About this trial
Arrhythmogenic ventricular cardiomyopathy (AVC) is a genetic condition which affects the heart and can lead to heart failure and rhythm problems, of which, sudden cardiac arrest or death is the most tragic and dangerous. Diagnosis and screening of blood-relatives is very difficult as the disease process can be subtle, but sufficient enough, so that the first event is sudden death.
The Mayo Clinic AVC Registry is a collaboration between Mayo Clinic, Rochester, USA and Papworth Hospital, Cambridge University Hospitals, Cambridge, UK. The investigators aim to enroll patients with a history of AVC or sudden cardiac death which may be due to AVC, from the US and UK. Family members who are blood-relatives will also be invited, including those who do not have the condition. Data collected include symptoms, ECG, echocardiographic, MRI, Holter, loop recorder, biopsies, exercise stress testing, blood, buccal and saliva samples.
Objectives of the study:
1. Discover new genes or altered genes (variants) which cause AVC 2. Identify biomarkers which predict (2a) disease onset, (2b) disease progression, (2c) and the likelihood of arrhythmia (ventricular, supra-ventricular and atrial fibrillation) 3. Correlate genotype with phenotype in confirmed cases of AVC followed longitudinally using clinical, electrocardiographic and imaging data. 4. Characterize desmosomal changes in buccal mucosal cells with genotype and validate with gold-standard endomyocardial biopsies
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Patients with a diagnosis of a non-MI SCA who survived
Patients with a non-MI SCD
Patient with a SCA associated with seizures, epilepsy, syncope, drowning and near-drowning, where a cardiomyopathy is suspected
Family member of a patient diagnosed with primary cardiomyopathy (including HCM, idiopathic DCM, AVC)
Disqualifiers
Patients with a clear, unambiguous known cause of SCA or SCD such as myocardial infarction or heart failure secondary to ischemic heart disease
Significant coronary artery disease (Epicardial coronary artery stenosis >50%) which can explain degree of LV dysfunction
Those unwilling to provide written consent or assent
Trial population
All patients seen at any Mayo Clinic facility or Papworth Hospital.Cambridge University Hospitals, who have AVC will be evaluated via their medical records (retrospective chart review) according to 2010 Task Force Criteria. Family members who are being screened for AVC are also eligible, as are patients with overlapping conditions (phenocopies such as myocarditis, sarcoidosis, inflammatory cardiomyopathies, outflow tract tachycardias and Brugada pattern, and familial dilated cardiomyopathy). Patients seen at other institutions who wish to enroll are encourgaed to apply and may be eligible. For the optional novel genetic variant discovery and biobank phases, patients will be invited to participate and undergo written consent.
Trial design
Family-based
Prospective
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
Genotyping
Using family 'trios' discover novel pathogenic variants and characterize them
Correlate genotype with phenotype
Correlate genotype with phenotype in confirmed cases of AVC followed longitudinally as per 2010 Task Force Criteria
Secondary outcomes
Natural history and secular trends of AVC
Test blood-based biomarkers (such high-sensitivity CRP, high-sensitivity troponin, NT-proBNP and miRNA) which predict disease onset, disease progression, and the likelihood of arrhythmia.
Natural history and secular trends of AVC
Discover ECG-based biomarkers which predict disease onset, disease progression, and the likelihood of arrhythmia.
Natural history and secular trends of AVC
Discover MRI-based biomarkers which predict disease onset, disease progression, and the likelihood of arrhythmia.
Cellular and Tissue phenotyping
Characterize desmosomal changes in buccal mucosal cells with endomyocardial biopsies and/or in vivo tissue characterization by cardiac MRI or cardiac CT
Sponsors and contacts
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Mayo Clinic
Lead sponsor
Cambridge University Hospitals NHS Foundation Trust
Collaborator