Network Medicine Approaches to Classify Heart Failure With PReserved Ejection Fraction by Signatures of DNA Methylation and Point-of-carE Risk calculaTors (PRESMET)

NCT ID: NCT05475028

Last Updated: 2022-07-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-09-14

Study Completion Date

2022-06-14

Brief Summary

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Heart failure (HF) is a syndrome, resulting from structural or functional impairment of ventricular filling or ejection of blood. Effective HF management depends on accurate and rapid diagnosis requiring assessment of symptoms and physical signs in combination with advanced and expensive imaging tools. However, several challenges arise from the traditional symptom-based diagnosis because co-morbidities of HF have similar presentations. This implies the need for a deeper knowledge of mechanistic links among genetic and epigenetic events governing the pathophysiology of HF leading to a novel molecular-based system to differentiate HF phenotypes. Now, it is emerging that the pathophysiology of HFpEF and HFrEF is different, it provides an opportunity to identify biomarker candidates that could aid in HF diagnosis and stratification between these two forms of the disease. The aim of PRESMET project is to perform liquid biopsy strategies to identify novel putative non-invasive epigenetic-sensitive biomarkers that could be used either alone or in combination with established diagnostic tests, such as natriuretic peptide, to help differentiate HFpEF from HFrEF. The Investigators will perform DNA methylation analysis on CD4+ T cells isolated from patients versus controls. Remarkably, big data generated from NGS tools will be analyzed by advanced network-oriented algorithms. Our results may provide a useful clinical roadmap in order to improve precision medicine and personalized therapy of HF.

Detailed Description

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The Investigators will perform the first Network Medicine approach to integrate the DNA methylome of circulating CD4+T cells and clinical parameters in patients with HFpEF and HFrEF.

Liquid biopsy strategies will be performed to isolate PBMCs and purificate CD4+ T cells. Successivelly, genomic DNA will be extracted on columns and will be send out for RRBS.

Network-oriented algorithms will be used to analyze DNA methylation signatures and to identify specific epigenetic changes in relation to left ventricle ejection fraction.

Network-oriented DNA methylation signatures will be integrated to the H2FPEF point-of-care calculator and, then, will be validated by the use of q-RT-PCR, WB, and ELISA.

Conditions

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Heart Failure, Diastolic Heart Failure, Systolic Pulmonary Hypertension Atrial Fibrillation

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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HFpEF

We will recruit HFpEF (LVEF \> 50%)

RRBS

Intervention Type OTHER

Reduced Representation Bisulfite Sequencing

HFrEF

We will recruit HFrEF (LVEF \< 40%)

RRBS

Intervention Type OTHER

Reduced Representation Bisulfite Sequencing

Healthy controls

We will recruit volunteer blood donors

RRBS

Intervention Type OTHER

Reduced Representation Bisulfite Sequencing

Interventions

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RRBS

Reduced Representation Bisulfite Sequencing

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* HFrEF (LVEF \< 40%)
* HFpEF (LVEF \> 50%)

Exclusion Criteria

* Patients with HF with a history of a reduced LVEF ≤ 40% (HFrEF) who recover LV function (LVEF ≥ 50%)
* Chronic inflammatory diseases
* Cancer
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Monaldi Hospital

OTHER

Sponsor Role collaborator

Federico II University

OTHER

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

University of Campania Luigi Vanvitelli

OTHER

Sponsor Role lead

Responsible Party

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Giuditta Benincasa

Principal Investigator Giuditta Benincasa, Biol.D, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of Campania Luigi Vanvitelli

Naples, , Italy

Site Status

Countries

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Italy

References

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Napoli C, Benincasa G, Donatelli F, Ambrosio G. Precision medicine in distinct heart failure phenotypes: Focus on clinical epigenetics. Am Heart J. 2020 Jun;224:113-128. doi: 10.1016/j.ahj.2020.03.007. Epub 2020 Mar 12.

Reference Type RESULT
PMID: 32361531 (View on PubMed)

Other Identifiers

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UniCampania

Identifier Type: -

Identifier Source: org_study_id

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