Screening for Amyloidosis Before Aortic Valve Elective Replacement

NCT ID: NCT04869631

Last Updated: 2025-02-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-02-01

Study Completion Date

2028-03-31

Brief Summary

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Previous studies detected that up to 15% of patients undergoing aortic valve replacement (AVR) for degenerative aortic stenosis have concomitant transthyretin amyloidosis (ATTR) cardiomyopathy (Castano, 2017). The aim of this study is to investigate the effectivity and practicability of a systematic ATTR-Screening in patients undergoing planned AVR. Moreover, we plan to develop a screening algorithm to detect ATTR in aortic stenosis (AS).

Detailed Description

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Untreated cardiac amyloidosis is accompanied with an impaired prognosis. Amyloidosis is often associated with ventricular hypertrophy which leads to severe heart failure and occurs frequently in conjunction with bradycardic or tachycardic malignant arrhythmia. Patients with degenerative aortic valve stenosis suffer more frequently from cardiac ATTR. However, it remains unclear whether the development of aortic stenosis is promoted by ATTR. Due to very similar symptoms (shortness of breath during physical exertion, reduced walking distance) diagnosis of aortic valve stenosis is more often diagnosed in a typical cohort of patients aged between 70-80 years but, in contrast, leads to underdiagnosis of patients with additional cardiac amyloidosis. Six to fifteen percent of patients with aortic valve replacement due to degenerative aortic valve stenosis exhibit a cardiac amyloidosis. Since cardiac amyloidosis without therapeutic intervention is associated with significantly reduced life expectancy, it can be assumed that these patients will not benefit to the same extent from the AVR alone as patients without ATTR. New therapeutic approaches for patients exhibiting ATTR lead to a reduction of mortality and hospitalizations. The primary aim of this study is to establish a simple ATTR screening tool in patients with planned AVR in the clinical routine and, furthermore, to compare the clinical course following AVR between patients with and without ATTR.

Conditions

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Amyloidosis Aortic Valve Stenosis

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Aortic valve stenosis undergoing aortic valve replacement

Aortic valve stenosis undergoing aortic valve replacement.

The outcome of an intervention is not evaluated, but aortic stenosis and additional amyloidosis are compared.

Intervention Type OTHER

We aim to compare patients with aortic valve stenosis with and without cardiac amyloidosis.

Interventions

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The outcome of an intervention is not evaluated, but aortic stenosis and additional amyloidosis are compared.

We aim to compare patients with aortic valve stenosis with and without cardiac amyloidosis.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* age ≥40 years
* written informed consent from the patient or of his/her legal guardian
* hospitalization for AVR due to degenerative aortic valve stenosis

Exclusion Criteria

* hemodynamically unstable patient
* severe co-morbidities with an estimated life expectancy of \<1 year
Minimum Eligible Age

40 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Deutsches Herzzentrum Berlin, Klinik für Innere Medizin - Kardiologie

UNKNOWN

Sponsor Role collaborator

Klinik für Neurologie mit Experimenteller Neurologie, Charité - Universitätsmedizin Berlin

UNKNOWN

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role lead

Responsible Party

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Isabel Mattig

Project lead

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Charité - Universitätsmedizin Berlin

Berlin, , Germany

Site Status

Countries

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Germany

References

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Maurer MS, Schwartz JH, Gundapaneni B, Elliott PM, Merlini G, Waddington-Cruz M, Kristen AV, Grogan M, Witteles R, Damy T, Drachman BM, Shah SJ, Hanna M, Judge DP, Barsdorf AI, Huber P, Patterson TA, Riley S, Schumacher J, Stewart M, Sultan MB, Rapezzi C; ATTR-ACT Study Investigators. Tafamidis Treatment for Patients with Transthyretin Amyloid Cardiomyopathy. N Engl J Med. 2018 Sep 13;379(11):1007-1016. doi: 10.1056/NEJMoa1805689. Epub 2018 Aug 27.

Reference Type BACKGROUND
PMID: 30145929 (View on PubMed)

Kerr D. Lin zhong guan huai: terminal care in China. Am J Hosp Palliat Care. 1993 Jul-Aug;10(4):18-26. doi: 10.1177/104990919301000407. No abstract available.

Reference Type BACKGROUND
PMID: 7687139 (View on PubMed)

Amramy A. Waste treatment for ground water recharge. Air Water Pollut. 1965 Oct;9(10):605-19. No abstract available.

Reference Type BACKGROUND
PMID: 5837725 (View on PubMed)

Related Links

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https://amyloidosis-center.charite.de/

Amyloidosis center of the Charité

Other Identifiers

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EA4/235/20

Identifier Type: -

Identifier Source: org_study_id

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