Quantification of Myocardial Fibrosis in Aortis Stenosis

NCT ID: NCT06571175

Last Updated: 2025-08-07

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

ENROLLING_BY_INVITATION

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-01-21

Study Completion Date

2026-04-15

Brief Summary

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This study is a long term follow-up of patients that were included as part of a previous study (NCT03422770), where patients with aortic stenosis and healthy controls went through echocardiography, cardiac MRI, long-term ECG-recording, blood tests and quality of life assessment. Echocardiography included high frame ultrasound for detection of natural mechanical waves, and the measured speed of these waves were used as a marker of the extent of myocardial fibrosis.

Up to five years have now passed since inclusion at baseline, and a proportion of the patients in the cohort have undergone aortic valve replacement at some point. In this study, the investigators will repeat the cardiac imaging (echocardiography and cardiac MRI), ECG and blood test, to assess long-term changes in myocardial fibrosis in aortic stenosis patients.

Detailed Description

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High frame rate ultrasound with quantification of myocardial mechanical wave velocities provides a new approach to evaluation of myocardial stiffness.

Principle: An elastic medium (the left ventricle) is incited by a force (naturally occuring mechanical wave generated by atrial contraction and/or closure of mitral and aortic valve), and the resulting oscillation wave propagates through the medium with a speed that depends only on the density and stiffness of the medium. If the density of the medium is known, measuring the propagation velocity of the wave is the same as measuring the stiffness of the medium.

There is a lack of longitudinal data in this research area. A follow-up study of the described cohort, will add valuable insight into high frame rate ultrasound as a potential tool to quantify myocardial fibrosis in heart failure patient, and to monitor any changes from baseline.

Conditions

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Aortic Valve Stenosis Myocardial Fibrosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Aortic stenosis

Mild aortic stenosis:25 patients were included at baseline, and those that still avoid exclusion criteria, will be invited to undergo repeat echocardiography, MRI, blood test, questionnaires, 6 min walking test, ECG and Holter-ECG.

Moderate aortic stenosis: 25 patients were included at baseline, and those that still avoid exclusion criteria, will be invited to undergo repeat echocardiography, MRI, blood test, questionnaires, 6 min walking test, ECG and Holter-ECG.

Severe aortic stenosis: 50 patients were included at baseline, and those that still avoid exclusion criteria, will be invited to undergo repeat echocardiography, MRI, blood test, questionnaires, 6 min walking test, ECG and Holter-ECG.

High frame rate echocardiography

Intervention Type DIAGNOSTIC_TEST

Conventional transthoracic echocardiography will be performed, with added 3D-imaging and acquisitions with high frame rate. The data from these patients will be anonymized and transferred for post-hoc analysis in dedicated computer software (GE Vingmed, EchoPac 2.6) and in validated machine learning algorithms.

MRI

Intervention Type DIAGNOSTIC_TEST

Cardiac MRI will be performed. In all patients without contraindications, a gadolinium-based contrast agent will be given.

Blood test

Intervention Type DIAGNOSTIC_TEST

Conventional brachial venous blood samples will be drawn. Hematocrit value {in %} will be used to calculate CMR-derived exttracellular volume (ECV)

ECG and Holter-ECG

Intervention Type DIAGNOSTIC_TEST

ECG/Holter-ECG will be performed, and the findings will be related to the imaging findings.

6 min walking test

Intervention Type DIAGNOSTIC_TEST

6 MWT will be performed, and the findings will be related to findings from CMRI/echocardiography.

Controls

The controls from baseline inclusion will be invited to undergo repeat echocardiography, blood test and CMRI

High frame rate echocardiography

Intervention Type DIAGNOSTIC_TEST

Conventional transthoracic echocardiography will be performed, with added 3D-imaging and acquisitions with high frame rate. The data from these patients will be anonymized and transferred for post-hoc analysis in dedicated computer software (GE Vingmed, EchoPac 2.6) and in validated machine learning algorithms.

MRI

Intervention Type DIAGNOSTIC_TEST

Cardiac MRI will be performed. In all patients without contraindications, a gadolinium-based contrast agent will be given.

Blood test

Intervention Type DIAGNOSTIC_TEST

Conventional brachial venous blood samples will be drawn. Hematocrit value {in %} will be used to calculate CMR-derived exttracellular volume (ECV)

Interventions

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High frame rate echocardiography

Conventional transthoracic echocardiography will be performed, with added 3D-imaging and acquisitions with high frame rate. The data from these patients will be anonymized and transferred for post-hoc analysis in dedicated computer software (GE Vingmed, EchoPac 2.6) and in validated machine learning algorithms.

Intervention Type DIAGNOSTIC_TEST

MRI

Cardiac MRI will be performed. In all patients without contraindications, a gadolinium-based contrast agent will be given.

Intervention Type DIAGNOSTIC_TEST

Blood test

Conventional brachial venous blood samples will be drawn. Hematocrit value {in %} will be used to calculate CMR-derived exttracellular volume (ECV)

Intervention Type DIAGNOSTIC_TEST

ECG and Holter-ECG

ECG/Holter-ECG will be performed, and the findings will be related to the imaging findings.

Intervention Type DIAGNOSTIC_TEST

6 min walking test

6 MWT will be performed, and the findings will be related to findings from CMRI/echocardiography.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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GE Vingmed ultrasound scanner E95, 2017 Cardiac magnetic resonance imaging (CMRI)

Eligibility Criteria

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Inclusion Criteria

* Part of the initial cohort that were included in the baseline study
* Still able to undergo protocolled investigations
* Patients: Mild, moderate or severe AS

Exclusion Criteria

* Renal insufficiency
* Previously myocardial infarction (ECG, echocardiogram or hospital record)
* Severe valvular heart disease (except patients)
* Other cardiac disease known to cause myocardial fibrosis
* Severe hypertension
* Other medical conditions deterring protocolled investigation and follow-up
* Other medical conditions affecting 5-years prognosis (cancer, pulmonary disease)
* Severely reduced image-quality (echocardiography and MRI)
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Olavs Hospital

OTHER

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role collaborator

Norwegian University of Science and Technology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brage H: Amundsen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Norwegian University of Science and Technology (NTNU)

Locations

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St. Olavs Hosptial

Trondheim, Trøndelag, Norway

Site Status

Countries

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Norway

References

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Salles S, Espeland T, Molares A, Aase SA, Hammer TA, Stoylen A, Aakhus S, Lovstakken L, Torp H. 3D Myocardial Mechanical Wave Measurements: Toward In Vivo 3D Myocardial Elasticity Mapping. JACC Cardiovasc Imaging. 2021 Aug;14(8):1495-1505. doi: 10.1016/j.jcmg.2020.05.037. Epub 2020 Aug 26.

Reference Type BACKGROUND
PMID: 32861651 (View on PubMed)

M. Mohajery, S. Salles, T. Espeland, S. Fadnes and L. Lovstakken,

Reference Type BACKGROUND

Espeland T, Wigen MS, Dalen H, Berg EAR, Hammer TA, Salles S, Lovstakken L, Amundsen BH, Aakhus S. Mechanical Wave Velocities in Left Ventricular Walls in Healthy Subjects and Patients With Aortic Stenosis. JACC Cardiovasc Imaging. 2024 Feb;17(2):111-124. doi: 10.1016/j.jcmg.2023.07.009. Epub 2023 Sep 6.

Reference Type RESULT
PMID: 37676209 (View on PubMed)

Other Identifiers

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527717

Identifier Type: -

Identifier Source: org_study_id

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