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- Essai clinique NCT04914481
Anatomic Stenosis Severity as a Prognostic Marker in Patients With Low-Flow Low-Gradient Aortic Stenosis Undergoing TAVI (ATLAS TAVI)
AnaTomic Stenosis Severity Derived From Computed Tomography as a Prognostic Marker in Patients With Low-flow Low-gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Aortic valve calcification (AVC) as assessed by MSCT is highly correlated with aortic stenosis (AS) severity and, thus, has become an important tool for diagnosing severe AS, especially in patients with low-flow low-gradient aortic stenosis (LFLG AS). Moreover, in medically treated AS patients AVC is directly associated with poor prognosis. In contrast, the prognostic benefit of eliminating AS by Transcatheter Aortic Valve Implantation (TAVI) in patients with LFLG AS seems to be larger in patients with high AVC density (AVCd) compared to those with low AVCd, at least in "classical" (low EF) LFLG AS. Hence, we hypothesize that AVCd might be a valuable marker for treatment response among TAVI patients with LFLG AS, who are known to suffer from poor outcome even after elimination of AS.
The multicentric ATLAS TAVI Registry of LFLG AS patients, who underwent TAVI, assesses the impact of AVCd on outcome in these patients.
Type d'étude
Inscription (Anticipé)
Contacts et emplacements
Coordonnées de l'étude
- Nom: Niklas Schofer, MD
- Numéro de téléphone: +49-40-7410-0
- E-mail: n.schofer@uke.de
Lieux d'étude
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Bad Nauheim, Allemagne
- Recrutement
- Kerckhoff-Klinik
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Contact:
- Won K Kim, MD
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Hamburg, Allemagne
- Recrutement
- University Heart and Vascular Center Hamburg
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Leipzig, Allemagne
- Recrutement
- Heart Center Leipzig
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Contact:
- Mohamed Abdel-Wahab, MD
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Montréal, Canada
- Recrutement
- Montreal Heart Institute
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Contact:
- Walid Ben Ali, MD
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Québec, Canada
- Recrutement
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval
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Contact:
- Marie-Annick Clavel, PhD
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Odense, Danemark
- Recrutement
- Odense University Hospital
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Contact:
- Jordi Dahl, MD
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Lille, France
- Recrutement
- CHU de Lille
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Contact:
- Augustin Coisne, MD
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Paris, France
- Recrutement
- Hôpital Bichat - Claude-Bernard
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Contact:
- Marina Urena Alcazar, MD
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Petah Tikva, Israël
- Recrutement
- Rabin Medical Center
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Contact:
- Uri Landes, MD
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Rotterdam, Pays-Bas
- Recrutement
- Erasmus University Medical Centre
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Contact:
- Nicolas van Mieghem, MD
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Edinburgh, Royaume-Uni
- Recrutement
- University of Edinburgh
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Contact:
- Mark Dweck, MD
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- age ≥18 years
- patient gave written informed consent for data acquisition and transfer
- for LFLG AS: -- available non-contrast MSCT data on aortic valve calcification (AVC, Agatston Units)
Exclusion Criteria:
- LFLG AS without non-contrast MSCT data on AVC
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
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Classical Low-Flow, Low-Gradient Aortic Stenosis
Classical Low-Flow, Low-Gradient Aortic Stenosis is defined as valve area <1 cm2, mean gradient <40 mmHg, ejection fraction <50% and stroke volume index (SVi) ≤35 mL/m2 by resting transthoracic echocardiography.
Dobutamine stress echocardiography is not mandatory for the definition of classical LFLG AS.
All patients in this subgroup underwent TAVI and have available data on aortic valve calcification.
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Paradoxical Low-Flow, Low-Gradient Aortic Stenosis
Paradoxical Low-Flow, Low-Gradient Aortic Stenosis is defined as valve area <1 cm2, mean gradient <40 mmHg, ejection fraction ≥50% and SVi ≤35 mL/m2 by resting transthoracic echocardiography.
All patients in this subgroup underwent TAVI and have available data on aortic valve calcification.
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High-Gradient Aortic Stenosis (Control group)
High-Gradient Aortic Stenosis is defined as valve area <1 cm2 and mean gradient >40 mmHg by resting transthoracic echocardiography.
All patients in this subgroup underwent TAVI.
Data on aortic valve calcification is not mandatory for this control group.
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Conservative treatment (Control group)
The subgroup includes all patients with (severe or non-severe) aortic stenosis, who underwent conservative treatment.
Data on aortic valve calcification is not mandatory for this control group.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
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Mortalité toutes causes confondues
Délai: 12 mois
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12 mois
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Cardiovascular Mortality
Délai: 12 months
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Incidence of cardiovascular death, defined as death attributable to myocardial ischemia and infarction, heart failure, cardiac arrest because of other or unknown cause, or cerebrovascular accident.
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12 months
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Rehospitalizations for congestive heart failure
Délai: 12 months
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Incidence of new-onset or worsening signs and symptoms of heart failure that required urgent therapy and resulted in hospitalization, e.g. as assessed by patient interviews or hospital records.
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12 months
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Marie-Annick Clavel, PhD, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
- Chercheur principal: Niklas Schofer, MD, University Heart and Vascular Center Hamburg, Hamburg, Germany
- Chercheur principal: Sebastian Ludwig, MD, University Heart and Vascular Center Hamburg, Hamburg, Germany
Publications et liens utiles
Publications générales
- Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Munoz D, Rosenhek R, Sjogren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791. doi: 10.1093/eurheartj/ehx391. No abstract available.
- Cueff C, Serfaty JM, Cimadevilla C, Laissy JP, Himbert D, Tubach F, Duval X, Iung B, Enriquez-Sarano M, Vahanian A, Messika-Zeitoun D. Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction. Heart. 2011 May;97(9):721-6. doi: 10.1136/hrt.2010.198853. Epub 2010 Aug 18.
- Clavel MA, Messika-Zeitoun D, Pibarot P, Aggarwal SR, Malouf J, Araoz PA, Michelena HI, Cueff C, Larose E, Capoulade R, Vahanian A, Enriquez-Sarano M. The complex nature of discordant severe calcified aortic valve disease grading: new insights from combined Doppler echocardiographic and computed tomographic study. J Am Coll Cardiol. 2013 Dec 17;62(24):2329-38. doi: 10.1016/j.jacc.2013.08.1621. Epub 2013 Sep 24.
- Clavel MA, Pibarot P, Messika-Zeitoun D, Capoulade R, Malouf J, Aggarval S, Araoz PA, Michelena HI, Cueff C, Larose E, Miller JD, Vahanian A, Enriquez-Sarano M. Impact of aortic valve calcification, as measured by MDCT, on survival in patients with aortic stenosis: results of an international registry study. J Am Coll Cardiol. 2014 Sep 23;64(12):1202-13. doi: 10.1016/j.jacc.2014.05.066.
- Ludwig S, Gossling A, Waldschmidt L, Linder M, Bhadra OD, Voigtlander L, Schafer A, Deuschl F, Schirmer J, Reichenspurner H, Blankenberg S, Schafer U, Westermann D, Seiffert M, Conradi L, Schofer N. TAVR for low-flow, low-gradient aortic stenosis: Prognostic impact of aortic valve calcification. Am Heart J. 2020 Jul;225:138-148. doi: 10.1016/j.ahj.2020.03.013. Epub 2020 Apr 8.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- ATLAS TAVI
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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