Sudden Cardiac death

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Background

Sudden cardiac death is a devastating event with severe consequences for the survivors and family members. If SCD occurs below age 45, a genetic cause is suspected. Also for SCD in the setting of ischemic heart disease or cardiomyopathy, vulnerability to fatal arrhythmia’s could be driven by genetics.

As such is the collection of biosamples of these patients and their family members essential for further diagnostic and pathogenic research studies.
Good clinical data are essential for the optimal use of a biobank initiative. Enrichment of  the sample with precious clinical data is required to facilitate translational research.

Aim. To build a detailed and extended cardiac clinical database on the CMI backbone and gather high quality biosamples for translational and clinical research in 4 research projects:

  • Research project 1: coronary artery disease
  • Research project 2: primary electrical disorders
  • Research project 3: aortic aneurysmal disorders
  • Research project 4: cardiomyopathies

Overall objectives for projects

The main areas of the cardiovascular disease research programme related to sudden cardiac death are:

  1. Translating genetic technology into improved clinical care
    • Optimalization of the genetic screening methods through the use of next generation sequencing technology to allow fast genetic confirmation of the suspected clinical diagnosis in the different disease categories (vulnerable atherosclerotic plaque and myocardial ischemia, PED, CMP, aortic pathology)
    • Identifying new genes and biological markers related to vulnerable coronary plaques and their natural history
    • Identification of new genes in families/patients without known disease gene for the primary electrical disease groups, mainly focusing on Brugada syndrome, Long QT and ARVC/D.
    • Functional characterization of new genetic variants in the genes encoding for cardiac ion channels to allow treatment and prevention strategies tailored to the genotype and/or specific molecular diagnosis.
    • Identifying new genes and biological markers responsible for structural changes to aortic wall and bicuspid aortic valves
  2. In vitro and in vivo diagnostics of sudden cardiac death
    • Improve understanding of the atherosclerotic plaque microenvironment in the pathogenesis of plaque instability
    • Develop and validate noninvasive and invasive imaging techniques to identify and monitor vulnerable plaques
    • Develop and validate noninvasive and invasive imaging techniques to identify the presence of a vulnerable myocardium and to monitor left ventricular remodeling
    • Develop and validate noninvasive and invasive imaging techniques to visualize and assess changes of aortic wall structure and elastic characteristics
  3. Prevention of sudden cardiac death through innovative technologies targeting structural abnormalities
    • Develop and validate noninvasive and invasive techniques to treat vulnerable plaques
    • Develop and validate a risk stratified approach of the use of ICD in the prevention of SCD in PED
    • Validate new pharmacological treatment strategies that are directed by the molecular diagnosis to prevent cardiac arrhythmias
    • Repairing the failing heart muscle using cardiac gene therapies and stem cell therapies,
    • Supporting the failing heart using new miniaturized mechanical heart devices and novel drug strategies
    • Assessing effectiveness of preventive aortic operation in patients with inherited Marfan Syndrome  and related aortic pathologies
    • Develop therapeutic drug trials to target restoring the structure of the aortic wall
    • Setting up and hosting of a nationwide Sudden Cardiac Death registry to document and centralize, and to provide access to clinical, epidemiologic and outcome data to facilitate the study and identification of clinical risk determinants

Valorisation

  1. Societal
    • Individual patient: lifestyle modification, pharmacological/surgical treatment or internal cardioverter defibrillator
    • First degree relatives: primary prevention through clinical and molecular, cardiogenetic cascade screening
    • Flemish society: psychosocial and socio-economic impact
  2. Economic
    • Improved imaging techniques
    • Optimal medical device design
    • Development of accurate biomarkers
    • Advanced pharmacological design

Contact details Research Platform “Sudden Cardiac Death”

Name coordinator: Prof dr Chris Vrints
Chair Cardiology UZA/UA

Name coordinator WG1 coronary artery disease: Prof dr Marc Claeys
Vice chair Cardiology UZA/UA

Name coordinator WG 2 primary electrical disorders: Prof dr Johan Saenen
Staff Cardiology UZA/UA

Name coordinator WG 3 aortic aneurysmal disorders: Prof dr Bart Loeys
Vice chair Medical Genetics UZA/UA

Name coordinator WG 4 cardiomyopathies: Prof dr Emeline Van Craenenbroeck
Staff Cardiology UZA/UA

Name CMI Liaison CRC Antwerpen: Prof dr Elke Smits
Manager Science & Innovation Policy UZA