Clinical trial NCT03123523: Study of the Relation Between Lipid Myocardial Overload Evaluated by Cardiac Magnetic Resonance Imaging (MRI), Alteration of Longitudinal Myocardial Deformations by Echocardiography, and Clinical Achievements (Functional, Biological and Electrical) in Fabry Disease, and Its Outcomes.
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Fabry Disease
Lead sponsor: University Hospital, Bordeaux
Sponsor class: OTHER
First posted: 2017-04-21
Enrollment: 55
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: - The 35 patients will be selected from Dr Réant (Cardiologist) and Dr Rooryck-Thambo's (Genetician) consultations, co-responsible of the Regional Competence Centre in Inherited Cardiomyopathies (Bordeaux, france) and from a medical specialized group following regularly these patients (Dr Valérie de Précigout in Nephrology at Bordeaux Pellegrin Hospital, Pr Cyril Goizet and Pr Didier Lacombe in Genetics at Bordeaux Pellegrin Hospital).

Inclusion will be performed according to current management and follow-up recommendations.

- The 20 healthy volunteers will be recruited form a local database (" HSync Study " of Dr Cornolle). Their consent will be requested at inclusion.

Brief summary: Anderson-Fabry disease is a genetic lysosomal storage disease, linked to chromosome X (gene GLA), responsible of enzyme synthesis deficit in α-galactosidase A with intracellular sphingolipids accumulation and multiorganic achievement.

If renal complication is principally responsible of the pejorative evolution of the disease, it may also exist a cardiac achievement, symptomatic or not (heart failure symptoms including dyspnea, conduction abnormalities, supra-ventricular and ventricular arrhythmias), with or without left ventricular hypertrophy (LVH).

Administration of agalsidase-α or ß, a genetic engineering synthetic equivalent of the deficient enzyme, should significantly slow disease evolution indeed reduce LVH.

Some patients with Fabry disease without LVH should present, compared to healthy subjects, indirect early markers of intramyocyte lipid overload:

* in echocardiography, longitudinal myocardial deformation (strain) should be altered while ejection fraction is preserved, and
* in cardiac MRI, T1 mapping should be reduced1. This was also previously demonstrated in Fabry patients with LVH2. However, are these abnormalities of longitudinal deformation in echocardiography and of T1 mapping in MRI correlated to the presence of pejorative cardiac markers (such as clinical and functional tolerances, Brain Natriuretic Peptide (BNP) level and electrical complications)?


Eligibility criteria: Inclusion Criteria:

Patients group :

* Adults (age ≥18 years), male and female.
* Patients diagnosed genetically having Fabry disease, with or without clinical cardiac symptoms and with different evolution stades of the disease.
* For female in age of procreation, efficient contraception will be required and a negative pregnancy test.
* Oral agreement of the patient after having read information note.
* Patient affiliated to social national Security registry.

Healthy volunteers group:

* Adults (age ≥18 years), male and female.
* Unscathed of cardiovascular pathologies and cardiovascular risk factors.
* For female in age of procreation, efficient contraception will be required and a negative pregnancy test.
* Oral agreement of the patient after having read information note.
* Patient affiliated to social national Security registry.

Exclusion Criteria:

For the 2 groups :

* Extracardiac pathology limiting life expectancy \<1 year (cancer).
* Pregnant or breastfeeding female.
* Claustrophobia.
* Mechanical prosthetic valve.
* Severe obesity \> 140 kg
* Patients with intracardiac device (implantable cardiac defibrillator, pace maker, resynchronisation), surgical clips not MRI compatible, neurosensorial stimulators, cochlear implants, ferromagnetic foreign bodies (ocular, cerebral), neurosurgical derivation valves)
* Impossibility to provide consent or refusal to sign the consent form.

For the patients:

- Previous history of hypersensitivity to gadolinium.

Primary outcomes:
measure: Cardiovascular symptoms
timeFrame: Baseline
measure: Metabolic exercise test marker : poor blood pressure adaptation to exercise
timeFrame: Baseline
measure: Metabolic exercise test marker: max level achieved
timeFrame: Baseline
measure: Metabolic exercise test marker : percentage of theoretical maximal heart rate
timeFrame: Baseline
measure: Metabolic exercise test marker : peak of Oxygen uptake (VO2)
timeFrame: Baseline
measure: Metabolic exercise test marker : percentage of expected peak VO2
timeFrame: Baseline
measure: Metabolic exercise test marker : Expiratory volume / carbon dioxide production (VE/VCO2)
timeFrame: Baseline
measure: Biological marker : BNP elevation
timeFrame: Baseline
measure: Electrical markers at ECG and Holter ECG
timeFrame: Baseline
Secondary outcomes:
Other outcomes:
Locations:
city: Pessac
country: France
facility: CHU de Bordeaux
Study officials:
References: