Using cardiac magnetic resonance imaging (MRI) to measure left ventricular wall stress in patients with asymptomatic aortic stenosis

Accuracy of using cardiac magnetic resonance imaging (MRI) to measure left ventricular wall stress and predict clinical outcomes in patients with asymptomatic aortic stenosis

Status

Recruiting

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12625000818437

Enrollment

Registered

2025-07-31

Start date

2025-07-01

Completion date

2027-01-04

Last updated

2026-01-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Historically, AS severity has been assessed using transvalvular gradients and valve area estimates derived from echocardiography, however, cardiac MRI provides more precise assessment of LV systolic parameters which are more accurate measures of pressure overload. Systolic LVWS, calculated using a combination of TTE and cardiac MRI data, has been demonstrated to be a helpful adjunct to echocardiography and symptom assessment in aortic stenosis. This study aims to investigate the correlation between TTE and MRI derived systolic LVWS and symptom status, traditional echocardiographic markers of AS severity, and clinical outcomes including progression to SAVR or TAVI.

Interventions

Cardiac magnetic resonance imaging (Cardiac MRI) - Duration of scan 30-45mins - One scan at the commencement of the study - Gadolinium intravenous contrast injection during the MRI (approximately 0.2 mL/kg) - Scan administered by an RMH radiographer - Scan reported by MRI radiologist & cardiologist

Study design

Allocation

Non-randomised trial

Intervention model

Single group

Primary purpose

Diagnosis

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Adult patients with asymptomatic aortic stenosis (AS) (moderate or severe) determined on transthoracic echocardiography (TTE) as either: - Moderate: o Aortic valve area (AVA) 20mmHg - Severe: o AVA 40mmHg o Dimensionless index (DI) <0.25

Exclusion criteria

• Any contraindication to cardiac MRI, including suspected metallic foreign bodies (patients will not be screened with X-rays. • Any contraindication to gadolinium contrast. • Claustrophobia. • estimated glomellular filtration rate (eGFR) <30. • Current pregnancy. • Any cardiac implantable electronic device (CIED). • History of transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). • Severe left ventricular systolic dysfunction (left ventricular ejection fracton (LVEF) <35%). • Severe airways disease. • Unable to provide informed consent

Outcome results