A study protocol to characterise pathophysiological and molecular markers of rheumatic heart disease and degenerative aortic stenosis using multiparametric cardiovascular imaging and multiomics techniques

PLoS One. 2024 May 13;19(5):e0303496. doi: 10.1371/journal.pone.0303496. eCollection 2024.

Abstract

Introduction: Rheumatic heart disease (RHD), degenerative aortic stenosis (AS), and congenital valve diseases are prevalent in sub-Saharan Africa. Many knowledge gaps remain in understanding disease mechanisms, stratifying phenotypes, and prognostication. Therefore, we aimed to characterise patients through clinical profiling, imaging, histology, and molecular biomarkers to improve our understanding of the pathophysiology, diagnosis, and prognosis of RHD and AS.

Methods: In this cross-sectional, case-controlled study, we plan to recruit RHD and AS patients and compare them to matched controls. Living participants will undergo clinical assessment, echocardiography, CMR and blood sampling for circulatory biomarker analyses. Tissue samples will be obtained from patients undergoing valve replacement, while healthy tissues will be obtained from cadavers. Immunohistology, proteomics, metabolomics, and transcriptome analyses will be used to analyse circulatory- and tissue-specific biomarkers. Univariate and multivariate statistical analyses will be used for hypothesis testing and identification of important biomarkers. In summary, this study aims to delineate the pathophysiology of RHD and degenerative AS using multiparametric CMR imaging. In addition to discover novel biomarkers and explore the pathomechanisms associated with RHD and AS through high-throughput profiling of the tissue and blood proteome and metabolome and provide a proof of concept of the suitability of using cadaveric tissues as controls for cardiovascular disease studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / metabolism
  • Aortic Valve Stenosis* / physiopathology
  • Biomarkers* / metabolism
  • Case-Control Studies
  • Cross-Sectional Studies
  • Echocardiography / methods
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Metabolomics / methods
  • Multiomics
  • Proteomics / methods
  • Rheumatic Heart Disease* / diagnostic imaging
  • Rheumatic Heart Disease* / metabolism
  • Rheumatic Heart Disease* / physiopathology

Substances

  • Biomarkers

Grants and funding

This research is funded through a Blue Skies research grant from the National Research Foundation to SS (Grant Numbers 104839 and 105858) https://www.nrf.ac.za/. NABN gratefully acknowledges funding from the National Research Foundation (https://www.nrf.ac.za/), South African Medical Research Council (https://www.samrc.ac.za) and the Lily and Ernst Hausmann Trust. The funders has no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.