Atrial Fibrillation Clinical Trial
Official title:
Role and Interactions of Adenosine, Receptors, Methionine Cycle Nutritional, Metabolic and Genetic Determinants in the Onset of Atrial Fibrillation in Normal Heart
The purpose of this study is to analyze the association of atrial fibrillation onset in
normal heart and:
- Genetic determinants (genes of receptors, enzymes involved in synthesis and
degradation, genes of bioavailability of coenzymes and nutritional precursors)
- Metabolic determinants of adenosine and methionine cycles
- Nutritional determinants.
Secondary purposes are:
- Analysis of physiopathologic mechanisms of AF in normal hearts and adenosine
metabolisms and its interaction with methionine metabolism, according to identified
genetic determinants
- Analysis of blood markers of adenosine and methionine metabolites as phenotypic markers
of detected polymorphisms
- Evaluate the role of adenosine receptors in AF onset
Atrial fibrillation (AF) is the most frequent arrhythmia and its causes are not well known.
Experimental and clinical studies showed that activation of parasympathetic system can
induce and maintain AF. Adenosine is a cardiovascular modulator with effects on vascular
tonus and activation of nodal tissue through the activation of A1, A2A, A2B et A3 receptors.
Intracellular production of adenosine is directly dependent (30%) on the hydrolysis of
S-adenosylhomocysteine (SAH) by S-adenosylhomocysteine hydrolase in methionine cycle.
Cellular production of adenosine depends on ratio SAH/S-adenosylmethionine (SAM) and
modulates the expression of receptors. Other potential interactions between this 2
metabolisms in AF are: 1) ratio SAM/SAH influences epigenetic mechanisms that can modify the
expression of candidate genes involved in synaptic transmission and potassium canals, 2)
ratio SAM/SAH influences also the cellular production of homocysteine with effects on
cellular polarization, 3) adenosine and homocysteine are factors involved in thrombophilia
and potentially associated to thromboembolic complications of AF.
This study will evaluate the genetic (micro SNP-array) and adenosine and methionine
metabolic determinants in the physiopathology of AF in normal hearts.
Perspectives of this study are the prevention of AF in normal hearts through a nutritional
and metabolic approach in subjects having a multigenic predisposition.
;
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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