
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At baseline and 12 months post-surgery
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Secondary outcome [11]
437358
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Measures of the glycated form of haemoglobin (HbA1c)
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Assessment method [11]
437358
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Timepoint [11]
437358
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At baseline and 12 months post-surgery
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Secondary outcome [12]
437359
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Measures of the N-terminal prohormone of brain natriuretic peptide in the blood (NT-proBNP)
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Assessment method [12]
437359
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Timepoint [12]
437359
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At baseline and 12 months post-surgery
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Eligibility
Key inclusion criteria
Individuals with a BMI >= 30
Weight <200kg
Individuals suitable for bariatric surgery
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Contraindication to MRI
Unable to provide a valid consent to participate in the study
Known cardiovascular disease
Claustrophobia
Pregnancy
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
The sample size has been calculated based on cardiac output. For a paired sample, assuming a 1.5L reduction in cardiac output with a standard deviation of 2.5L/min before and after surgery, set at a p-value of 0.05 and power of 95%, we will require 40 participants. Considering that attrition rates of 10-80% have been reported in obesity studies, we plan to recruit 80 participants. As our study includes a longer follow-up period (i.e. 12 months), we have accommodated for 50% loss to follow-up.
Normality of data will be assessed using histograms and the Shapiro-Wilk test. Categorical variables will be compared using the Chi-Square test and reported as percentages. A paired sample T-test will be used to analyse parametric (normally distributed variables) which will be reported as mean and standard deviation (SD). A Wilcoxon test (non-parametric paired t-test) will be used to compare non-normally distributed variables which will be expressed as median and interquartile range (IQR). Univariate analyses will be performed. Associations between clinical and imaging variables will be assessed using multivariate linear or logistic regression analysis, where appropriate. Data comparisons between echocardiography and CMR will utilise Bland- Altman analysis for assessment of systematic and proportional bias.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
26/04/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
40
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
22588
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Nepean Hospital - Kingswood
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Recruitment postcode(s) [1]
37842
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2747 - Kingswood
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Funding & Sponsors
Funding source category [1]
311667
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Government body
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Name [1]
311667
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NSW Health
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Address [1]
311667
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100 Christie Street, St Leonards NSW 2065
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Country [1]
311667
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Australia
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Primary sponsor type
Hospital
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Name
Nepean Blue Mountains Local Health District
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Address
Derby Street, Penrith NSW 2750
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Country
Australia
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Secondary sponsor category [1]
313120
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None
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Name [1]
313120
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Address [1]
313120
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Country [1]
313120
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311123
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Nepean Blue Mountains Local Health District HREC
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Ethics committee address [1]
311123
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Nepean Hospital Derby Street, Penrith NSW 2750
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Ethics committee country [1]
311123
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Australia
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Date submitted for ethics approval [1]
311123
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Approval date [1]
311123
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31/03/2021
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Ethics approval number [1]
311123
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2020/ETH03050
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Summary
Brief summary
Obesity continues to be a major public health concern in Australia and overseas. In particular, obesity contributes to changes in the heart’s blood flow in the form of increased circulating blood volume, cardiac output, systolic blood pressure and pulmonary pressures. Long-term, these lead to the development of heart failure, atrial fibrillation and ischaemia. Furthermore, fat deposited around the heart is associated with the development of a specific type of heart failure common in individuals with obesity. Hence, obesity is considered an important risk factor for cardiovascular disease. However, there is growing evidence that effective management of obesity also improves cardiovascular outcomes for patients. Bariatric surgery, an established treatment for weight loss, has been shown to reduce the incidence of cardiovascular risk factors and heart attacks. In this study, we seek to assess the impact of bariatric surgery on the heart’s structures and blood flow using cardiac magnetic resonance imaging (CMR). Although ultrasound technology or echocardiography is widely used for assessing such features, challenges remain when acquiring accurate images in those with obesity. CMR offers an opportunity to overcome some of these imaging challenges. CMR is less user dependent compared to echocardiography and has demonstrated excellent feasibility in this population. We hypothesize that bariatric surgery will lead to a decrease in cardiac output, and reductions in the degree of fibrosis of the heart muscle and the volume of fat around the heart as measured by pre- and post-surgery CMR, thus reducing cardiovascular disease risk. Eighty participants will be recruited for this study. Assessments will include cardiac imaging scans, measurement of exercise capacity, blood tests, and quality of life questionnaires. These will be performed before and 12 months after their bariatric surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
120018
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Dr Faraz Pathan
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Address
120018
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Nepean HospitalDepartment of CardiologyDerby Street, Penrith NSW 2750
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Country
120018
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Australia
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Phone
120018
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+61 2 4734 1719
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Fax
120018
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Email
120018
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[email protected]
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Contact person for public queries
Name
120019
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Faraz Pathan
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Address
120019
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Nepean HospitalDepartment of CardiologyDerby Street, Penrith NSW 2750
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Country
120019
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Australia
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Phone
120019
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+61 2 4734 2000
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Fax
120019
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Email
120019
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[email protected]
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Contact person for scientific queries
Name
120020
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Faraz Pathan
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Address
120020
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Nepean HospitalDepartment of CardiologyDerby Street, Penrith NSW 2750
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Country
120020
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Australia
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Phone
120020
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+61 2 4734 2000
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Fax
120020
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Email
120020
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Participant consent has not been obtained to use the data for future studies.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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