PRIMARY Ancillary Substudy

NCT ID: NCT07103733

Last Updated: 2025-08-19

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-16

Study Completion Date

2027-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The PRIMARY trial (NCT05051033), which compares mitral valve repair (MVr) to transcatheter-edge-to-edge-repair (TEER), offers a platform for conducting mechanistic studies to develop early insights into the pathophysiological processes by which mitral valve prolapse (MVP) can impact left ventricular (LV) myocardial structure and function, and, thereby, predispose to arrhythmias and sudden death. Such insights are key to identifying interventions to reduce the long-term sequelae of heart failure (HF) and arrhythmias, as well as delineate optimal therapeutic approaches for different patient sub-groups.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This is an ancillary study of a multicenter randomized clinical trial comparing MVr to TEER for degenerative mitral regurgitation (MR) involving up to 250 patients from the parent trial. All patients will receive rhythm monitoring, up to 200 patients will receive pre/post intervention CMR, all patients in the parent trial will undergo a transthoracic echocardiogram (TTE) (as part of the randomized controlled trial (RCT)), and 60 surgical patients will undergo tissue biopsies. The study is being conducted in highly experienced clinical centers in the U.S., Canada, Germany, the U.K. and Spain. The estimated enrollment period is 12-18 months. Outcomes will be measured from baseline to 12 months after randomization.

This mechanistic ancillary study has the following aims:

1. To compare the impact of MVr and TEER on disordered ventricular biomechanics and myocardial fibrosis that predispose to ventricular arrhythmias, using speckle tracking strain echocardiography, cardiac magnetic resonance imaging (CMR), and rhythm monitoring pre- and post-mitral valve (MV) intervention. The research team hypothesize's that a treatment strategy that more effectively and durably reduces MVP and MR will lead to improved ventricular mechanics, limit progression of myocardial fibrosis and decrease the burden of ventricular arrhythmias and HF.
2. To compare the impact of MVr and TEER on recurrent/residual MR, LV and left atrial (LA) reverse remodeling with baseline and 1-year post-intervention CMR, and to use quantitative CMR myocardial tissue phenotyping as a predictor of response to MVr and TEER.
3. To construct functional pre-operative CMR fingerprints that recapitulate the mechanical state of the heart to develop individualized computational models, which will be altered in silico based on the proposed treatment plan, to predict patients' response to therapy. These results will be validated against post-operative outcome data to test the validity of this approach for predicting treatment response.
4. To explore the relationships among gene products, structural variables, and post-operative clinical outcomes, including reverse remodeling, using tissue obtained at surgery from ventricular myocardium.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Mitral Valve Prolapse Left Ventricular Fibrosis Ventricular Arrhythmias

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators
The PRIMARY trial is an open-label trial. As in the parent trial, clinical investigators, and coordinators, however, will be blinded to all overall outcome data in the ancillary study.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Mitral valve repair

Mitral surgery will be conducted using general anesthesia and cardiopulmonary bypass. Mitral surgery may be performed via a sternotomy or a right thoracotomy approach with or without robotic assistance.

Group Type ACTIVE_COMPARATOR

Cardiac Magnetic Resonance Imaging

Intervention Type PROCEDURE

Non-invasive imaging test that uses powerful magnets and radio waves to create detailed pictures of the heart without using radiation.

ZioPatch Monitoring

Intervention Type DEVICE

ZioPatch is a small, wearable heart monitor that sticks to the chest and records the heart's electrical activity continuously for up to 14 days. It helps doctors detect irregular heart rhythms (arrhythmias) without the need for bulky wires or equipment.

Myocardial Tissue Biopsy

Intervention Type PROCEDURE

During the MVr procedure, surgeons will biopsy approximately 50 μg of tissue from the endocardial and subendocardial myocardium in the inferobasilar and control areas using a surgical rongeur.

Transcatheter edge-to-edge repair

Patients will be treated with a commercially-approved edge-to-edge mitral repair device.

Group Type ACTIVE_COMPARATOR

Cardiac Magnetic Resonance Imaging

Intervention Type PROCEDURE

Non-invasive imaging test that uses powerful magnets and radio waves to create detailed pictures of the heart without using radiation.

ZioPatch Monitoring

Intervention Type DEVICE

ZioPatch is a small, wearable heart monitor that sticks to the chest and records the heart's electrical activity continuously for up to 14 days. It helps doctors detect irregular heart rhythms (arrhythmias) without the need for bulky wires or equipment.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Cardiac Magnetic Resonance Imaging

Non-invasive imaging test that uses powerful magnets and radio waves to create detailed pictures of the heart without using radiation.

Intervention Type PROCEDURE

ZioPatch Monitoring

ZioPatch is a small, wearable heart monitor that sticks to the chest and records the heart's electrical activity continuously for up to 14 days. It helps doctors detect irregular heart rhythms (arrhythmias) without the need for bulky wires or equipment.

Intervention Type DEVICE

Myocardial Tissue Biopsy

During the MVr procedure, surgeons will biopsy approximately 50 μg of tissue from the endocardial and subendocardial myocardium in the inferobasilar and control areas using a surgical rongeur.

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

CMR iRhythm Monitoring Heart Bioplsy

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients who meet all eligibility criteria and are randomized in the parent PRIMARY trial.
* For the ancillary biospecimen study, patients who are randomized to MVr in the parent trial.

Exclusion Criteria

* Severe claustrophobia not controlled with sedation.
* Prior adverse reaction to gadolinium administration.
* Patients with an implantable subcutaneous cardioverter defibrillator and/or cardiac resynchronization therapy device with defibrillator may be excluded as they typically produce substantial artifacts on cardiac MRI making assessment very challenging.
* Known allergic reaction to adhesives or hydrogels or with family history of adhesive skin allergies (for patients undergoing rhythm monitoring).
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Annetine Gelijns

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Annetine Gelijns

Department Chair, Department of Population Health Science & Policy Edmond A. Guggenheim Professor of Health Policy Co-Director, InCHOIR

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Joanna Chikwe, MD

Role: STUDY_DIRECTOR

Cedars-Sinai

Martin Leon, MD

Role: STUDY_DIRECTOR

Columbia University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Keck Hospital of the University of Southern California

Los Angeles, California, United States

Site Status RECRUITING

Cedars-Sinai

Los Angeles, California, United States

Site Status RECRUITING

University of California San Francisco

San Francisco, California, United States

Site Status RECRUITING

Stanford University

Stanford, California, United States

Site Status RECRUITING

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status RECRUITING

Maine Medical Center

Portland, Maine, United States

Site Status RECRUITING

The Johns Hopkins Hospital

Baltimore, Maryland, United States

Site Status RECRUITING

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

University of Michigan Hospital

Ann Arbor, Michigan, United States

Site Status RECRUITING

Saint Luke's Hospital of Kansas City/MidAmerica Heart and Lung Surgeons

Kansas City, Missouri, United States

Site Status RECRUITING

Weill Cornell Medicine/ New York-Presbyterian Hospital

New York, New York, United States

Site Status RECRUITING

Northwell--Lenox Hill, North Shore, South Shore, Staten Island University Hospital

New York, New York, United States

Site Status RECRUITING

Duke University Hospital

Durham, North Carolina, United States

Site Status RECRUITING

Cleveland Clinic

Cleveland, Ohio, United States

Site Status RECRUITING

University of Virginia Medical Center

Charlottesville, Virginia, United States

Site Status RECRUITING

West Virginia University Hospital

Morgantown, West Virginia, United States

Site Status RECRUITING

Deutsches Herzzentrum der Charité

Berlin, , Germany

Site Status RECRUITING

Herzzentrum Leipzig

Leipzig, , Germany

Site Status RECRUITING

Royal Papworth Hospital NHS Foundation Trust

Trumpington, Cambridge, United Kingdom

Site Status RECRUITING

The Leeds Teaching Hospitals NHS Trust

Leeds, England, United Kingdom

Site Status RECRUITING

Barts Health NHS Trust

Whitechapel, London, United Kingdom

Site Status RECRUITING

Manchester University NHS Foundation Trust

Oxford, Manchester, United Kingdom

Site Status RECRUITING

South Tees Hospitals NHS Foundation Trust

Marton-in-Cleveland, Middlesbrough, United Kingdom

Site Status RECRUITING

Oxford University Hospitals NHS Foundation Trust

Oxford, Oxfordshire, United Kingdom

Site Status RECRUITING

University Hospitals Sussex NHS Foundation Trust

Worthing, West Sussex, United Kingdom

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States Germany United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Chari Ponder, RN, BSN

Role: CONTACT

(646) 899-8106

Jonathan Hupf

Role: CONTACT

(646) 385-0854

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Edward Lozano

Role: primary

Vanessa Wilson

Role: primary

Georgia Applegarth

Role: primary

Luz Memije

Role: primary

Danielle Griffith

Role: primary

Monica Palmeri

Role: primary

Zyriah Robinson

Role: primary

Patrick Udeh

Role: primary

Nicole White

Role: primary

Diane Peterman

Role: primary

Marshagay Rodriques

Role: primary

Ameerah Ali

Role: primary

Kathleen Lane

Role: primary

Anna M Simmons

Role: primary

Linda Bailes

Role: primary

Josh Bombard

Role: primary

Andreas Bader-Wölfle, RN, PhD

Role: primary

+49 (0)30-4593-2204

Andreas Bader-Wölfle, RN, PhD

Role: primary

+49 (0)30-4593-2204

Louise Steel

Role: primary

Louise Steel

Role: primary

Louise Steel

Role: primary

Louise Steel

Role: primary

Louise Steel

Role: primary

Louise Steel

Role: primary

Louise Steel

Role: primary

Related Links

Access external resources that provide additional context or updates about the study.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

5U01HL088942-17

Identifier Type: NIH

Identifier Source: secondary_id

View Link

GCO 08-1078 ANC

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

SQ-Kyrin-T First-in-man Feasibility Study
NCT06605313 ACTIVE_NOT_RECRUITING NA
Sutra Hemi-valve First-in-Human Study
NCT06552689 RECRUITING NA