Pathogenetic Basis of Aortopathy and Aortic Valve Disease

NCT ID: NCT03440697

Last Updated: 2025-04-18

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 3000 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2015-12-10
• Study Completion Date: 2030-12-31

Brief Summary

The main purpose of this study is to define the complex genetic and pathogenic basis of thoracic aortic aneurysm (TAA) and other forms of aortopathy and/or aortic valve disease by identifying novel disease-causing genes and by identifying important genetic modifiers for aortic and aortic valve disease severity.

Detailed Description

Thoracic aortic aneurysm (TAA) is a type of aortopathy describing dilation of the proximal aortic dimensions including the aortic root, which is a risk factor for aortic dissection and sudden cardiac death. TAA and other forms of aortopathy (e.g. aortic tortuosity or aortic hypoplasia/stenosis) develop in the presence or absence of additional cardiovascular malformations including bicuspid aortic valve. TAA is associated with connective tissue disorders (e.g. Marfan syndrome), and familial clustering has been identified in a significant proportion of nonsyndromic cases, establishing high heritability. Pedigree analysis of TAA kindreds clearly identifies complex inheritance; however, progress towards understanding the genetic basis of TAA and other forms of aortopathy and, ultimately, the susceptibility to aortic dissection remains incomplete. There is a clinical need to develop novel methods for predicting disease risk based on genotype and phenotype, to further elucidate the genetic and pathogenic mechanisms of aortopathy, and to improve medical and surgical therapies. The overarching hypothesis of this study is that individual genetic variation modulates susceptibility to disease severity and progression. The goals of this study are 1) to ascertain a cohort of subjects who have aortopathy and/or aortic valve disease including TAA or who have genetic risk for the development of aortopathy and/or aortic valve disease, 2) to collect paired blood and tissue samples from well-characterized subjects, family members of subjects, and controls to perform genome-wide DNA sequence, histopathologic, transcriptional, and proteomic analyses, and 3) to establish a tissue biorepository with detailed phenotype information to facilitate a broad spectrum of current and future studies.

Conditions

Aortopathies; Thoracic Aortic Aneurysm; Aortic Valve Disease; Thoracic Aortic Disease; Thoracic Aortic Dissection; Thoracic Aortic Rupture; Ascending Aortic Disease; Descending Aortic Disease; Ascending Aortic Aneurysm; Descending Aortic Aneurysm; Marfan Syndrome; Loeys-Dietz Syndrome; Vascular Ehlers-Danlos Syndrome; Shprintzen-Goldberg Syndrome; Turner Syndrome; PHACE Syndrome; Autosomal Recessive Cutis Laxa; Congenital Contractural Arachnodactyly; Arterial Tortuosity Syndrome; Bicuspid Aortic Valve-Associated Aortopathy; Bicuspid Aortic Valve; Familial Thoracic Aortic Aneurysm and Aortic Dissection

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Aortopathy- Closed to external enrollment

Subjects with aortic disease including TAA or dissection, aortic tortuosity, or aortic hypoplasia/stenosis (based on any cardiac imaging modality including echocardiography, CT, MRI, or angiography)

No interventions assigned to this group

Syndromic- Open to external enrollment

Subjects with a genetic diagnosis of Marfan Syndrome (MFS), Loeys-Dietz Syndrome (LDS), Vascular Ehlers-Danlos Syndrome (EDS)

•positive genetic testing and/or a previous cardiac study required to be eligible

No interventions assigned to this group

Aortopathy with Positive Genetic Results- Open to Enrollment

Subjects with aortic disease including TAA or dissection, aortic tortuosity, or aortic hypoplasia/stenosis (based on any cardiac imaging modality including echocardiography, CT, MRI, or angiography) who also have positive genetic testing results related to aortopathy.

No interventions assigned to this group

Aortic Valve Disease- Closed to enrollment

Subjects with aortic valve disease (bicuspid, unicuspid, or tricuspid disease)

No interventions assigned to this group

Family Members- Open to external enrollment

Family members of eligible subjects

•Only family members of subjects with syndromic diagnoses are eligible for external enrollment at this time

No interventions assigned to this group

Controls- Closed to external enrollment

Control subjects having tissue removed during a surgical procedure (e.g. coronary artery bypass graft surgery (CABG), cardiac transplant, etc.)

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Open to external enrollment:

• Subjects with a genetic diagnosis of Marfan Syndrome (MDS), Loeys-Dietz Syndrome (LDS), or Vascular Ehlers-Danlos Syndrome (EDS); (Positive genetic testing or a previous cardiac study required to be eligible)
• Family members of eligible subjects (Only family members of subjects with syndromic diagnoses are eligible for external enrollment at this time)
• Closed to external enrollment:

• Subjects with aortic disease including TAA* or dissection, aortic tortuosity, or aortic hypoplasia/stenosis (based on any cardiac imaging modality including echocardiography, CT, MRI, or angiography)
• Subjects with aortic valve disease (bicuspid, unicuspid, or tricuspid disease)
• Control subjects having tissue removed during a surgical procedure (e.g. coronary artery bypass graft surgery (CABG), cardiac transplant, etc.)

Exclusion Criteria

• Inability or unwillingness to provide consent (assent when indicated)

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Indiana University

OTHER

Sponsor Role: lead

Responsible Party

Benjamin Landis

Associate Professor of Pediatrics

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Benjamin Landis, MD

Role: PRINCIPAL_INVESTIGATOR

IU School of Medicine

Locations

Childrens Healthcare of Atlanta

Atlanta, Georgia, United States

Site Status: NOT_YET_RECRUITING

IU School of Medicine

Indianapolis, Indiana, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Lindsey Helvaty, BS, BA

Role: CONTACT

lhelvaty@iu.edu

317-278-3020

Benjamin Landis, MD

Role: CONTACT

benjland@iu.edu

317-278-2808

Facility Contacts

Glen Iannucci, MD

Role: primary

iannuccig@kidsheart.com

404-694-0109

Lindsey Helvaty, BA, BS

Role: primary

lhelvaty@iu.edu

317-278-3020

Benjamin Landis, MD

Role: backup

benjland@iu.edu

317-278-2808

Other Identifiers

1509977311

Identifier Type: -

Identifier Source: org_study_id