171 Participants Needed

Advanced Imaging Techniques for Cardiomyopathy

(MICA Trial)

SD
Overseen BySharmila Dorbala, MD, MPH
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

Cardiac amyloidosis is a major cause of early treatment-related death and poor overall survival in individuals with systemic light chain amyloidosis. This project will develop a novel approach to visualize cardiac amyloid deposits using advanced imaging methods. The long-term goal of this work is to identify the mechanisms of cardiac dysfunction, in order to guide the development of novel life-saving treatments.

Research Team

RL

Ronglih Liao, PhD

Principal Investigator

Stanford School of Medicine (AHA Study)

SD

Sharmila Dorbala, MBBS, MPH

Principal Investigator

Brigham and Women's Hospital (AHA and NIH Studies)

RF

Rodney Falk, MD

Principal Investigator

Brigham and Women's Hospital (NIH Study)

Eligibility Criteria

Adults diagnosed with light chain amyloidosis or heart failure without amyloidosis, able to exercise and consent. Excludes those with severe coronary artery disease, claustrophobia that sedatives can't help, pregnancy, significant kidney dysfunction, certain metallic implants (except MR compatible devices for control subjects), on dialysis, unable to attend follow-up visits or lie flat for an hour.

Inclusion Criteria

I have been diagnosed with heart failure, not caused by amyloidosis.
For subjects traveling from out of town referred for systemic AL therapy based on clinical evaluation and laboratory testing, but, pending biopsy results, study enrollment and procedures may begin before official confirmation of biopsy results. If biopsy is negative for AL amyloidosis, subject will be considered a screen failure. There will be no more than 10 subjects who fall under this screen failure for the duration of the study.
Willing and able to provide consent
See 8 more

Exclusion Criteria

I have a significant blockage in a heart artery.
I cannot lie flat for an hour due to heart failure.
Inability to return to BWH 12 month clinical evaluation.
See 11 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo baseline imaging and blood analysis, including F-18 florbetapir PET, C-11 acetate PET, MRI, and heavy metal analysis

1-2 weeks
1 visit (in-person)

Treatment and Monitoring

Participants receive chemotherapy and are monitored for changes in myocardial structure, function, and metabolism using advanced imaging techniques

12 months
3 visits (in-person) at baseline, 6 months, and 12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Treatment Details

Interventions

  • F-18 florbetapir/C-11 acetate PET
  • MRI
  • N-13 ammonia PET
Trial Overview The trial is testing advanced imaging methods like F-18 florbetapir/C-11 acetate PET scans and MRI to visualize cardiac amyloid deposits in patients with cardiac amyloidosis. The goal is to understand the mechanisms of cardiac dysfunction better.
Participant Groups
5Treatment groups
Experimental Treatment
Active Control
Group I: Heart FailureExperimental Treatment2 Interventions
10 individuals with diagnosis of heart failure without amyloidosis by standard criteria will undergo a research F-18 florbetapir PET, C-11 acetate PET, and MRI of the heart, as well as a heavy metal analysis of the blood at baseline..
Group II: Active AL cardiac amyloidosisExperimental Treatment3 Interventions
75 individuals with light chain systemic amyloidosis with active plasma cell dyscrasia and cardiac involvement will undergo a research F-18 florbetapir PET, C-11 acetate PET, and MRI of blood of the heart, as well as the heavy metal analysis of the blood at baseline, 6 months and 12 months after initiation of chemotherapy. 25 of these individuals will also undergo a N-13 ammonia PET scan of the heart following supine bicycle stress at baseline and at 6 months after initiation of chemotherapy.
Group III: Active AL Pre-CMPExperimental Treatment2 Interventions
36 individuals with light chain systemic amyloidosis with active plasma cell dyscrasia and without cardiac involvement will undergo a research F-18 florbetapir PET, C-11 acetate PET, and MRI of the heart, as well as a heavy metal analysis of the blood at baseline. At 6 months they will undergo a research MRI of the heart and at 12 months they will have a clinical follow up. Subjects with contraindications to Cardiac MRI or gadolinium contrast may still be eligible for study participation.
Group IV: Multiple Myeloma ControlsActive Control1 Intervention
25 individuals with diagnosis of multiple myeloma without concomitant amyloidosis by standard criteria will undergo urine and blood testing only.
Group V: Remission AL cardiac amyloidosisActive Control2 Interventions
25 individuals with light chain systemic amyloidosis with cardiac involvement and plasma cell dyscrasia in hematological remission (complete hematological remission or very good partial response-differential free light chain (dFLC)\<40 mg/dL for \> 1 year prior to enrollment) will undergo a research F-18 florbetapir PET, C-11 acetate PET, and MRI scan of the heart as well as a heavy metal analysis of the blood at baseline.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Brigham and Women's Hospital

Lead Sponsor

Trials
1,694
Recruited
14,790,000+

National Institutes of Health (NIH)

Collaborator

Trials
2,896
Recruited
8,053,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials
3,987
Recruited
47,860,000+

American Heart Association

Collaborator

Trials
352
Recruited
6,196,000+
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