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RecruitingNCT06277297EVOLUTIONUpdated Jun 8, 2025

Prognotic Role of CMR in Takotsubo Syndrome

An observational study in Takotsubo Cardiomyopathy, Machine Learning and Magnetic Resonance Imaging, sponsored by University of Cagliari. Recruiting at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-06-08.

Sponsored by University of Cagliari · Observational

From the registry’s dates

  • Started Nov 2022; still recruiting 4 years later.
Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
350
Ages
18 Years and older
Sex
All
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Study summary

The primary objective of this observational registry is to develop a comprehensive clinical and imaging score (incorporating echocardiography and cardiac magnetic resonance data) that enhances risk stratification for patients with Takotsubo syndrome.

The secondary objectives of this registry are as follows:

Investigate the diagnostic value of cardiac magnetic resonance parameters in predicting in-hospital and long-term outcomes in patients with Takotsubo syndrome.

Compare the proposed risk stratification score for patients with Takotsubo syndrome with previously existing scores.

Investigate the contribution of machine learning models in predicting in-hospital and long-term outcomes compared to standard clinical scores.

The design and rationale of this registry are available at 10.1097/RTI.0000000000000709

Read the detailed description

The prognosis of Takotsubo syndrome patients remains contentious, necessitating improved risk stratification for better management. While various clinical characteristics and parameters from transthoracic echocardiography have been associated with outcomes, none of the existing predictive scores incorporate cardiac magnetic resonance imaging (CMR) data, despite its ability to noninvasively assess tissue characterization. CMR offers a comprehensive evaluation of functional and structural changes, including an accurate assessment of right ventricular function. While CMR has been extensively studied for diagnostic purposes in Takotsubo syndrome, its role in prognosis is still debated. Emerging technologies like computed tomography show promise in myocardial characterization but lack robust investigation in prognostic roles. The EVOLUTION registry aims to address this gap by incorporating CMR parameters into a risk stratification score alongside clinical and transthoracic echocardiography data, with machine learning models also explored for enhanced outcome prediction. This initiative seeks to provide a more reliable predictive tool for the optimized management of Takotsubo syndrome patients. The main objective of this study is to enhance risk assessment in Takotsubo syndrome patients by incorporating CMR data alongside demographic, clinical, and transthoracic echocardiography parameters. Specifically, the aim is to analyze CMR data and their association with both short-term and long-term patient outcomes. Additionally, the effectiveness of the proposed risk stratification score for Takotsubo syndrome patients will be evaluated in comparison to existing scoring systems. Moreover, all available CMR, transthoracic echocardiography, and clinical variables will be utilized to develop machine learning models for predictive analysis

02

Conditions studied

  • Takotsubo Cardiomyopathy
  • Machine Learning
  • Magnetic Resonance Imaging
03

In context

Takotsubo Cardiomyopathy

63 studies on the registry are indexed under Takotsubo Cardiomyopathy; 26 are open to participants now.

This study's planned enrollment of 350 is above the median of 250 across 39 observational studies indexed under Takotsubo Cardiomyopathy.

Browse Takotsubo Cardiomyopathy studies →

Lead sponsor

University of Cagliari is the lead sponsor of 85 studies on the registry; 17 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Takotsubo syndrome patients

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Takotsubo syndrome diagnosis (according to Position Statement of the European Society of Cardiology Heart Failure Association)
  • Adult patients ( > 18y old)
  • Availability at baseline of clinical variables, standard transthoracic echocardiography, and cardiovascular magnetic resonance acquisition

Exclusion criteria

Exclusion Criteria:

  • \<18 y old
  • Lack of transthoracic echocardiography and cardiovascular magnetic resonance examinations
  • Preexisting cardiomyopathies
  • Previous myocardial infarction
  • Suspected or known prior irreversible myocardial damage
  • Valvular heart disease
05

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
350 participants (estimated)
Patient registry
No
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What researchers measure

Primary outcomes

  1. All-cause mortality

    cardiovascular death, pulmonary edema, arrhythmias, heart failure, sudden car- diac death, and major adverse cardiac and cerebrovascular events (MACCE) defined as a composite endpoint of death from any cause, myocardial infarction, recurrence of Takotsubo syndrome, transient ischemic attack, and stroke.

    Time frame: 2 years

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Cau R, Muscogiuri G, Pisu F, Gatti M, Velthuis B, Loewe C, Cademartiri F, Pontone G, Montisci R, Guglielmo M, Sironi S, Esposito A, Francone M, Dacher N, Peebles C, Bastarrika G, Salgado R, Saba L. Exploring the EVolution in PrognOstic CapabiLity of MUltisequence Cardiac MagneTIc ResOnance in PatieNts Affected by Takotsubo Cardiomyopathy Based on Machine Learning Analysis: Design and Rationale of the EVOLUTION Study. J Thorac Imaging. 2023 Nov 1;38(6):391-398. doi: 10.1097/RTI.0000000000000709. Epub 2023 Apr 4. PubMed 37015834 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Nov 2022 (actual). Primary completion is estimated for Nov 2026, 48 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 9, 2024
First posted
Feb 26, 2024
StartActual
Nov 9, 2022
Primary completionEst.
Nov 2026
CompletionEst.
Nov 2032
Last update
Jun 8, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06277297
Lead sponsor
University of Cagliari
Collaborators
Centro Cardiologico Monzino, IRCCS San Raffaele, University of Roma La Sapienza, Fondazione C.N.R./Regione Toscana "G. Monasterio", Pisa, Italy, University of Messina, University of Udine, Vannini Hospital Rome, A.O.U. Città della Salute e della Scienza - Molinette Hospital, University Hospital, Bonn, University Hospital, Rouen
Responsible party
Riccardo Cau (Principal investigator, University of Cagliari) — Principal investigator
First posted
Feb 26, 2024
Start date
Nov 9, 2022
Primary completion
Nov 2026 (estimated)
Completion
Nov 2032 (estimated)
Last update
Jun 8, 2025

Study contacts

Riccardo Cau, MD
Contact
riccardo.cau@unica.it
+3393493317

Oversight

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

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