Myocardial Protection With Perhexiline in Left Ventricular Hypertrophy (HYPER)
Recruitment status was Recruiting
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Purpose
Open-heart surgery causes injury of the heart muscle. Although this is usually mild, temporary and reversible, if it is severe it can endanger life and require additional high cost care. During surgery, techniques are used to protect the heart from injury, but these remain imperfect. Patients with a thickened wall of the heart (left ventricular hypertrophy) may be at greater risk. This study assesses the effect of facilitating sugar metabolism (a more efficient fuel) by the heart muscle using the drug Perhexiline given before the operation.
This treatment has a sound experimental basis for improving outcome. If this improvement is confirmed surgical results could be improved. The investigators will be studying heart function, heart muscle energy stores and chemicals which quantify the amount of heart muscle injury. The investigators' hypothesis is that Perhexiline will improve the protection of the heart by decreasing damage that may occur during heart surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Myocardial Reperfusion Injury Cardiac Output, Low Hypertrophy, Left Ventricular |
Drug: Perhexiline Drug: Placebo marked PEXSIG |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Myocardial Protection With Perhexiline in Left Ventricular Hypertrophy |
- Absolute difference in Cardiac Index (>0.3 l/min/m2) [ Time Frame: 6 hours post-removal of aortic X-clamp ] [ Designated as safety issue: No ]
- Incidence of Low Cardiac Output Syndrome [ Time Frame: 6 hours post-removal of aortic X-clamp ] [ Designated as safety issue: No ]
- Incidence of inotrope use according to protocol [ Time Frame: 6 and 12 hours post-removal of aortic X-clamp ] [ Designated as safety issue: No ]
- Peak and total release of Troponin [ Time Frame: 12 and 24 hours post-release of aortic X-clamp ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 220 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | September 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Perhexiline
Pre-operative administration of Perhexiline tablets according to dosing schedule
|
Drug: Perhexiline
Tablets. Dose: 200mg BD for 3 days, then 100mg BD until surgery. Duration of therapy: 5-31 days.
Other Name: PEXSIG
|
|
Placebo Comparator: Placebo marked PEXSIG
Pre-operative administration of placebo tablets according to dosing schedule
|
Drug: Placebo marked PEXSIG
Tablets. Dose: 200mg BD for 3 days, then 100mg BD until surgery. Duration of therapy: 5-31 days.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adult
- First-time
- Aortic valve surgery for aortic stenosis +/- coronary artery bypass
Exclusion Criteria:
- Diabetes Mellitus
- Renal impairment with Creatinine greater than or equal to 200micromol/L
- Atrial fibrillation
- Amiodarone therapy, recent (in last month) or current
- Hepatic impairment, significant preoperative
- Peripheral neuropathy
- Pregnancy or breast-feeding
- Emergency surgery or required on clinical grounds within 5 days of referral
Contacts and Locations| Contact: Eshan Senanayake, MBBS MRCS | +44-7810-251454 | eshan.senanayake@uhb.nhs.uk |
| Contact: Nigel E Drury, BM MRCS | +44-7714-332364 | nigel.drury@uhb.nhs.uk |
| United Kingdom | |
| University Hospital Birmingham | Recruiting |
| Birmingham, West Midlands, United Kingdom, B15 2TH | |
| Contact: Eshan Senanayake, MBBS MRCS +44-7810-251454 eshan.senanayake@uhb.nhs.uk | |
| Contact: Nigel E Drury, BM MRCS +44-7714-332364 nigel.drury@uhb.nhs.uk | |
| Principal Investigator: Domenico Pagano, MD FRCS | |
| Sub-Investigator: Timothy R Graham, FRCS | |
| Sub-Investigator: Stephen J Rooney, FRCS | |
| Sub-Investigator: Ian C Wilson, MD FRCS | |
| Sub-Investigator: C Jorge G Mascaro, MD FRCS | |
| Principal Investigator: | Domeinco Pagano, MD FRCS | University Hospital Birmingham |
More Information
Publications:
| Responsible Party: | Mr Domenico Pagano, University Hospital Birmingham |
| ClinicalTrials.gov Identifier: | NCT00989508 History of Changes |
| Other Study ID Numbers: | RRK3535, Eudract 2008-002376-95, REC 08/H0304/48, BHF PG/08/040 |
| Study First Received: | October 2, 2009 |
| Last Updated: | August 10, 2011 |
| Health Authority: | United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Keywords provided by University Hospital Birmingham:
|
Perhexiline Aortic Valve Stenosis Hypertrophy, Left Ventricular |
Myocardial Reperfusion Injury Cardiac Output, Low Troponin |
Additional relevant MeSH terms:
|
Cardiac Output, Low Hypertrophy Myocardial Reperfusion Injury Reperfusion Injury Hypertrophy, Left Ventricular Heart Diseases Cardiovascular Diseases Signs and Symptoms Pathological Conditions, Anatomical Cardiomyopathies Myocardial Ischemia Vascular Diseases |
Postoperative Complications Pathologic Processes Cardiomegaly Perhexiline Calcium Channel Blockers Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Cardiovascular Agents Therapeutic Uses Vasodilator Agents |
ClinicalTrials.gov processed this record on May 19, 2013