MITAORTA - Role of Mitochondrial Dynamic in Aneurysm and Dissection of Ascending Thoracic Aorta

University Hospital, Angers

Status: Active, not recruiting

Conditions: Aortic Aneurysm and Dissection

Treatments: Other: Mitochondrial dynamic analysis in the aorta samples and metabolomic profiling in the aortic diseases

Study type: Interventional

Funder types: Other

Identifiers

NCT05434481

2022-A00719-34

Details and patient eligibility

About

The main objective is to compare the mitochondrial dynamic between patients operated for aneurysm of ascending aorta or type A aortic dissection (AAD) or control group

Full description

In an aortic aneurysm process, the alteration of the extracellular matrix (ECM) as well as the apoptosis of the smooth muscle cells are due to inflammatory phenomena and oxydative stress, involving mitochondria which has a key place within cells.

Mitochondrial fusion and fission constitute mitochondrial dynamic and are involved in the mechanisms described above.

The alteration of mitochondrial dynamics has been demonstrated in many pathologies, in particular neurological, cancer and cardiovascular disease and generally occurs in favor of fission.

In a mouse model (FASEB J, 2021, Robert P ), the role of mitochondrial fusion has been demostrated as a protective factor against hypertension in resistance arteries and a deletion of OPA1 (optic Atrophy 1) fusion protein may lead to aneurysm until aortic dissection. The results of this experimental study suggest a role of the alteration of mitochondrial dynamic in the development of aneurysm and aortic dissection.

Enrollment: 60 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aneurysm aortic group: patients treated for an aneurysm of the ascending thoracic aorta with surgical indication according to the ESC guidelines (2014).
• Aortic dissection group: patients treated for type A acute aortic dissection or intramural hematoma of the ascending thoracic aorta in emergency.
• Control group: patients operated for aortic valve replacement (little aortic sample before closing aortotomy) or coronary artery bypass grafting which the use of a saphenous graft and the performance of a proximal anastomosis on the ascending aorta is planned

Exclusion criteria

• Patients under 18 years old
• Other acute aortic syndromes (penetrating ulcers, iatrogenic or traumatic dissections)
• Patients treated for aortic valve replacement in the context of infective endocarditis
• Patients treated for emergency aortic valve replacement or coronary bypass surgery**
• Pregnant, parturient and breastfeeding women
• Patients protected by an administrative or judicial measure (curatorship, guardianship)
• Patients receiving psychiatric care under duress
• Adults subject to a legal protection measure.
• Patients whose the samples planned for the study could not be taken;
• Patients in the control group whose tissue sampling will not be performed.

Trial design

Primary purpose: Other

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

60 participants in 3 patient groups

Aneurysm group

Active Comparator group

Description:

Patients operated for aneurysm of the ascending aorta according the guidelines on the diagnosis and treatment of aortic diseases (European Society of Cardiology - 2014).

Treatment:

Other: Mitochondrial dynamic analysis in the aorta samples and metabolomic profiling in the aortic diseases

Type A aortic dissection group

Active Comparator group

Description:

Patients operated for type A aortic dissection according the guidelines on the diagnosis and treatment of aortic diseases (European Society of Cardiology - 2014).

Treatment:

Other: Mitochondrial dynamic analysis in the aorta samples and metabolomic profiling in the aortic diseases

Control group

Sham Comparator group

Description:

Patients without aortic aneurysm or aortic dissection operated for aortic valve replacement (AVR) and/or coronary artery bypass with a saphenous vein graft for proximal aortic anastomosis to collect the aortic sample. For patients operated for AVR, an aortic sample will be collected before closing the aorta.

Treatment:

Other: Mitochondrial dynamic analysis in the aorta samples and metabolomic profiling in the aortic diseases