This is a clinical registry of patients with cardiac amyloidosis being treated at University Hospital Leipzig. The aim of the registry is to collect detailed information about clinical events, symptoms, imaging, biomarkers, comorbidities, and treatment from routine patient management which would not be provided by randomized clinical trails.
Cardiac amyloidosis is increasingly diagnosed since awareness of the disease and therapeutic options increase. There is evidence from clinical trials about warning signs ("red flags"), diagnostic algorithms, and evidence for specific treatment. However, patients in randomized clinical studies are highly selected and do not necessarily reflect clinical practise. Furthermore, large clinical trials do not account for national medical care differences nor provide data about long-term outcome and the associations with comorbidities. Clinical registries may reflect broad clinical practise and help to characterize cardiac amyloidosis in terms of epidemiology, application of diagnostic methods, the impact of comorbidities, and real-world clinical course. Furthermore, clinical registry studies may validate data from randomized clinical trials, provide information on implementation of treatment, the quality of interventions, monitoring patients during treatment, and inform about the safety of procedures. The cardiac amyloidosis registry aims to collect data from the routine clinical management of patients with cardiac amyloidosis at the tertiary care University Hospital Leipzig. In particular, obtaining data about clinical events of heart disease, hemodynamic measures from echocardiography and circulation biomarkers, cardiac morphology from different imaging methods, clinical status, functional capacity, quality of life, and impact of comorbidities during the course of the disease will be the goal of this registry.
Study Type
OBSERVATIONAL
Enrollment
500
Data collection of routine diagnostics
Data collection of routine treatment
University Hospital Leipzig
Leipzig, Saxony, Germany
RECRUITINGAll-cause and cardiac mortality
Mortality
Time frame: 10 years
Cumulative rate of patients with worsening heart failure
Heart failure endpoint
Time frame: 10 years
Rate of any hospitalizations
Record of any clinical events requiring hospitalization
Time frame: 10 years
Change in left ventricular ejection fraction
Change in LVEF assessed by echocardiography or cardiac MRI
Time frame: Every 6-12 months over 10 years
Change in left ventricular wall thickness
Change in left ventricular wall thickness/ mass assessed by echocardiography or cardiac MRI
Time frame: Every 6-12 months over 10 years
Change in systolic arterial pressure
Change in sPAP assessed by echocardiography
Time frame: Every 6-12 months over 10 years
Change in T1 values
Change in T1 values assessed by cardiac MRI
Time frame: Approx. every 12 months over 10 years
Change in extracellular volume values
Change in ECV assessed by cardiac MRI
Time frame: Approx. every 12 months over 10 years
Change in N-Terminal Pro-B-Type Natriuretic Peptide over time
Change in serum concentration of NT-proBNP
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Time frame: Every 3-6 months over 10 years
Change in high-sensitivity cardiac troponin T over time
Change in serum concentration of hs-cTnT
Time frame: Every 3-6 months over 10 years
Changes in medical treatment for heart failure
Changes in heart failure medication (i.e. diuretics, beta-blocker, renin-angiotensin system inhibitors, mineralocorticoid receptor antagonists, sodium glucose cotransporter type 2 inhibitors) as well as specific treatment for amyloidosis (e.g. tafamidis) is recorded.
Time frame: Every 3-6 months over 10 years
Prevalence and incidence of cardiac and non-cardiac comorbidities
Medical history and reports regarding any comorbidities and previous treatment will be assessed in detail at inclusion. Patients are asked for new comorbidities and new treatments at every visit.
Time frame: Every 3-6 months over 10 years
New York Heart Association (NYHA) class over time
As parameter of clinical status
Time frame: Every 3-6 months over 10 years
Functional capacity over time
Measured using 6 minute walk test
Time frame: Every 3-6 months over 10 years
Quality of life over time
Measured via questionnaire (e.g. KCCQ)
Time frame: Every 3-6 months over 10 years
Vital signs over time
Blood pressure
Time frame: Every 3-6 months over 10 years
Clinical signs of congestion over time
E.g. edema, jugular venous distension, crackles on lung auscultation
Time frame: Every 3-6 months over 10 years
Number of cardiovascular interventions
Indication, efficacy and safety of any cardiovascular intervention will be recorded, such as rate of pacemaker implantations, numbers of valve procedures (aortic valve implantation, mitral or tricuspid valve clipping), left atrial appendage occluder implantation, electrophysiological studies and ablation procedures
Time frame: Monitoring continuously over 10 years