Clinical trial NCT03860454: The Deep Phenotype of Lamin A/C Cardiomyopathy
Official title: The Deep Phenotype of Lamin A/C Cardiomyopathy - A Proof-of-principle Relax-omic Pipeline
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Lamin A/C Gene Mutation
Dilated Cardiomyopathy, Familial
Keywords: Dilated Cardiomyopathy
Lamin A/C Cardiomyopathy
Heart failure
Lead sponsor: University College, London
Sponsor class: OTHER
Collaborators: name: NIHR Rare Diseases Translational Research Collaboration
name: Barts Cardiovascular registry
First posted: 2019-03-04
Enrollment: 150
Sex: ALL
Minimum age (years): 16
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adults with known pathogenic lamin (LMNA+) gene mutations, adults with heart muscle failure but normal (wild-type) LMNA gene (DCMWT) and matched healthy volunteers (HV).

Brief summary: This study seeks to discover clinically useful tests to improve the diagnosis of a rare and serious heart muscle disease caused by mutations in a gene called 'Lamin'.

Patients born with lamin gene mutations have apparently healthy hearts initially, they begin experiencing symptoms in their twenties or thirties, and by age 45 the majority have undergone a heart transplant, experienced a major cardiac complication, or have died. Sudden heart rhythm abnormalities are a major cause of sudden death so earlier diagnosis can save lives by enabling timely treatment or implantation of specialised pacemakers (defibrillators). In clinical practice, diagnosis of lamin heart disease currently relies on the genetic test. Very little is known about the detailed imaging features of the hearts of patients with lamin heart disease although advanced echocardiography and cardiac MRI now offer the opportunity to study the health of the heart without the need for radiation.

Detailed description: * Research participants will undergo resting 12-lead ECG, 24-hour ambulatory ECG, baseline echocardiography, exercise echocardiography, cardiac MRI scan.
* Blood samples will be collected in all participants from both centers for immediate laboratory testing.
* Blood and urine samples will be collected in all participants and used for metabolomic, proteomic and lipidomic profiling and for targeted metabolite and enzyme analysis.
* Blood samples will be collected in all participants for future gene code analysis (DNA / RNA).

Eligibility criteria: Inclusion Criteria:

* LMNA+ cases with pathogenic LMNA mutations for LMNA+ and heart myocardial samples from the explanted hearts of LMNA+ patients who are scheduled to undergo clinically indicated heart transplantation at the Papworth Hospital NHS Trust.
* DCMWT cases: patients with heart muscle failure but with wild-type lamin gene. Heart myocardial samples from the explanted hearts of DCMWT patients who are scheduled to undergo clinically indicated heart transplantation at the Papworth Hospital NHS Trust.
* HV (controls): matched to cases.

Exclusion Criteria:

* Needle-phobia that would preclude blood-letting
* Participants unwilling to consent
* Patients that have a conventional contraindication for cardiac magnetic resonance imaging (MRI).
* Patients that have had a blood transfusion within the last month and patients having haemodialysis will be excluded.

Primary outcomes:
measure: Positive and negative predictive value of imaging-omics test for diagnosing LMNA-related heart muscle disease.
timeFrame: 3-4 years
Secondary outcomes:
Other outcomes:
Locations:
city: Birmingham
country: United Kingdom
facility: University Hospital Birmingham (UHB)
city: London
country: United Kingdom
facility: Barts Heart Center, St Bartholomew's Hospital NHS Trust
city: London
country: United Kingdom
facility: Royal Brompton Hospital NHS Trust (RBHT)
city: London
country: United Kingdom
facility: Royal Free Hospital NHS Trust (RFH)
city: London
country: United Kingdom
facility: University College London Hospital NHS Trust (UCLH)
city: Papworth Everard
country: United Kingdom
facility: Papworth Hopsital NHS Trust
Study officials:
References: