ATTR Amyloidosis in Elderly Patients With Aortic Stenosis
NCT04061213 · Status: UNKNOWN · Type: OBSERVATIONAL · Enrollment: 489
Last updated 2022-12-15
Summary
Severe aortic stenosis is defined with a mean transvalvular pressure gradient (MTPG) \> 40mmHg and a calculated aortic valve area of \< 1cm2. However, a considerable proportion of patients do have a MTPG \< 40mmHg due to a reduced stroke volume (stroke volume indexed to body surface area ≤ 35ml/m2) despite a normal left ventricular ejection fraction (LVEF \> 50%). This entity is termed paradoxical low flow low gradient aortic stenosis (PLFLG AS) and is associated with a worse prognosis.
ATTR amyloidosis is a disease of the elderly and might coexist in patients with severe aortic stenosis. Case reports and small observational studies suggest that senile ATTR amyloidosis could be frequent but underdiagnosed in patients with aortic stenosis. There is significant overlap between PLFLG AS and cardiac amyloidosis with regard to symptoms, increasing prevalence with age, concentric hypertrophy, impaired diastolic filling of the left ventricle (LV), as well as longitudinal LV dysfunction despite preserved ejection fraction - all features, which lead to a reduction in stroke volume, the underlying mechanism of the low flow condition as observed in PLFLG AS patients.
Conditions
- Aortic Stenosis Symptomatic
- Amyloidosis Cardiac
Interventions
- DIAGNOSTIC_TEST
-
Tc-99m-DPD scintigraphy
Myocardial scintigraphy
Sponsors & Collaborators
-
Insel Gruppe AG, University Hospital Bern
lead OTHER
Principal Investigators
-
Stefan Stortecky, MD · Swiss Cardiovascular Center Bern
Eligibility
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2019-08-26
- Primary Completion
- 2022-12-31
- Completion
- 2022-12-31
Countries
- Switzerland
Study Locations
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