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Not yet recruitingNCT07690748Remote-ASUpdated Jul 8, 2026

Remote Monitoring for Patients With Aortic Stenosis

An observational study in Aortic Stenosis, sponsored by Baker Heart and Diabetes Institute. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-08.

Sponsored by Baker Heart and Diabetes Institute · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
160
Ages
18 Years and older
Sex
All
01

Study summary

Remote-AS aims to develop a remote digital monitoring cohort of people with AS and use these data to establish a digital twin intervention to personalise risks and benefits, and optimise the time of surgical or transcatheter aortic valve replacement (AVR) referral. Our digital solution will also seek modelling for optimal care for patients to whom AVR is indicated who choose not to undergo the procedure, supporting a patient-selected observational strategy for managing heart failure symptoms, facilitating patient education and self-care.

Objectives of the study are:

  • To establish a large-scale interdisciplinary research program to drive implementation of substantial improvements to health care and/or health system effectiveness in patients with aortic stenosis (AS)
  • To establish a new model of patient-centred management strategy for asymptomatic severe AS to inform the optimal time at which valve intervention should take place
  • For patients to whom AVR is indicated who choose not to undergo the procedure, to support a patient-selected observational strategy for managing heart failure symptoms
  • To develop a digital twin with predictive capabilities of artificial intelligence (AI) for guiding the optimal timing of AVR in patients with asymptomatic severe AS

Participants will be patients with asymptomatic moderate to severe native AS (n=160) (based on guideline-recommended diagnosis and care with peak aortic velocity >3.5m/sec).

Participants will undergo:

Wearables: collection of physiological (e.g., blood pressure, heart rate, rhythm) and behavioural (physical activity) data through a wearable device ('smart watch'), collected through the comprehensive remote heart health monitoring and automated feedback delivery system app SMART.

Patient reported outcome measures: KCCQ-CSS; EQ-5D-5L index score; "Toronto Aortic Stenosis" quality of life questionnaires.

Advanced cardiovascular imaging: Cardiovascular magnetic resonance (CMR) imaging; 31phosphorus magnetic resonance spectroscopy (31P-MRS); proton magnetic resonance spectroscopy (1H-MRS); echocardiography.

Comprehensive plasma proteome profiling: Plasma proteomic preparation coupled with the Orbitrap Astral mass spectrometer.

Recording of clinical outcomes.

02

Conditions studied

  • Aortic Stenosis

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03

Who can participate

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

Study population

Potential participants will be identified by their cardiologist or cardiothoracic surgeon at high-volume Australian centres in Melbourne.

Inclusion criteria

  • Male or female ≥18 years of age
  • Suitable to undergo MRI scans
  • With asymptomatic moderate to severe native AS (based on guideline-recommended diagnosis and care)
  • Eligible for Medicare
  • Ability and willingness to provide written and informed consent and to comply with the requirements of the study.

Exclusion criteria

Exclusion Criteria:

  • Serious comorbidity other than AS that limits the life expectancy (\<2 years), or affects study participation or outcome (severe frailty and mobility issues [Rockwood frailty score >6], severe kidney disease eGFR\<30, infiltrative cardiomyopathy)
  • Known heart failure or reduced left ventricular ejection fraction (\<50%)
  • Moderate or above valvular pathology other than AS
  • Contra-indications to CMR (including presence of foreign metallic bodies)
  • Known hypersensitivity to adenosine (ever requiring hospital admission with asthma or chronic obstructive pulmonary disease) or gadolinium
  • Significant renal impairment (eGFR\<30ml/min/m2)
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
160 participants (estimated)
Patient registry
No

Groups and cohorts

  • Aortic stenosis

    Patients with asymptomatic moderate to severe native AS (n=160) (based on guideline-recommended diagnosis and care with peak aortic velocity \>3.5m/sec).

05

What researchers measure

Primary outcomes

  1. LV hypertrophy

    Left ventricular mass index\[g/m2\], imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  2. Diastolic function - Mitral inflow E/A ratio

    Mitral inflow E/A ratio, imaging endpoint on echocardiography

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  3. Diastolic function - average E/e' ratio

    Average E/e' ratio, imaging endpoint on echocardiography

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  4. Diastolic function - septal e' velocity

    Septal e' velocity, imaging endpoint on echocardiography.

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  5. Diastolic function - lateral e' velocity

    Lateral e' velocity, imaging endpoint on echocardiography.

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  6. Diastolic function - left atrial volume index

    Left atrial volume index, imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  7. Diastolic function - peak diastolic strain rate

    Peak diastolic strain rate, imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  8. Global longitudinal strain (GLS)

    Imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  9. Myocardial perfusion

    Rest and adenosine stress CMR-measured myocardial blood flow and myocardial perfusion reserve imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  10. Myocardial energetics index

    31P-MRS-measured phosphocreatine to ATP ratio, imaging endpoint on cardiovascular magnetic resonance spectroscopy (MRS)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  11. Myocardial triglyceride content

    Imaging endpoint as measured by 1H-MRS

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  12. Myocardial fibrosis index - extra cellular volume [ECV] fraction

    Extra cellular volume \[ECV\] fraction, tissue characteristic imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  13. Myocardial fibrosis index - index-ECV

    Index-ECV, imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  14. Myocardial fibrosis index - scar percentage

    Late gadolinium enhancement imaging-assessed scar percentage, imaging endpoint on cardiovascular magnetic resonance imaging (CMR)

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

Secondary outcomes

  1. Physical activity

    Digital endpoint measured from wearable devices and processed via the SMART architecture

    Time frame: Daily for the duration of the participant's participation in the study (six months post guideline-indicated AVR, or if AVR is not performed until completion of the overall study, i.e. maximum 4 years, whichever comes first).

  2. Blood pressure

    Digital endpoint measured from wearable devices and processed via the SMART architecture

    Time frame: Daily for the duration of the participant's participation in the study (six months post guideline-indicated AVR, or if AVR is not performed until completion of the overall study, i.e. maximum 4 years, whichever comes first).

  3. Heart rhythm

    Digital endpoint measured from wearable devices and processed via the SMART architecture

    Time frame: Daily for the duration of the participant's participation in the study (six months post guideline-indicated AVR, or if AVR is not performed until completion of the overall study, i.e. maximum 4 years, whichever comes first).

  4. Heart rate variability

    Digital endpoint measured from wearable devices and processed via the SMART architecture

    Time frame: Daily for the duration of the participant's participation in the study (six months post guideline-indicated AVR, or if AVR is not performed until completion of the overall study, i.e. maximum 4 years, whichever comes first).

  5. Oxygen saturation

    Digital endpoint measured from wearable devices and processed via the SMART architecture

    Time frame: Daily for the duration of the participant's participation in the study (six months post guideline-indicated AVR, or if AVR is not performed until completion of the overall study, i.e. maximum 4 years, whichever comes first).

  6. NTproBNP

    Blood biomarker

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  7. High sensitivity cardiac troponin (hscTNT)

    Blood biomarker

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  8. Proteomics

    Advanced, label-free quantitative mass spectrometry-based proteomics blood biomarkers

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  9. Quality-of-Life questionnaire: KCCQ-CSS

    Patient-reported outcome measure via Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score \[KCCQ-CSS\]

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  10. Quality-of-Life questionnaire: EQ-5D-5L

    Patient-reported outcome measure via EuroQoL 5-dimension 5-level \[EQ-5D-5L\] index score

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

  11. Quality-of-Life questionnaire: Toronto AS QoL

    Patient-reported outcome measure via "Toronto Aortic Stenosis" quality of life questionnaire

    Time frame: 6-monthly repeat assessments prior to AVR, with a concluding assessment 6 months after AVR

06

Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: Yes — Upon publications, the investigators envisage allowing access to the data in a systematic manner through a platform dedicated to sharing scientific research data (e.g., ShareFile). Specific datasets will be made available after publications by us and sharing of data is intended to be determined on a case-by-case basis at the discretion of the Principal Investigator, and provided agreement to preserve the confidentiality of the information. All data will be shared in a non-identifiable format. Data will be collected, stored and shared in accordance with National Statement 3.1.44 and 3.1.55. If journals request that the research team make raw data available, the anonymised raw non-identifiable data will be shared in a systematic manner through a platform dedicated to sharing scientific research data (e.g., ShareFile). The participant information/consent form includes this information for participants following guidelines from the Australian Research Data Commons (ARDC) guide.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07690748
Lead sponsor
Baker Heart and Diabetes Institute
Collaborators
The Alfred, Monash Medical Centre, St Vincent's Hospital Melbourne, University of Melbourne, Deakin University, La Trobe University, The University of Western Australia, Melbourne Health
Responsible party
Eylem Levelt (Professor of Cardiology, Head of Cardiometabolic Imaging Lab, Baker Heart and Diabetes Institute) — Principal investigator
First posted
Jul 8, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Aug 2030 (estimated)
Completion
Aug 2030 (estimated)
Last update
Jul 8, 2026

Study contacts

Sjoerd Levelt, PhD
Contact
sjoerd.levelt@baker.edu.au
+61385321874
View the source record on ClinicalTrials.gov ↗

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