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CompletedNCT04862273CMR for CAUpdated Apr 13, 2026

CMR T1 Mapping for Diagnosis of Cardiac Amyloidosis

An observational study in Heart Failure NYHA Class II, Heart Failure NYHA Class III and Heart Failure NYHA Class IV, sponsored by University of Leipzig. Completed at 1 site in Germany. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2026-04-13.

Sponsored by University of Leipzig · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
112
Ages
60 Years and older
Sex
All
01

Study summary

The study aims to test the diagnostic accuracy of T1 mapping for the diagnosis of cardiac amyloidosis prospectively. The hypothesis is that T1 mapping in older patients with symptomatic heart failure, increased LV wall thickness and elevated cardiac biomarkers is non-inferior to the reference method to diagnose cardiac amyloidosis (CA).

As secondary measure, a web-based ATTR probability estimator for the diagnosis of CA will be evaluated.

Read the detailed description

Cardiac amyloidosis (CA) is an important differential diagnosis in older patients with symptomatic heart failure with preserved or mid-range ejection fraction and increased left ventricular wall thickness. The prevalence of CA among patients with heart failure and left ventricular (LV) hypertrophy is approximately 13%. However, diagnosis of CA is challenging because specific clinical signs are often lacking.

Amyloid fibrils deposit in the extracellular space of the myocardium increases myocardial T1 values on cardiac magnetic resonance (CMR). Therefore, T1 imaging provides a promising non-invasive method to identify CA.

A preliminary retrospective analysis of 128 patients with increased LV wall thickness identified an area under the curve of 0.9954 (p\<0.0001) for native T1 to detect CA. The optimal cut-off value was 1341ms, with a sensitivity of 100% and a specificity of 97%.

The investigators aim to test the diagnostic accuracy of T1 mapping for the diagnosis of CA compared to the reference method prospectively. Moreover, the web-based ATTR probability estimator for the diagnosis of CA will be evaluated.

02

Conditions studied

  • Heart Failure NYHA Class II
  • Heart Failure NYHA Class III
  • Heart Failure NYHA Class IV
  • Heart Failure With Preserved Ejection Fraction
  • Heart Failure With Mid Range Ejection Fraction
  • Hypertrophy, Left Ventricular
  • Cardiac Amyloidosis
03

Who can participate

Ages eligible
60 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients with symptomatic heart failure (NYHA functional class II to IV, LVEF ≥40%), increased left ventricular wall thickness and elevated cardiac biomarkers

Inclusion criteria

  • Age ≥ 60 years
  • Symptomatic heart failure (NYHA II-IV) with LVEF ≥40%
  • Increased LV wall thickness (≥12mm end-diastolic)
  • NT-proBNP ≥1000pg/mL
  • Elevated hs-troponin T ≥14ng/L

Exclusion criteria

Exclusion Criteria:

  • Contraindications for CMR
  • Acute myocarditis
  • Acute myocardial infarction \<1 month
  • Severe aortic stenosis and RAISE score \< 2 points
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
112 participants (actual)
Patient registry
No

Groups and cohorts

  • CMR T1 mapping

    Diagnostic accuracy of T1 mapping and ATTR probability estimator are tested against the reference methods (99mTc-DPD scintigraphy, laboratory screening for multiple myeloma / AL amyloidosis; or cardiac biopsy, if noninvasive evaluation is inconclusive)

    Diagnostic Test: Native T1 CMR · Diagnostic Test: Web-based ATTR probability estimator (Pfizer, New York) · Diagnostic Test: 99mTc-DPD scintigraphy · Diagnostic Test: Laboratory screening for multiple myeloma / AL amyloidosis · Procedure: Cardiac biopsy

Interventions

  • Diagnostic testNative T1 CMR

    Observed method

  • Diagnostic testWeb-based ATTR probability estimator (Pfizer, New York)

    Observed method

  • Diagnostic test99mTc-DPD scintigraphy

    Reference method

  • Diagnostic testLaboratory screening for multiple myeloma / AL amyloidosis

    Reference method

  • ProcedureCardiac biopsy

    If non-invasive tests for CA (99mTc-DPD scintigraphy, biochemistry) are inconclusive

05

What researchers measure

Primary outcomes

  1. Diagnostic accuracy of T1 mapping for diagnosis of CA

    Comparison of CMR T1 mapping to the reference method for diagnosis of CA

    Time frame: up to 7 days

Secondary outcomes

  1. Diagnostic accuracy of ATTR probability estimator to predict CA

    Comparison of a probability score to predict ATTR with the final diagnosis of ATTR

    Time frame: up to 7 days

  2. Association of parametric T1 values with cardiovascular outcome

    All-cause death, cardiovascular death and heart failure hospitalizations

    Time frame: 1 year

  3. Association of ATTR probability estimator values with cardiovascular outcome

    All-cause death, cardiovascular death and heart failure hospitalizations

    Time frame: 1 year

06

Study locations

1 site
  • University of Leipzig
    Leipzig, Saxony 04103, Germany
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04862273
Lead sponsor
University of Leipzig
Responsible party
Daniel Lavall (Cardiologist, University of Leipzig) — Principal investigator
First posted
Apr 27, 2021
Start date
Apr 1, 2021
Primary completion
Mar 1, 2023
Completion
Dec 1, 2024
Last update
Apr 13, 2026

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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