CMR T1 Mapping for Diagnosis of Cardiac Amyloidosis (CMR for CA)
Native T1 Cardiac Magnetic Resonance Imaging for Diagnosis of Cardiac Amyloidosis
The study aims to test the diagnostic accuracy of T1 mapping for the diagnosis of cardiac amyloidosis prospectively. The hypothesis is that T1 mapping in older patients with symptomatic heart failure, increased LV wall thickness and elevated cardiac biomarkers is non-inferior to the reference method to diagnose cardiac amyloidosis (CA).
As secondary measure, a web-based ATTR probability estimator for the diagnosis of CA will be evaluated.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Cardiac amyloidosis (CA) is an important differential diagnosis in older patients with symptomatic heart failure with preserved or mid-range ejection fraction and increased left ventricular wall thickness. The prevalence of CA among patients with heart failure and left ventricular (LV) hypertrophy is approximately 13%. However, diagnosis of CA is challenging because specific clinical signs are often lacking.
Amyloid fibrils deposit in the extracellular space of the myocardium increases myocardial T1 values on cardiac magnetic resonance (CMR). Therefore, T1 imaging provides a promising non-invasive method to identify CA.
A preliminary retrospective analysis of 128 patients with increased LV wall thickness identified an area under the curve of 0.9954 (p<0.0001) for native T1 to detect CA. The optimal cut-off value was 1341ms, with a sensitivity of 100% and a specificity of 97%.
The investigators aim to test the diagnostic accuracy of T1 mapping for the diagnosis of CA compared to the reference method prospectively. Moreover, the web-based ATTR probability estimator for the diagnosis of CA will be evaluated.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Daniel Lavall, MD
- Phone Number: +493419712650
- Email: daniel.lavall@medizin.uni-leipzig.de
Study Contact Backup
- Name: Romy Langhammer, MD
- Phone Number: +493419712650
- Email: Romy.Langhammer@medizin.uni-leipzig.de
Study Locations
-
-
Saxony
-
Leipzig, Saxony, Germany, 04103
- University of Leipzig
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age ≥ 60 years
- Symptomatic heart failure (NYHA II-IV) with LVEF ≥40%
- Increased LV wall thickness (≥12mm end-diastolic)
- NT-proBNP ≥1000pg/mL
- Elevated hs-troponin T ≥14ng/L
Exclusion Criteria:
- Contraindications for CMR
- Acute myocarditis
- Acute myocardial infarction <1 month
- Severe aortic stenosis and RAISE score < 2 points
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
CMR T1 mapping
Diagnostic accuracy of T1 mapping and ATTR probability estimator are tested against the reference methods (99mTc-DPD scintigraphy, laboratory screening for multiple myeloma / AL amyloidosis; or cardiac biopsy, if noninvasive evaluation is inconclusive)
|
Observed method
Observed method
Reference method
Reference method
If non-invasive tests for CA (99mTc-DPD scintigraphy, biochemistry) are inconclusive
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic accuracy of T1 mapping for diagnosis of CA
Time Frame: up to 7 days
|
Comparison of CMR T1 mapping to the reference method for diagnosis of CA
|
up to 7 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic accuracy of ATTR probability estimator to predict CA
Time Frame: up to 7 days
|
Comparison of a probability score to predict ATTR with the final diagnosis of ATTR
|
up to 7 days
|
|
Association of ATTR probability estimator values with cardiovascular outcome
Time Frame: 1 year
|
All-cause death, cardiovascular death and heart failure hospitalizations
|
1 year
|
|
Association of parametric T1 values with cardiovascular outcome
Time Frame: 1 year
|
All-cause death, cardiovascular death and heart failure hospitalizations
|
1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Cardiovascular Diseases
- Pathological Conditions, Anatomical
- Heart Diseases
- Neuromuscular Diseases
- Metabolism, Inborn Errors
- Genetic Diseases, Inborn
- Metabolic Diseases
- Peripheral Nervous System Diseases
- Neurodegenerative Diseases
- Heredodegenerative Disorders, Nervous System
- Proteostasis Deficiencies
- Cardiomegaly
- Amyloid Neuropathies
- Amyloidosis, Familial
- Hypertrophy
- Amyloidosis
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Hypertrophy, Left Ventricular
- Amyloid Neuropathies, Familial
Other Study ID Numbers
Other Study ID Numbers
- DL-L-20006_V16
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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