[64Cu]FBP8 PET for Early Detection of Intracardiac Thrombus in Amyloid Cardiomyopathy
The primary goal of this pilot study is to determine whether [64Cu]FBP8, a novel fibrin-binding positron emission tomography (PET) probe, can identify intracardiac thrombi when paired with simultaneous hybrid cardiac PET/MRI in twenty (20) individuals with transthyretin or light chain cardiac amyloidosis and atrial fibrillation (AF) or atrial flutter (AF).
The primary hypothesis of this study is that [64Cu]FBP8 PET/MRI can identify intracardiac thrombi in >90% of subjects with confirmed intracardiac thrombi based on transesophageal echocardiogram (TEE). In secondary analyses, the investigators will seek to determine associations between intracardiac thrombi and left atrial function and left ventricular amyloid burden.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
[64Cu]FBP8 is a novel copper-64 labeled molecular imaging probe that selectively binds to fibrin, the main constituent of human thrombi. In animal models, [64Cu]FBP8 has been shown to effectively detect pulmonary emboli, deep venous thromboses, and intracardiac thrombi. In a first-in-human study, [64Cu]FBP8 paired with simultaneous cardiac positron emission tomography (PET) and magnetic resonance imaging (MRI) accurately detected intracardiac thrombi (specifically, left atrial appendage [LAA] thrombi) in patients with atrial fibrillation (AF) with an accuracy of >90% using transesophageal echocardiogram (TEE) as the reference standard. The investigators propose to study the value of [64Cu]FBP8 PET/MRI to detect intracardiac thrombi in patients with cardiac amyloidosis.
This pilot study is designed to assess the value of [64Cu]FBP8 PET/MRI to detect intracardiac thrombi in twenty (20) patients with cardiac amyloidosis and atrial fibrillation (AF) or atrial flutter (AFL) compared to TEE. The primary hypothesis is that [64Cu]FBP8 PET/MRI can identify intracardiac thrombi in >90% of subjects with confirmed intracardiac thrombi based on TEE. In secondary analyses, the investigators will seek to determine associations between intracardiac thrombi and left atrial function and left ventricular amyloid burden.
Type d'étude
Inscription (Estimé)
Phase
- Phase 3
Contacts et emplacements
Coordonnées de l'étude
- Nom: Vicente Morales Oyarvide, MD, MPH
- Numéro de téléphone: 6172335860
- E-mail: vmorales-oyarvide@bwh.harvard.edu
Sauvegarde des contacts de l'étude
- Nom: Sharmila Dorbala, MD, MPH
- Numéro de téléphone: 617-732-6290
- E-mail: sdorbala@bwh.harvard.edu
Lieux d'étude
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Massachusetts
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Boston, Massachusetts, États-Unis, 02115
- Recrutement
- Brigham and Women's Hospital
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Contact:
- Vicente Morales Oyarvide, MD, MPH
- Numéro de téléphone: 6172335860
- E-mail: vmorales-oyarvide@bwh.harvard.edu
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Contact:
- Sharmila Dorbala, MD, MPH
- Numéro de téléphone: 617-732-6290
- E-mail: sdorbala@bwh.harvard.edu
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Chercheur principal:
- Sharmila Dorbala, MD, MPH
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Sous-enquêteur:
- Vicente Morales Oyarvide, MD, MPH
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Sous-enquêteur:
- Ciprian Catana, MD
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Have the ability to give written informed consent;
- History of amyloid cardiomyopathy (ATTR-CM or AL-CM);
- History of AF or AFL;
- Retrospective enrollment: TEE to evaluate LAA within the previous 14 days, provided the anticoagulation regimen the patient is on is not changed after the TEE. If a patient has a negative TEE and continues the same stable anticoagulation regimen, then it is unlikely that a new thrombus will develop in the LAA within the next 14 days. Likewise, if a patient not taking any anticoagulation has a thrombus in the LAA, then it is unlikely that this thrombus will resolve spontaneously in the next 14 days if the patient remains off anticoagulation. If the TEE leads to a change being made in the anticoagulation regimen (started/stopped/dose modified), then a time window of 72 hours from the TEE to PET/MR imaging will be used. This scheme will ensure that the TEE can serve as an accurate gold standard;
- Prospective: TEE to evaluate LAA thrombus scheduled in upcoming 14 days;
Exclusion Criteria:
- Electrical implants such as cardiac pacemaker/defibrillator, perfusion pump, direct brain stimulator;
- Pregnancy or breastfeeding (a negative quantitative serum or urine hCG pregnancy test is required for females having child-bearing potential before the subject can participate);
- Claustrophobia;
- Subjects will be excluded if research-related radiation exposure exceeds current Radiology Department guidelines (i.e. 50 mSv in the prior 12 months);
- Unable to lie comfortably on a bed inside the PET/MR scanner;
- Subjects under direct or indirect (i.e., same department as PIs) supervision of the principal investigator;
- Body weight over the weight limit for the moving table (> 300 lbs for the MR table);
- Metallic or electric implants contraindicated for PET/MR scanning;
- Stroke, myocardial infarction, cardiac or major surgery within the last 3 months;
- History of LAA ligation/exclusion or presence of a LAA occlusion device;
- History of syncope within the last 6 weeks;
- Heart rate persistently >120 bpm or persistently <50 bpm;
- Daytime pauses >3 seconds;
- Lack of a prior transthoracic echocardiogram within the previous 6 months;
- Does not have the ability to give written informed consent;
- Determined by the investigator(s) to be clinically unsuitable for the study (e.g., based on screening visit and/or during study procedures);
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Diagnostique
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Autre: [64Cu]FBP8 PET/MR Cardiac Amyloid and Atrial Fibrillation/Atrial Flutter Subjects
Individuals with documented cardiac amyloidosis and atrial fibrillation/atrial flutter will undergo [64Cu]FBP8 PET/MR.
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Simultaneous cardiac PET/MR images will be obtained following injection of [64Cu]FBP8.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Intracardiac Thrombus
Délai: 1 day
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Presence or absence of intracardiac thrombus based on [64Cu]FBP8 PET/MR imaging, as determined by standardized uptake values (SUV), and transesophageal echocardiogram
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1 day
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Collaborateurs et enquêteurs
Parrainer
Publications et liens utiles
Publications générales
- Izquierdo-Garcia D, Desogere P, Philip AL, Mekkaoui C, Weiner RB, Catalano OA, Iris Chen YC, DeFaria Yeh D, Mansour M, Catana C, Caravan P, Sosnovik DE. Detection and Characterization of Thrombosis in Humans Using Fibrin-Targeted Positron Emission Tomography and Magnetic Resonance. JACC Cardiovasc Imaging. 2022 Mar;15(3):504-515. doi: 10.1016/j.jcmg.2021.08.009. Epub 2021 Oct 13.
- Vilches S, Fontana M, Gonzalez-Lopez E, Mitrani L, Saturi G, Renju M, Griffin JM, Caponetti A, Gnanasampanthan S, De Los Santos J, Gagliardi C, Rivas A, Dominguez F, Longhi S, Rapezzi C, Maurer MS, Gillmore J, Garcia-Pavia P. Systemic embolism in amyloid transthyretin cardiomyopathy. Eur J Heart Fail. 2022 Aug;24(8):1387-1396. doi: 10.1002/ejhf.2566. Epub 2022 Jul 11.
- Donnellan E, Hussain M, Marrouche N, Park M, Martin M, Hanna M, Wazni O, Collier P, Jaber W. Left Atrial Strain May Predict Thrombus Formation in Patients With Transthyretin Cardiac Amyloidosis. JACC Clin Electrophysiol. 2023 Aug;9(8 Pt 1):1418-1420. doi: 10.1016/j.jacep.2023.03.013. Epub 2023 May 24. No abstract available.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
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
Termes MeSH pertinents supplémentaires
- Maladies du système nerveux
- Maladies vasculaires
- Maladies cardiovasculaires
- Processus pathologiques
- Maladies neuromusculaires
- Métabolisme, erreurs innées
- Maladies génétiques, innées
- Maladies métaboliques
- Maladies du système nerveux périphérique
- Maladies neurodégénératives
- Embolie et thrombose
- Troubles hérédodégénératifs, système nerveux
- Déficits de protéostase
- Neuropathies amyloïdes
- Amylose familiale
- Maladies et anomalies congénitales, héréditaires et néonatales
- Conditions pathologiques, signes et symptômes
- Maladies nutritionnelles et métaboliques
- Thrombose
- Maladie
- Amylose
- Neuropathies amyloïdes, familiales
Autres numéros d'identification d'étude
- 2025P003091
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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