Phenotyping and Characterization of wtATTR-CM (TRACE 1)

Last updated: August 12, 2025
Sponsor: Steen Hvitfeldt Poulsen
Overall Status: Active - Recruiting

Phase

N/A

Condition

Amyloidosis

Circulation Disorders

Treatment

N/A

Clinical Study ID

NCT06291805
1-10-72-189-23
  • Ages > 18
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

Descriptive cross-sectional study on 100 consecutive ATTRwt-CM patients reflecting all NAC stages aiming primarily to investigate ATTRwt-CM patient's quality of life (QoL) measures and their relation to ATTRwt-CM severity. Secondarily aiming to investigate the possibility to measure misTTR and fragTTR in plasma and urine and to detect fragTTR in endomyocardial biopsies from ATTRwt-CM patients. To investigate whether misTTR and fragTTR levels are correlated with ATTRwt-CM severity.

Eligibility Criteria

Inclusion

Group 1: wtATTR-CM patients

Inclusion Criteria:

  • Patients > 18 years diagnosed with ATTRwt-CM by:

  • endomyocardial biopsy

  • DPD scintigraphy with Perugini grade 2-3 where variant amyloidosis is ruled out dueto genetic testing.

  • Informed oral and written consent

Exclusion

Exclusion Criteria:

  • AL amyloidosis (light-chain amyloidosis).

  • Myelomatosis

  • Waldenström macroglobulinemia

Group 2: Control group

Inclusion Criteria:

  • Patients > 18 years

  • Informed oral and written consent

Exclusion Criteria:

  • Known cardiovascular disease including ischemic heart disease, heart failure, atrialfibrillation, presence of a pacemaker, or malignant hypertension. Well-controlledhypertension is acceptable.

  • Suspicion of cardiac amyloidosis assessed through clinical history, physicalexamination, ECG, and echocardiography focusing on "red flags":

  • Echocardiography with:

  • Myocardial hypertrophy (septum >11 mm)

  • Apical sparing in LV-GLS

  • Infiltrative changes in the right ventricle free wall, thickened atrioventricularvalves, or thickened atrial septum

  • Symptoms of polyneuropathy

  • Low voltage on ECG or discrepancy between left ventricular thickness and ECGamplitude indicative of low voltage

  • Atrioventricular block (AV block)

  • Bilateral carpal tunnel syndrome

  • Surgery for spinal stenosis

  • Elevated troponin I or NT-pro-BNP

Study Design

Total Participants: 120
Study Start date:
February 20, 2024
Estimated Completion Date:
December 31, 2025

Study Description

Hypothesis:

  1. We hypothesize that more severe wild-type amyloidosis cardiomyopathy (ATTRwt-CM) according to clinical, biochemical, and diagnostic imaging parameters are correlated with worse quality of life (QoL) for patients.

  2. We expect misfolded (misTTR) and/or fragmented transthyretin (fragTTR) to be measurable in plasma and/or urine and fragTTR to be detectable in endomyocardial biopsies from patients with ATTRwt-CM. We expect the values of misTTR and fragTTR to be correlated with the severity of ATTRwt-CM according to clinical, biochemical, and diagnostic imaging parameters. We expect the level of fragTTR from endomyocardial biopsies to be correlated with plasma levels of fragTTR.

Method:

ATTRwt-CM patients: Prospective inclusion of 100 consecutive ATTRwt-CM patients reflecting all NAC stages (40 patients from NAC disease stage 1, 40 patients from NAC disease stage II and 20 patients from NAC disease stage III). Patients will be recruited from the out-patient amyloidosis clinic at Aarhus University hospital. Patients will be thoroughly clinically assessed.

Control patients:

A control cohort of 20 age- and gender-matched heart-healthy patients will be included for comparison of total/mis-/fragTTR values.

The investigating into QoL, bio markers and the analyses on cardiac MR imaging markers will hopefully provide us with tools to evaluate and monitor disease progression and response to treatment.

Connect with a study center

  • Aarhus University Hospital

    Aarhus, Arrhus N 8200
    Denmark

    Active - Recruiting

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