Genomic Investigation of Cardiovascular Diseases

Inclusion Criteria:

Candidates for this study must meet ALL of the following criteria:

• Age 18 years or older
• Be reliable, cooperative and willing to comply with all protocol-specified procedures and sub-study if consented.
• Able to understand and grant informed consent

• Have at least one of the following (a-g):

  1. Coronary Artery Disease (defined as):

     • Coronary artery bypass surgery or
     • Lesion >70% on cardiac or CT angiogram or
     • Percutaneous Coronary Intervention

  2. Myocardial infarction (defined as):

     • Diagnosed by elevated troponin level or
     • Diagnosed by ST segment elevations on EKG or
     • Diagnosed by pathologic Q waves on EKG or
     • Documented in the medical record or by self report

  3. Atrial Fibrillation (defined as):

     • Lone Atrial fibrillation (paroxysmal, persistent or permanent); OR
     • Lone Atrial Flutter (paroxysmal, persistent or permanent)
  4. Automatic Internal Cardiac Defibrillator

  5. Aortic Stenosis (defined by):

     • Calculated Aortic Valve Area ≤ 1.0 cm² or
     • Mean Pressure Gradient ≥ 40 mmHg or
     • Peak Pressure Gradient ≥ 64 mmHg or
     • Dimensionless Index < .25 or
     • Prior or planned Aortic Valve Replacement for Aortic Stenosis

  6. Mitral Regurgitation (insufficiency) (defined as)

     • Moderate to Severe (equivalent to +3 to +4) mitral regurgitation (insufficiency) on transthoracic echocardiogram as determined by the reading physician and structurally abnormal valve (i.e. myxomatous) and/or thickened or redundant leaflets; OR
     • Prior or planned Mitral Valve repair or replacement for mitral regurgitation

  7. Idiopathic (non-ischemic) Cardiomyopathy (defined as):

     • Diagnosed < age 40; OR
     • Non-ischemic etiology confirmed by cardiac angiography or CT angiography (may have non-obstructive or stable coronary artery disease if diagnosis of non-ischemic etiology of CM is established by cardiologist).

Exclusion Criteria:

Patients will be excluded if ANY of the following conditions apply:

• Previously enrolled in The Genebank at Scripps Clinic Registry
• Any active bleeding (i.e. GI bleed).
• Has a significant medical condition which in the investigator's opinion may interfere with the patient's optimal participation in the study
• Treatment with any investigational agents or devices within 30 days preceding enrollment in the study.
• Been administered or taken any CNS sedatives or depressants in the past 12 hours.
• Been administered or taken any CNS sedatives or depressants in the past 12 hours.

• Subject's qualifying diagnosis is Atrial fibrillation and they are known to have any one of the following:

  1. Prior myocardial infarction, coronary artery bypass surgery, or percutaneous coronary intervention
  2. EF < 45% at time of diagnosis (excluding tachycardia induced cardiomyopathy diagnosed by a cardiologist)
  3. Elevated left atrial pressures (> 20 mmHg)
  4. Dilated left atrium (> 4.0 cm or >2.0 cm/m2 body surface)

  5. Mitral valve disease with significant valve pathology

     • Mitral regurgitation/insufficiency greater than trace to mild on echo as determined by reading physician
     • Rheumatic mitral valve disease
  6. Congestive heart failure prior to diagnosis
  7. Hypertrophic cardiomyopathy
  8. Diagnosis following coronary artery bypass or valve replacement surgery
  9. Post heart transplant
  10. Congenital heart disease
  11. Diagnosed in setting of hyperthyroid
  12. COPD
  13. Obstructive sleep apnea

• Subject's qualifying diagnosis is Aortic Stenosis and they are known to have any one of the following:

  1. Bicuspid valve or other congenital abnormality of the aorta or aortic valve
  2. Evidence of Rheumatic involvement of the Aortic Valve

• Subject's qualifying diagnosis is Mitral regurgitation (insufficiency) and they are known to have any one of the following:

  1. Ejection fraction <50%
  2. Evidence of significant ischemic disease with regions of akinetic myocardium
  3. Rheumatic changes on echocardiogram (as determined by the reading physi4ian)

  5. Significant Mitral stenosis (greater than "mild" on echocardiogram as determined by the reading physician) 6. Evidence of valve perforation 7. Evidence of congenital abnormality (i.e. cleft valve)

• Subject's qualifying diagnosis is Idiopathic (non-ischemic) cardiomyopathy and they are known to have any one of the following:

  1. Ischemic cardiomyopathy
  2. Hypertrophic cardiomyopathy
  3. Viral cardiomyopathy
  4. Alcohol/drug induced cardiomyopathy