Transthyretin Amyloid Cardiomyopathy
Conditions
Keywords
Transthyretin Amyloid Cardiomyopathy, ATTR-CM, Ocular Imaging, Heart Failure, Machine Learning, Optical coherence tomography, Retinal fundus imaging
Brief summary
This multicenter pilot study will enroll adult participants with a confirmed clinical diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) and heart failure (HF) controls with documentation within the past 2 years that either excludes ATTR-CM or indicates a low probability of ATTR-CM. Ocular imaging and other study data will be collected to assess the feasibility of developing and preliminarily evaluating a machine learning model to discriminate ATTR-CM cases from HF controls without ATTR-CM.
Detailed description
A participant who does not complete the study within 90 days from enrollment will be discontinued from the study. A participant may be discontinued from the study at any time at the discretion of the investigator for behavioral or compliance reasons. A participant may withdraw from the study at any time at the participant's own request for any reason (or without providing any reason) without any implication on participant's rights.
Interventions
None listed
Sponsors
AstraZeneca
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 1\. Participant must be 18 years and older at the time of signing the informed consent form. * 2\. Participants with either of the following: * \- Positive ATTR-CM cases: Participants with a clinical diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) with amyloid deposits in cardiac or non-cardiac tissue confirmed by Congo Red (or equivalent) staining, or DPD-Tc, PYP-Tc, or HMDP-Tc scintigraphy with Grade 2 or 3 cardiac uptake in the absence of abnormal light chains ratio. * \- Control population: Participants with a clinical diagnosis of guideline-directed medical therapy-directed heart failure (HF) and either: * a) Subgroup A: Definitively excluded ATTR-CM amyloidosis: negative cardiac or non-cardiac tissue biopsy for amyloid, or negative technetium scintigraphy within the past 2 years. * b) Subgroup B: Low probability of ATTR-CM amyloidosis, not definitively excluded: absence of amyloid-suggestive features on echocardiography (ECHO), electrocardiography (ECG), or cardiac magnetic resonance imaging (MRI) within the past 2 years, with documented clinical assessment indicating HF etiology unlikely attributable to amyloidosis; no amyloid-specific testing (technetium scintigraphy or biopsy) performed. * 3\. Participant or legally authorized representative (LAR) must sign the informed consent form.
Exclusion criteria
* 1\. Any known eye condition that may preclude clear imaging of the retina. * 2\. Any known history of amyloid light-chain (AL) amyloidosis. * 3\. Any ocular surgery that, in the opinion of the investigator, makes participation in the study undesirable. * 4\. Any medical condition that, in the opinion of the investigator, makes participation in the study undesirable, for example, if the participant is critically unwell or requires ongoing emergency treatment. * 5\. Involvement in the planning and/or conduct of the study. * 6\. In the opinion of the investigator, the participant is unlikely to comply with study procedures, restrictions, and requirements. * 7\. Previous enrollment in the present study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of per-participant confidence scores distributions between ATTR-CM cases and HF controls without ATTR-CM | At a single assessment time point within 90 days following informed consent form signing | Per-participant confidence score distributions generated by the machine learning (ML) model will be compared between participants with clinically confirmed transthyretin amyloid cardiomyopathy (ATTR-CM) and heart failure controls without ATTR-CM. |
| Qualitative assessment of features learned indicative of ATTR pathology | At a single assessment time point within 90 days following informed consent form signing | Features learned by the machine learning (ML) model that are indicative of transthyretin amyloid pathology will be qualitatively assessed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity, specificity, and Area Under the Receiver Operating Characteristic Curve (AUROC) of the ML model to correctly identify ATTR-CM cases based on ocular imaging data | At a single assessment time point within 90 days following informed consent form signing | Sensitivity, specificity, and area under the receiver operating characteristic curve will be used to describe the performance of the machine learning model for distinguishing participants with clinically confirmed transthyretin amyloid cardiomyopathy (ATTR-CM) from heart failure controls without ATTR-CM based on ocular imaging data. |
| Descriptive comparison of score distributions across study population strata and demographics | At a single assessment time point within 90 days following informed consent form signing | Score distributions generated by the machine learning model will be descriptively compared across study population strata and demographic groups. |
Countries
Germany, Portugal, Spain, Sweden, United States
Contacts
CONTACTAstraZeneca Clinical Study Information Center
Outcome results
None listed