Local Inflammation in Arrhythmogenic Right Ventricular Cardiomyopathy

Обзор

The understanding of ARVC pathophysiology remains incomplete. Several clues indicate that disease progression is mediated through inflammation. The present study aim to document the feasibility of detecting the potential presence of intracardiac local inflammatory components in patients with ARVC.

Подробное описание

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heritable condition characterized by right ventricular (RV) dilatation/dysfunction and malignant ventricular arrhythmias. The understanding of ARVC pathophysiology remains incomplete. Several clues indicate that disease progression is mediated through inflammation. First, presence of subepicardial late gadolinium enhancement sharing the same characteristics as the ones found in myocarditis is common on cardiac magnetic resonance imaging (CMR). Second, clinical pathology findings of inflammatory infiltrates of mononuclear cells are frequent and correlate to the extent and severity of ARVC. Finally, from a biological standpoint, the exploratory study conducted by Campian et al. has shown an exaggerated humoral inflammatory response in peripheral blood whilst anti-desmoglein-2 antibodies (targeting a component of the desmosome) emerge as a sensitive and specific biomarker for ARVC. As specific treatments for ARVC are currently lacking, a better understanding of the humoral pathophysiology of the disease could unlock new therapeutic targets. We recently demonstrated that collecting local cardiomyocytes was feasible through irrigated ablation catheters in patients with ARVC. These steerable catheters may easily map the whole right ventricle and locate endocardial or epicardial scars. Aspiration of local blood or cellular material through the inner lumen of the catheter once pressed on the parietal wall may be an interesting technique for retrieving local inflammation markers.

Вмешательства

• Биопрепарат Peripheral immunological assessment on venous blood
  Peripheral immunological assessment carried out as part of the research, on venous blood at the puncture point necessary for the electrophysiological examination: 1 heparin tube and 1 EDTA tube
• Биопрепарат Immunological assessment carried out on intracardiac material
  Immunological assessment carried out as part of the research, on intracardiac material taken during the electrophysiological examination: 1 EDTA tube

Первичные конечные точки

• Identify the inflammatory components by C-reactive protein [Срок оценки: 24 months]
• Identify the inflammatory components by interleukine1 [Срок оценки: 24 months]
• Identify the inflammatory components by onterleukine6 [Срок оценки: 24 months]
• Identify the inflammatory components by interleukine10 [Срок оценки: 24 months]
• Identify the inflammatory components by Tumor Necrosis Factor [Срок оценки: 24 months]
• Identify the inflammatory components by Transforming Growth Factor [Срок оценки: 24 months]

Критерии участия

Критерии включения

• For cases:

• Arrhythmogenic right ventricular dysplasia diagnosed (according to 2010 Task Force Criteria)
• Admitted for right ventricle electrophysiologic mapping
• For controls \* Admitted for ablation procedures (accessory pathway, atrial flutter) on otherwise healthy hearts.

Критерии исключения

• Diagnostic of systemic chronic inflammatory disease
• Presence of possible or proven cardiac involvement of an inflammatory disease, an acute or chronic infectious disease.
• Taking immunosuppressant or immunomodulating medications

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Диагностика

Центры проведения

Франция · 1 центр

• Toulouse University Hospital Center — Toulouse

Идентификаторы

NCT: NCT05209776 · RC31/21/0026

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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