Pathogenetic Basis of Aortopathy and Aortic Valve Disease

  • STATUS
    Recruiting
  • End date
    Dec 23, 2028
  • participants needed
    3000
  • sponsor
    Indiana University
Updated on 23 January 2021
aortic dissection
stenosis
aneurysm
marfan syndrome
computed tomography
genetic testing
aortic disease
thoracic aortic aneurysm
ehlers-danlos syndrome
aortic diseases
tricuspid disease
loeys-dietz syndrome

Summary

The main purpose of this study is to define the complex genetic and pathogenic basis of thoracic aortic aneurysm (TAA) and other forms of aortopathy and/or aortic valve disease by identifying novel disease-causing genes and by identifying important genetic modifiers for aortic and aortic valve disease severity.

Description

Thoracic aortic aneurysm (TAA) is a type of aortopathy describing dilation of the proximal aortic dimensions including the aortic root, which is a risk factor for aortic dissection and sudden cardiac death. TAA and other forms of aortopathy (e.g. aortic tortuosity or aortic hypoplasia/stenosis) develop in the presence or absence of additional cardiovascular malformations including bicuspid aortic valve. TAA is associated with connective tissue disorders (e.g. Marfan syndrome), and familial clustering has been identified in a significant proportion of nonsyndromic cases, establishing high heritability. Pedigree analysis of TAA kindreds clearly identifies complex inheritance; however, progress towards understanding the genetic basis of TAA and other forms of aortopathy and, ultimately, the susceptibility to aortic dissection remains incomplete. There is a clinical need to develop novel methods for predicting disease risk based on genotype and phenotype, to further elucidate the genetic and pathogenic mechanisms of aortopathy, and to improve medical and surgical therapies. The overarching hypothesis of this study is that individual genetic variation modulates susceptibility to disease severity and progression. The goals of this study are 1) to ascertain a cohort of subjects who have aortopathy and/or aortic valve disease including TAA or who have genetic risk for the development of aortopathy and/or aortic valve disease, 2) to collect paired blood and tissue samples from well-characterized subjects, family members of subjects, and controls to perform genome-wide DNA sequence, histopathologic, transcriptional, and proteomic analyses, and 3) to establish a tissue biorepository with detailed phenotype information to facilitate a broad spectrum of current and future studies.

Details
Condition Thoracic aortic aneurysm, CONNECTIVE TISSUE DISEASE, Ehlers-Danlos Syndrome, Congenital Heart Defect, Loeys-Dietz Syndrome, Marfan's Syndrome, Collagen disease, Turner's Syndrome, Collagen Vascular Diseases, Congenital Heart Disease, Dermatomyositis (Connective Tissue Disease), Aortic Valve Disease, PHACE Syndrome, Aortopathies, Thoracic Aortic Disease, Thoracic Aortic Dissection, Thoracic Aortic Rupture, Ascending Aortic Disease, Descending Aortic Disease, Ascending Aortic Aneurysm, Descending Aortic Aneurysm, Shprintzen-Goldberg Syndrome, Autosomal Recessive Cutis Laxa, Congenital Contractural Arachnodactyly, Arterial Tortuosity Syndrome, Ehlers-Danlos, Shprintzen-Goldberg Syndrome, Connective Tissue Diseases, Turner Syndrome, Heart Defect, ehlers danlos syndrome, marfan syndrome, marfans syndrome, Shprintzen-Goldberg Syndrome
Clinical Study IdentifierNCT03440697
SponsorIndiana University
Last Modified on23 January 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Open to external enrollment
Subjects with a genetic diagnosis of Marfan Syndrome (MDS), Loeys-Dietz Syndrome (LDS), or Vascular Ehlers-Danlos Syndrome (EDS); (Positive genetic testing or a previous cardiac study required to be eligible)
Family members of eligible subjects (Only family members of subjects with syndromic diagnoses are eligible for external enrollment at this time)
Closed to external enrollment
Subjects with aortic disease including TAA or dissection, aortic tortuosity, or aortic hypoplasia/stenosis (based on any cardiac imaging modality including echocardiography, CT, MRI, or angiography)
Subjects with aortic valve disease (bicuspid, unicuspid, or tricuspid disease)
Control subjects having tissue removed during a surgical procedure (e.g. coronary artery bypass graft surgery (CABG), cardiac transplant, etc.)

Exclusion Criteria

Inability or unwillingness to provide consent (assent when indicated)
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