- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05850039
Study of the Expression of Autophagy Markers in the Myocardium in Patients With Persistent or Permanent Atrial Fibrillation (MIPAR-02)
Atrial Fibrillation (AFib) is the most common cardiac arrhythmia, causing the loss of the normal and coordinated atrial contractility.
Several studies have demonstrated the existence of some atrial anatomical sites involved in the initiation and maintenance of this arrhythmia, first of all the posterior wall in the area around the outlet of the pulmonary veins. In fact, the existence of a complex of structural and functional modifications has been documented, collectively defined as "structural remodeling" which involve both the cardiomyocyte and the interstitium (the space between the cardiomyocytes) from a histopathological point of view; at the cardiomyocyte level, a loss of sarcomeres in the perinuclear site (myocytolysis), a reduction in the expression of "adult" cellular proteins (e.g. cardiotin and titin) with concomitant re-expression of "fetal" proteins (e.g. muscle actin smooth), as well as a modification of the mitochondrial structure. At the interstitial level, remodeling is characterized by the deposition of fibrous tissue in the interstitium between the muscle bundles and by a reduction in capillary density. Regarding the deposition of collagen fibers, some studies on an experimental model of AFib have shown that the latter is not reversible.
Autophagy is an intracellular process regulated by numerous biochemical signals; it is present at basal levels in most tissues and allows the physiological turnover of the various structural components of the cell, directing them to lysosomal degradation. It can also be stimulated by external signals in unfavorable environmental conditions, such as in the case of pathologies that determine a condition of tissue oxidative stress protracted over time. Experimentally, an excessive activation of the latter has been associated with the early stages of pathological cardiac remodeling in various animal models of cardiovascular diseases and some recent studies have hypothesized that altered levels of autophagy may contribute to the possible mechanisms involved in the generation and maintenance of the remodeling cardiomyocyte and interstitial structure in AFib. The levels of autophagic activity can be evaluated by studying specific markers - such as the Beclin-1 and LC3B proteins - constituents of the autophagic signaling cascade. In the case of LC3B, the "LC3BII/LC3BI" ratio (the processed form of autophagosomal vesicles and the unprocessed form constitutively present at the cytoplasmic level) was used as an autophagy biomarker. Furthermore, some microRNAs (miRNAs) capable of controlling the expression of proteins of the autophagic cascade have been described in the literature. This is the case of miRNA 30a and miRNA 204, respectively, which respectively inhibit the expression of Beclin-1 and of LC3B.
This study aims to investigate from a histo-morphological and molecular point of view the presence of alterations of autophagy mechanisms in patients with persistent or permanent AFib and which correlate these modifications with the degree of structural remodeling present at the level of the left atrial myocardium.
Study Overview
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
-
-
-
Milan, Italy, 20132
- Recruiting
- Irccs Ospedale San Raffaele
-
Contact:
- Davide Schiavi, BS
- Phone Number: +390226435316
- Email: schiavi.davide@hsr.it
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Group 1 - Study Inclusion criteria
- Age between 18 and 85 years old
- Permanent or persistent AFib for which the patient undergoes ablation surgery surgery of atrial fibrillation with isolated radiofrequency or associated with possible correction of heart valve disease with or without coronary artery disease Exclusion criteria
- Age < 18 years
- Need for emergency cardiac surgery
- Presence of concomitant systemic inflammatory diseases
Group 2 - Control Inclusion criteria
- Age between 18 and 85 years old
- Sinus rhythm at the time of admission for surgery
- No AFib in history
- Hospitalized for correction of isolated mitral valve disease or associated with correction of other valve diseases Exclusion criteria
- Age < 18 years
- Need for surgical coronary revascularization
- Need for emergency cardiac surgery
- Presence of concomitant systemic inflammatory diseases
Group 3 - Autoptic control Inclusion criteria
- Age between 18 and 85 years old Exclusion criteria
- No signs of post-mortal tissue decomposition assessed by histological examination
- Documented history of arrhythmias, valvular dysfunction, atherosclerosis of the coronary arteries, previous myocardial infarctions, foci of myocardial fibrosis greater than 2 mm on histology, presence of inflammatory cells in the interstitium, sarcoidosis, amyloidosis, chronic inflammatory lung diseases and connective tissue diseases.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Study group
Patients with permanent or persistent AFib, undergoing surgical ablation, isolated or concomitant to valve surgery
|
Sample collection: a small fragment of atrial wall will be collected
|
Mitral surgery control group
Patients undergoing isolated or concomitant mitral valve surgery
|
Sample collection: a small fragment of atrial wall will be collected
|
Autoptic control group
Autopsy samples in subjects without arrhythmia
|
Sample collection: a small fragment of atrial wall will be collected
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Beclin-1 and LC3B levels in blood
Time Frame: Baseline
|
Baseline
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MIPAR-02
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Atrial Fibrillation
-
Ablacon, Inc.CompletedArrhythmias, Cardiac | Atrial Fibrillation, Persistent | Persistent Atrial Fibrillation | Longstanding Persistent Atrial FibrillationGermany
-
Ablacon, Inc.RecruitingAtrial Fibrillation | Arrhythmias, Cardiac | Arrhythmia | Atrial Flutter | Atrial Fibrillation, Persistent | Atrial Tachycardia | Atrial Arrhythmia | Atrial Fibrillation Paroxysmal | Atrial Fibrillation, Paroxysmal or PersistentUnited States, Belgium, Netherlands, Czechia
-
Barts & The London NHS TrustAtriCure, Inc.Not yet recruitingAtrial Fibrillation, Persistent | Persistent Atrial Fibrillation | Atrial Arrhythmia | Atrium; FibrillationUnited Kingdom
-
AtriCure, Inc.Active, not recruitingPersistent Atrial Fibrillation | Atrial Fibrillation (AF) | Longstanding Persistent Atrial FibrillationUnited States
-
Maastricht University Medical CenterRWTH Aachen UniversityUnknownAtrial Fibrillation (Paroxysmal) | Atrial Fibrillation Recurrent | Atrial Fibrillation Common Gene VariantsNetherlands
-
Adagio MedicalRecruitingAtrial Fibrillation | Atrial Flutter | Paroxysmal Atrial Fibrillation | Persistent Atrial FibrillationNetherlands, Germany, Belgium
-
Vivek ReddyEnrolling by invitationAtrial Fibrillation and Flutter | Atrial Flutter Typical | Atrial Fibrillation, Paroxysmal or PersistentUnited States
-
Fundació Institut de Recerca de l'Hospital de la...RecruitingAtrial Arrhythmia | Atrial Fibrillation and Flutter | Atrial Fibrillation RecurrentSpain
-
St. George's Hospital, LondonRecruitingAtrial Fibrillation | Atrial Fibrillation, Persistent | Persistent Atrial Fibrillation | Atrial ArrhythmiaUnited Kingdom
-
R-PharmFSBI "National Medical Research Center of Cardiology named after academician...CompletedAtrial Flutter | Paroxysmal Atrial Fibrillation | Persistent Atrial FibrillationRussian Federation
Clinical Trials on Sampling
-
Centre Hospitalier Sud FrancilienNot yet recruitingBacteria in Breast MilkFrance
-
Centre Hospitalier Universitaire DijonNot yet recruitingRhegmatogenous Retinal DetachmentsFrance
-
Medical University of GrazJoanneum Research Forschungsgesellschaft mbHCompleted
-
Institut PasteurInstitut National de la Santé Et de la Recherche Médicale, France; University... and other collaboratorsUnknownEncephalitisVietnam, Cambodia, Lao People's Democratic Republic, Myanmar
-
Assistance Publique Hopitaux De MarseilleCompleted
-
Rennes University HospitalCompletedMultiple SclerosisFrance
-
Institut PasteurSanofi Pasteur, a Sanofi Company; Institut Pasteur of Cote d'IvoireCompletedBordetella Pertussis, Whooping CoughCôte D'Ivoire
-
University Hospital, ToulouseCompletedPneumonia, PneumocystisFrance
-
Centre Hospitalier Universitaire de Saint EtienneWithdrawnAnorexia Nervosa | Eating DisorderFrance
-
Institut CurieRecruitingProstate Cancer | Healthy DonorsFrance