- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07734285
Detection of Cardiac Amyloidosis Using Right Ventricular Sensing Amplitude in Patients With Left Ventricular Hypertrophy (DETECT-AMY)
Diagnostic Performance of Right Ventricular Sensing Amplitude and Other Electrophysiological,Echographic, and Histological Parameters in Cardiac Amyloidosis Among Patients With Left Ventricular Hypertrophy: a Multicenter Prospective Study
This multicenter prospective study aims to evaluate the diagnostic performance of right ventricular sensing amplitude measured during cardiac implantable electronic device (CIED) implantation (pacemaker or defibrillator) to identify cardiac amyloidosis in patients with left ventricular hypertrophy and conduction abnormalities.
Patients aged 65 years or older referred for CIED implantation will be included. During the procedure, electrophysiological parameters will be recorded.
Additional assessments will be performed, including cardiac scintigraphy, biological analyses, and subcutaneous adipose tissue biopsy. The results of these investigations will be used to confirm or rule out cardiac amyloidosis.
Diagnostic performance will be assessed using the area under the receiver operating characteristic curve (AUROC).
Aperçu de l'étude
Statut
Intervention / Traitement
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Samia BALOUL
- Numéro de téléphone: 0149 81 33 85
- E-mail: samia.baloul@aphp.fr
Sauvegarde des contacts de l'étude
- Nom: Philippe Le Corvoisier, MD, PhD
- Numéro de téléphone: 01 49 81 37 96
- E-mail: philippe.lecorvoisier@aphp.fr
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Patient referred for CIED implantation (pacemaker or Implantable Cardioverter Defibrillator with a pacemaker feature) due to at least one conduction abnormality (Atrioventricular block, Sinoatrial block or Atrial fibrillation with slow ventricular rate). Patients referred for implantation of an Implantable Cardioverter Defibrillator with a pacemaker feature can be included if they present one of these conduction abnormalities.
- Left ventricular hypertrophy definite as maximal end-diastolic interventricular septum thickness ≥ 12mm
- Patients aged ≥ 65 years
- Written consent
- Patient affiliated to a social security
Exclusion Criteria:
- Severe aortic stenosis (valve area ≤ 1 cm2)
- Known cardiac amyloidosis
- Indication for cardiac resynchronisation therapy
- Indication for left bundle branch physiological pacing
- Ejection fraction < 45% on echocardiography.
- Participation in another interventional study involving human participants or being in the exclusion period at the end of a previous study involving human participants.
- Patient on AME (state medical aid)
- Adults subject to a legal protection measure (guardianship, curatorship, or safeguard of justice).
- Patients deprived of their liberty by a judicial or administrative decision.
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 |
|---|---|
|
Autre: Diagnostic Assessment During CIED Implantation
Single Group
|
Procedure of CIED implantation will not be modified by inclusion in the study. However, several exams will be performed to confirm or ruled out the diagnosis of cardiac amyloidosis: During the procedure: Subcutaneous adipose tissue sampling Collection of a subcutaneous adipose tissue sample during device implantation for histological analysis to detect amyloid deposits. Blood sampling for serum free light chain assay, serum and urine electrophoresis with immunofixation (baseline visit) Diagnostic Test: 99mTc-DPD or HMDP Scintigraphy Cardiac scintigraphy performed within 3 months after implantation to assess myocardial tracer uptake and detect cardiac amyloidosis. |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Area under the receiver operating characteristic curve (AUROC) of the right ventricular sensing amplitude for the identification of patients with cardiac amyloidosis
Délai: During CIED implantation
|
The area under the receiver operating characteristic curve (AUROC) of the right ventricular sensing amplitude, measured during CIED implantation in patients with conduction abnormalities, for the identification of patients with cardiac amyloidosis.
|
During CIED implantation
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Diagnostic performance of right atrial sensing amplitude for diagnostic of cardiac amyloidosis
Délai: During hospitalization for CEID implantation (Day 0)
|
The area under the receiver operating characteristic curve (AUROC) and sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of right atrial sensing amplitude, atrial and ventricular pacing thresholds estimated during CIED implantation for identifying patients with cardiac amyloidosis.
|
During hospitalization for CEID implantation (Day 0)
|
|
Diagnostic performance of atrial pacing thresholds for diagnostic of cardiac amyloidosis
Délai: During hospitalization for CEID implantation (Day 0)
|
The area under the receiver operating characteristic curve (AUROC) and sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of right atrial sensing amplitude, atrial and ventricular pacing thresholds estimated during CIED implantation for identifying patients with cardiac amyloidosis.
|
During hospitalization for CEID implantation (Day 0)
|
|
Diagnostic performance of ventricular pacing thresholds for diagnostic of cardiac amyloidosis
Délai: During hospitalization for CEID implantation (Day 0)
|
The area under the receiver operating characteristic curve (AUROC) and sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of right atrial sensing amplitude, atrial and ventricular pacing thresholds estimated during CIED implantation for identifying patients with cardiac amyloidosis.
|
During hospitalization for CEID implantation (Day 0)
|
|
Diagnostic performance of maximal end-diastolic interventricular septal thickness
Délai: During hospitalization for CEID implantation (Day 0)
|
The area under the receiver operating characteristic curve (AUROC) and sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of maximal end-diastolic interventricular septum thickness at echocardiography for identifying patients with cardiac amyloidosis.
|
During hospitalization for CEID implantation (Day 0)
|
|
Diagnostic performance of adipose tissue histology
Délai: During hospitalization for CEID implantation (Day-0)
|
The area under the receiver operating characteristic curve (AUROC) and sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of histological analysis of adipose tissue for identifying patients with cardiac amyloidosis.
|
During hospitalization for CEID implantation (Day-0)
|
|
Diagnostic performance of right atrial and ventricular sensing amplitudes and pacing thresholds
Délai: 6 months after CIED implantation (Day 0)
|
The area under the receiver operating characteristic curve (AUROC) and sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of 12-lead electrocardiogram data (low voltage in limb leads) for identifying patients with cardiac amyloidosis.
|
6 months after CIED implantation (Day 0)
|
|
The implantation procedure duration (min) between patients with or without cardiac amyloidosis
Délai: During CIED implantation
|
During CIED implantation
|
|
|
The prevalence of cardiac amyloidosis in the study population
Délai: Up to 3 months after CIED implantation
|
Up to 3 months after CIED implantation
|
|
|
The proportion of modifications in the treatment at the 6-month visit.
Délai: 6 months after CIED implantation
|
6 months after CIED implantation
|
|
|
Change in RAND 36-Item Health Survey (SF-36) score
Délai: Inclusion and 6 months after CIED implantation
|
Change in health-related quality of life between inclusion and the 6-month visit, assessed using the RAND 36-Item Health Survey, Version 1.0 (SF-36).
The questionnaire comprises 36 items grouped into 8 domains.
Each domain score ranges from 0 to 100, with higher scores indicating better health-related quality of life.
|
Inclusion and 6 months after CIED implantation
|
|
Change in New York Heart Association (NYHA) Functional Classification
Délai: Inclusion and 6 months after CIED implantation
|
Change in New York Heart Association (NYHA) Functional Classification between baseline and the 6-month visit in patients with and without cardiac amyloidosis.
The NYHA Functional Classification ranges from Class I to Class IV, with higher class indicating worse functional status.
|
Inclusion and 6 months after CIED implantation
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Philippe Le Corvoisier, MD, PhD, Assistance public Hôpitaux de Paris
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
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 cardiovasculaires
- Conditions pathologiques, anatomiques
- Maladies cardiaques
- Maladies neuromusculaires
- Métabolisme, erreurs innées
- Maladies génétiques, innées
- Maladies métaboliques
- Maladies du système nerveux périphérique
- Maladies neurodégénératives
- Troubles hérédodégénératifs, système nerveux
- Déficits de protéostase
- Cardiomégalie
- Neuropathies amyloïdes
- Amylose familiale
- Hypertrophie
- Amylose
- Maladies et anomalies congénitales, héréditaires et néonatales
- Conditions pathologiques, signes et symptômes
- Maladies nutritionnelles et métaboliques
- Hypertrophie ventriculaire gauche
- Neuropathies amyloïdes, familiales
Autres numéros d'identification d'étude
- APHP240915
Informations sur les médicaments et les dispositifs, documents d'étude
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