Genomic Investigation of Cardiovascular Diseases

Prior treatment

• Previously enrolled in The Genebank at Scripps Clinic Registry
• Treatment with any investigational agents or devices within 30 days preceding enrollment in the study.
• Subject's qualifying diagnosis is Atrial fibrillation and they are known to have any one of the following:
  • Prior myocardial infarction, coronary artery bypass surgery, or percutaneous coronary intervention
  • EF \< 45% at time of diagnosis (excluding tachycardia induced cardiomyopathy diagnosed by a cardiologist)
  • Elevated left atrial pressures (\> 20 mmHg)
  • Dilated left atrium (\> 4.0 cm or \>2.0 cm/m2 body surface)
  • Mitral valve disease with significant valve pathology
  • Mitral regurgitation/insufficiency greater than trace to mild on echo as determined by reading physician
  • Rheumatic mitral valve disease
  • Congestive heart failure prior to diagnosis
  • Hypertrophic cardiomyopathy
  • Diagnosis following coronary artery bypass or valve replacement surgery
  • Post heart transplant
  • Congenital heart disease
  • Diagnosed in setting of hyperthyroid
  • COPD
  • Obstructive sleep apnea
• Subject's qualifying diagnosis is Idiopathic (non-ischemic) cardiomyopathy and they are known to have any one of the following:
  • Ischemic cardiomyopathy
  • Hypertrophic cardiomyopathy
  • Viral cardiomyopathy
  • Alcohol/drug induced cardiomyopathy

Other illness

• Patients will be excluded if ANY of the following conditions apply:
• Any active bleeding (i.e. GI bleed).
• Has a significant medical condition which in the investigator's opinion may interfere with the patient's optimal participation in the study

Lab values

• Subject's qualifying diagnosis is Mitral regurgitation (insufficiency) and they are known to have any one of the following:
  • Ejection fraction \<50%
  • Evidence of significant ischemic disease with regions of akinetic myocardium
  • Rheumatic changes on echocardiogram (as determined by the reading physi4ian)
  • 5\. Significant Mitral stenosis (greater than "mild" on echocardiogram as determined by the reading physician) 6. Evidence of valve perforation 7. Evidence of congenital abnormality (i.e. cleft valve)

Other

• Been administered or taken any CNS sedatives or depressants in the past 12 hours.
• Been administered or taken any CNS sedatives or depressants in the past 12 hours.
• Subject's qualifying diagnosis is Aortic Stenosis and they are known to have any one of the following:
  • Bicuspid valve or other congenital abnormality of the aorta or aortic valve
  • Evidence of Rheumatic involvement of the Aortic Valve

• Candidates for this study must meet ALL of the following criteria:
• Age 18 years or older
• Be reliable, cooperative and willing to comply with all protocol-specified procedures and sub-study if consented.
• Able to understand and grant informed consent
• Have at least one of the following (a-g):
  • Coronary Artery Disease (defined as):
  • Coronary artery bypass surgery or
  • Lesion \>70% on cardiac or CT angiogram or
  • Percutaneous Coronary Intervention
  • Myocardial infarction (defined as):
  • Diagnosed by elevated troponin level or
  • Diagnosed by ST segment elevations on EKG or
  • Diagnosed by pathologic Q waves on EKG or
  • Documented in the medical record or by self report
  • Atrial Fibrillation (defined as):
  • Lone Atrial fibrillation (paroxysmal, persistent or permanent); OR
  • Lone Atrial Flutter (paroxysmal, persistent or permanent)
  • Automatic Internal Cardiac Defibrillator
  • Aortic Stenosis (defined by):
  • Calculated Aortic Valve Area ≤ 1.0 cm² or
  • Mean Pressure Gradient ≥ 40 mmHg or
  • Peak Pressure Gradient ≥ 64 mmHg or
  • Dimensionless Index \< .25 or
  • Prior or planned Aortic Valve Replacement for Aortic Stenosis
  • Mitral Regurgitation (insufficiency) (defined as)
  • Moderate to Severe (equivalent to +3 to +4) mitral regurgitation (insufficiency) on transthoracic echocardiogram as determined by the reading physician and structurally abnormal valve (i.e. myxomatous) and/or thickened or redundant leaflets; OR
  • Prior or planned Mitral Valve repair or replacement for mitral regurgitation
  • Idiopathic (non-ischemic) Cardiomyopathy (defined as):
  • Diagnosed \< age 40; OR
  • Non-ischemic etiology confirmed by cardiac angiography or CT angiography (may have non-obstructive or stable coronary artery disease if diagnosis of non-ischemic etiology of CM is established by cardiologist).