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TMAO in Patients With Severe Aortic Stenosis

Conditions
Aortic Stenosis
Heart Failure
Interventions
Diagnostic Test: Measurement of plasma and urine trimethylamine-N-oxide concentration
Registration Number
NCT04406805
Lead Sponsor
Medical University of Warsaw
Brief Summary

Trimethylamine N-oxide (TMAO) has recently gained increasing scientific interest in the field of cardiovascular disease, including its role in cell protection against osmotic and hydrostatic stress. Aortic stenosis (AS) is the most common valvular heart disease, affecting about 7.6 million people over 75 years of age in North America and Europe alone. We hypothesized that TMAO plays a role in protection of the cardiomyocytes against pressure overload in patients with AS. The primary aim of this study is to assess the correlation between the serum and urine TMAO concentration, and (i) echocardiographic, (ii) biochemical and (iii) histopathological parameters of heart failure in patients with severe AS. The secondary aim of this study is to evaluate a correlation between the baseline TMAO concentrations and the post-treatment clinical status, as well as the post-treatment echocardiographic and biochemical parameters.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
70
Inclusion Criteria
  • Informed consent to participate in the study
  • Severe aortic stenosis, defined as aortic valve area <1.0 cm2 or aortic valve area index <0.6 cm2/m2 as calculated by the continuity equation on transthoracic echocardiography, regardless of the transvalvular gradient, with or without coexisting symptoms of heart failure
  • Qualification for surgical aortic valve replacement or transcatheter aortic valve implantation by the Heart Team in accordance with European Society of Cardiology guidelines
Exclusion Criteria
  • Heart failure of etiology other than aortic stenosis
  • Coexisting, haemodynamically significant aortic regurgitation
  • Myocardial infarction within the last 3 months
  • Coronary revascularization within the last month or planned during transcatheter aortic valve implantation or surgical aortic valve replacement
  • Chronic kidney disease with estimated glomerular filtration rate <45 ml/min/1.73 m2
  • Acute gastrointestinal disease within the last month
  • Active neoplastic disease
  • Chronic inflammatory disease
  • Autoimmune disease
  • Chronic intestinal disease
  • Antibiotic therapy within the last 2 months
  • Dietary supplements within the last 7 days

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Severe aortic stenosisMeasurement of plasma and urine trimethylamine-N-oxide concentrationPatients will be enrolled among those who will be (i) aged from 18 to 99 years, (ii) admitted to the hospital due to severe aortic stenosis, and (iii) qualified for treatment with either surgical aortic valve replacement or transcatheter aortic valve implantation
Primary Outcome Measures
NameTimeMethod
Correlation between the serum and urine trimethylamine N-oxide concentration and aortic valve area indexJanuary 15, 2019 - February 15, 2023
Secondary Outcome Measures
NameTimeMethod
Correlation between the serum and urine trimethylamine N-oxide concentration and (i) other echocardiographic, (ii) biochemical and (iii) histopathological parameters of heart failure.January 15, 2019 - February 15, 2023
Correlation between the baseline trimethylamine N-oxide concentrations and the post-treatment clinical status, as well as the post-treatment echocardiographic and biochemical parameters.January 15, 2019 - February 15, 2023

Trial Locations

Locations (1)

1st Chair and Department of Cardiology and Department of Cardiosurgery, Medical University of Warsaw

🇵🇱

Warsaw, Masovia, Poland

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