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Gene Expression Profiles in Patients With Permanent Atrial Fibrillation (AF) Versus Sinus Rhythm (SR)

Sponsor
Ankara University (Other)
Overall Status
Unknown status
CT.gov ID
NCT00970034
Collaborator
The Scientific and Technological Research Council of Turkey (Other)
60
Enrollment
1
Location
36
Duration (Months)
1.7
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The aim of this project is to determine the morphological criteria of apoptosis in atrial tissues of patients with AF versus SR at transcriptome and genomic size.

Condition or Disease Intervention/Treatment Phase

    Detailed Description

    Mitral valve regurgitation (MR) is the second most common valvular heart disease encountered in adults. Furthermore, atrial fibrillation (AF) is the most common cardiac arrhythmia seen in clinical practice. Overall, 70% of the patients with severe MR are associated with AF independent from etiopathogenesis of MR. AF is clinically divided into three subgroups; 1) paroxysmal AF, occurs as episodes and ends spontaneously, 2) persistent AF, episodes terminate only with medical or electrical cardioversion, and 3) permanent AF, current medical treatments and electrical cardioversion does not restore a normal sinus rhythm. Despite intensive electrophysiological studies, the molecular mechanisms and pathways of AF are still not fully elucidated.

    Apoptosis which has distinctive morphological and biochemical characteristics is genetically regulated, active programmed cell death process. It is known that cardiac morphogenesis restore from apoptosis. In addition, apoptosis has an important role in several cardiovascular system pathologies. It has been shown that atrial apoptosis causes numerous arrhythmias including AF. Likewise, in the pilot study which has been performed by our study group, AF is associated with apoptosis by immunohistochemical and DNA fragmentation analysis methods.

    The aim of this project is to determine the morphological criteria of apoptosis in atrial tissues of patients with AF by using electron microscopy and immunohistochemistry. Moreover, we will investigate the transcriptional profile of AF associated genes by oligonucleotide microarray method. The gene expression profiles of patients with AF and degenerative MR will be compared with the atrial tissue samples from the patients with degenerative MR who preserve normal sinus rhythm which will serve as controls. In summary the apoptotic pathways would be analyzed at transcriptomic and genomic level. Besides, the pathways that may interfere AF pathophysiology would also be evaluated. The expression profiles of the genes primarily verified by quantitative real time RT-PCR will be further confirmed by translation of end-result proteins determined with Western blot technique. Thus, brand-new clues about physiology of fibrillating atrial cells would be achieved.

    Keywords: Atrial fibrillation, apoptosis, oligonucleotide microarray

    Study Design

    Study Type:
    Observational
    Anticipated Enrollment :
    60 participants
    Observational Model:
    Cohort
    Time Perspective:
    Prospective
    Official Title:
    Comparative Gene Expression Profiles in Patients With Permanent Atrial Fibrillation and Normal Sinus Rhythm
    Study Start Date :
    Dec 1, 2008
    Anticipated Study Completion Date :
    Dec 1, 2011

    Arms and Interventions

    Arm Intervention/Treatment
    AF

    Patients with degenerative mitral valve regurgitation and permanent atrial fibrillation who require mitral valve repair or replacement.
    SR

    Patients with degenerative mitral valve regurgitation and maintaining sinus rhythm who require mitral valve repair or replacement.

    Outcome Measures

    Primary Outcome Measures

    1. Expression profiles of genes related to apoptosis [6 months]

    Secondary Outcome Measures

    1. Expression profiles of pro-apoptotic and anti-apoptotic proteins [6 months]

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 85 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:

    • Patients with permanent atrial fibrillation or sinus rhythm and degenerative mitral valve regurgitation who require cardiac surgery

    • Pulmonary hypertension (systolic PA > 45 mmHg)

    • Left ventricular ejection fraction > 30%

    Exclusion Criteria:

    • Paroxysmal AF or atrial flutter

    • Second or third degree heart block

    • Permanent pacemaker

    • Wolff-Parkinson-White syndrome

    • Brugada syndrome

    • Ischemic or rheumatic mitral valve disease

    • Dilated cardiomyopathy

    • LVEF < 30%

    • Infective endocarditis, myocarditis

    • Trauma

    • Active HBV, HCV, HIV infection

    • Chronic renal failure

    • Autoimmune diseases

    • Vasculitis

    • Known genetic disorders

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Ankara University Medical Faculty, Department of Cardiovascular Surgery, Ankara Turkey 06340

    Sponsors and Collaborators

    • Ankara University
    • The Scientific and Technological Research Council of Turkey

    Investigators

    • Principal Investigator: RUCHAN A AKAR, Assoc. Prof., Ankara University

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    , ,
    ClinicalTrials.gov Identifier:
    NCT00970034
    Other Study ID Numbers:
    • 108S375
    First Posted:
    Sep 2, 2009
    Last Update Posted:
    Sep 3, 2009
    Last Verified:
    Sep 1, 2009
    Keywords provided by , ,
    Atrial fibrillation, apoptosis, oligonucleotide microarray
    Additional relevant MeSH terms:
    Atrial Fibrillation
    Mitral Valve Insufficiency

    Study Results

    No Results Posted as of Sep 3, 2009