- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07620925
Derivation and Validation of the Aortic Valve Echocardiographic Calcium Score to Confirm Severe Aortic Stenosis: the Echo-AVCS Study (Echo-AVCS)
3. juni 2026 opdateret af: Emanuele Barbato, Azienda Ospedaliera "Sant'Andrea"
The Echo-AVCS Study is an investigator-initiated, prospective, multicenter observational study designed to derive and validate an artificial intelligence (AI)-based echocardiographic aortic valve calcium score (Echo-AVCS) for confirming severe aortic stenosis (AS).
Transthoracic echocardiography (TTE) is the standard imaging modality for assessing AS severity; however, discrepancies between valve area and transvalvular gradient measurements may complicate diagnosis, particularly in low-flow or discordant AS presentations.
Cardiac computed tomography (CT)-derived aortic valve calcium scoring is currently used to resolve diagnostic uncertainty, but it involves additional cost and radiation exposure.
This study will enroll consecutive adult patients undergoing clinically indicated TTE and cardiac CT with calcium scoring performed within 3 months.
Standardized echocardiographic images will be centrally analyzed using dedicated AI-based image segmentation and machine learning methods to quantify aortic valve calcification directly from TTE images.
CT-derived aortic valve calcium score will serve as the reference standard.
The primary objective is to derive and validate the Echo-AVCS score for identifying severe AS.
Secondary objectives include determination of sex-specific diagnostic thresholds, correlation with CT calcium volume, association with symptoms and NYHA class, and evaluation of prognostic associations with aortic valve replacement, heart failure hospitalization, cardiovascular events, and mortality at 1-year follow-up.
Studieoversigt
Status
Rekruttering
Intervention / Behandling
Undersøgelsestype
Observationel
Tilmelding (Anslået)
250
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiekontakt
- Navn: Emanuele Barbato, Full Professor
- Telefonnummer: 0633778763
- E-mail: emanuele.barbato@uniroma1.it
Studiesteder
-
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Bologna, Italien
- Rekruttering
- University of Bologna
-
Kontakt:
- Carmine Pizzi
- E-mail: carmine.pizzi@unibo.it
-
Underforsker:
- Luca Bergamaschi
-
Underforsker:
- Matteo Armillotta
-
Underforsker:
- Francesco Angeli
-
Milan, Italien
- Rekruttering
- Centro Cardiologico Monzino
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Kontakt:
- Gianluca Pontone
- Telefonnummer: 02 58002574
- E-mail: gianluca.pontone@cardiologicomonzino.it
-
Underforsker:
- Saima Mushtaq, MD, PhD
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Underforsker:
- Maria Elisabetta Mancini, MD
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Milan, Italien
- Rekruttering
- IRCCS Galeazzi-Sant'Amborgio
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Kontakt:
- Edoardo Conte
- E-mail: edoardo.conte86@gmail.com
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Underforsker:
- Tommaso Viva
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Underforsker:
- Davide Marchetti
-
Milan, Italien
- Aktiv, ikke rekrutterende
- Politecnico di Milano
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Roma, Italien
- Rekruttering
- Sant'Andrea University Hospital
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Underforsker:
- Pasquale Paolisso, MD, PhD
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Underforsker:
- Marta Belmonte, MD, PhD
-
Kontakt:
- Emanuele Barbato, Full Professor
- Telefonnummer: 0633778763
- E-mail: emanuele.barbato@uniroma1.it
-
Kontakt:
- Pasquale Paolisso, MD, PhD
- E-mail: pasquale.paolisso@gmail.com
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Ingen
Prøveudtagningsmetode
Sandsynlighedsprøve
Studiebefolkning
The Echo-CA score Study is an investigator-initiated, prospective, multicenter study of consecutive patients undergoing clinically indicated standard transthoracic echocardiography and cardiac CT with available calcium score performed within 3 months.
The study population is expected to include approximately 50% patients with severe AS and 50% without severe AS, in order to ensure a balanced case-control distribution and optimize the precision of diagnostic performance estimates.
All patients will be managed according to current standards of care.
Clinical evaluation will include systematic collection of cardiovascular risk factors, comorbidities, medical therapy, and detailed symptom assessment (angina, syncope, dyspnea), as well as NYHA functional class.
Each participant will undergo: i) comprehensive transthoracic echocardiography (TTE) performed according to current ESC Guideline; ii) cardiac CT with aortic valve calcium quantification, performed according to contemporary acquisiti
Beskrivelse
Inclusion Criteria:
- Age > 18 years old
- Clinical indication for standard transthoracic echocardiography.
- Clinical indication for cardiac CT with available calcium score.
- 3-month time interval between transthoracic echocardiography and cardiac CT.
- Able to give informed consent.
Exclusion Criteria:
- Patients with inadequate transthoracic echocardiographic images.
- Poor quality cardiac CT, inadequate for standard calcium score assessment.
- Patients with known prior stents and/or coronary artery bypass grafts.
- Patients with known previous percutaneous or surgical aortic valve replacement.
- Patients with active or a history of endocarditis.
- Patients with congenital heart defects (other than isolated bicuspid aortic valve).
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
|
Patients undergoing transthoracic echocardiography and cardiac-CT with available calcium score
Consecutive patients undergoing clinically indicated standard transthoracic echocardiography and cardiac CT with available calcium score performed within 3 months
|
This is a non-interventional, observational study in which all patients will undergo clinically indicated standard-of-care transthoracic echocardiography (TTE) and cardiac computed tomography (CT) with aortic valve calcium scoring.
No investigational drug, device, or additional invasive procedure will be administered as part of the study.
Echocardiographic images acquired during routine clinical practice will be anonymized and centrally analyzed using dedicated artificial intelligence-based software to derive and validate the echocardiographic aortic valve calcium score.
Patient management, follow-up, and therapeutic decisions, including referral for aortic valve replacement, will remain entirely at the discretion of the treating physicians according to current clinical guidelines and standard practice.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Derivation of Echo-AVCS
Tidsramme: 6 months
|
To derive an echocardiographic aortic valve calcium score (Echo-AVCS) for confirming severe aortic stenosis (AS), using CT-derived aortic valve calcium as the reference standard.
|
6 months
|
|
Validation of Echo-AVCS
Tidsramme: 6 months
|
To validate an echocardiographic aortic valve calcium score (Echo-AVCS) for confirming severe aortic stenosis (AS), using CT-derived aortic valve calcium as the reference standard.
|
6 months
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Sex-specific thresholds
Tidsramme: 6 months
|
To determine sex-specific thresholds (male vs. female) for the echocardiographic aortic valve calcium score (Echo-AVCS).
|
6 months
|
|
Correlation between the echocardiographic aortic valve calcium score and the calcium volume (mm³)
Tidsramme: 6 months
|
To assess the correlation between the echocardiographic aortic valve calcium score and the calcium volume (mm³) measured by cardiac computed tomography.
|
6 months
|
|
Correlation of the echocardiographic aortic valve calcium score and the presence and occurrence of patient symptoms
Tidsramme: 1-year
|
To correlate the echocardiographic aortic valve calcium score and the presence and occurrence of patient symptoms (angina, syncope, and dyspnea).
|
1-year
|
|
Association between the echocardiographic aortic valve calcium score and the time to aortic valve replacement (AVR)
Tidsramme: 1 year
|
To evaluate the association between the echocardiographic aortic valve calcium score and the time to aortic valve replacement (AVR) according to current ESC Guidelines.
|
1 year
|
|
Correlation of the echocardiographic aortic valve calcium score with the patient's NYHA Class.
Tidsramme: 1 year
|
To correlate the echocardiographic aortic valve calcium score with the patient's NYHA Class.
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1 year
|
|
Correlation of the echocardiographic aortic valve calcium score with all-cause death at 1-year follow-up.
Tidsramme: 1 year
|
To correlate the echocardiographic aortic valve calcium score with all-cause death at 1-year follow-up.
|
1 year
|
|
Correlation of the echocardiographic aortic valve calcium score with cardiovascular death at 1-year follow-up.
Tidsramme: 1 year
|
To correlate the echocardiographic aortic valve calcium score with cardiovascular death at 1-year follow-up.
|
1 year
|
|
Correlation of the echocardiographic aortic valve calcium score with hospitalization for heart failure at 1-year follow-up.
Tidsramme: 1 year
|
To correlate the echocardiographic aortic valve calcium score with hospitalization for heart failure at 1-year follow-up.
|
1 year
|
|
Correlation of the echocardiographic aortic valve calcium score with major adverse cardiovascular events (cardiovascular death and hospitalization for heart failure) at 1-year follow-up.
Tidsramme: 1 year
|
To correlate the echocardiographic aortic valve calcium score with major adverse cardiovascular events (cardiovascular death and hospitalization for heart failure) at 1-year follow-up.
|
1 year
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
1. marts 2026
Primær færdiggørelse (Anslået)
31. december 2026
Studieafslutning (Anslået)
31. december 2027
Datoer for studieregistrering
Først indsendt
27. maj 2026
Først indsendt, der opfyldte QC-kriterier
27. maj 2026
Først opslået (Faktiske)
2. juni 2026
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
4. juni 2026
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
3. juni 2026
Sidst verificeret
1. maj 2026
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Aortaklapsygdom
- Hjerte-kar-sygdomme
- Hjertesygdomme
- Hjerteklapsygdomme
- Ventrikulær udstrømningsobstruktion
- Aortaklapstenose
- Aortaklap, Forkalkning af
- Diagnostiske teknikker og procedurer
- Diagnose
- Diagnostisk billeddannelse
- Diagnostiske teknikker, kardiovaskulær
- Hjertefunktionstest
- Hjertebillede -teknikker
- Ultrasonografi
- Ekkokardiografi
Andre undersøgelses-id-numre
- 0335/2026
Plan for individuelle deltagerdata (IPD)
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