Physiological Effects of Grape Seed Extract in Diastolic Heart Failure (GRAPEVINE-HF)
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Purpose
Diastolic heart failure (also known as "heart failure with normal ejection fraction" or "heart failure with preserved ejection fraction") occurs even though the heart muscle's pumping function is normal. In many cases diastolic heart failure is related to stiffening of the heart and blood vessels in people who have high blood pressure. Current guidelines suggest that patients should limit the salt content of their diet, as too much salty food can cause fluid retention and other problems in diastolic heart failure. Studies in animals with diastolic heart failure suggest that antioxidant chemicals found in grapes can block some of the harmful effects of salty diets. Because it is often difficult for patients with diastolic heart failure to maintain a low salt diet, the investigators are researching the effects of the antioxidant properties of grape seed extract, a natural supplement made from grape seeds. The investigators hypothesize that supplementing the diet with grape seed extract (GSE) can decrease the levels of harmful chemicals and improve heart and blood vessel function in patients with diastolic heart failure and a history of high blood pressure.
The University of Michigan research group plans to enroll 25 patients with a history of high blood pressure and diastolic heart failure in a research study. The study will assess the effects of GSE on hormones and other chemicals that can cause heart and blood vessel damage. The investigators will also study the effects of GSE on the ability of the blood vessels and heart muscles to relax at the proper time and speed. Finally, the investigators will observe how GSE affects participants' overall ability to exercise, quality of life, and blood pressure control. Study participants will be randomly assigned to take either GSE or placebo (looks like but does not contain GSE) capsules twice a day for six weeks. After a two-week break, all subjects will cross over to the opposite group of capsules for an additional six-week period. At the start of the study and at the end of each six-week time period study participants will have non-invasive heart and blood vessel testing, blood work and urine tests, and blood pressure monitoring.
| Condition | Intervention | Phase |
|---|---|---|
|
Diastolic Heart Failure Hypertensive Heart Disease Heart Failure With Preserved Ejection Fraction Hypertension Oxidative Stress |
Drug: grape seed extract (MegaNatural BP, Polyphenolics, Inc.) |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | GRAPe Seed Extract and Ventriculovascular Investigation in Normal Ejection-Fraction Heart Failure |
- Brachial artery flow-mediated dilation (FMD) [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Ultrasound measure of conduit artery endothelial function
- Brachial artery flow-mediated dilation (FMD) [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Ultrasound measure of conduit artery endothelial function
- 24-hour blood pressure [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Mean and diurnal variation
- EndoPAT arterial endothelial function [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Plethysmographic measure of resistance arterial endothelial function
- Carotid-femoral pulse wave velocity [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
- Maximal exercise capacity and oxygen consumption [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
- Resting and post-exercise ventricular systolic and diastolic function [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Standard and novel echocardiographic measures including strain/strain rate
- Urinary 8-isoprostanes [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Measure of oxidative stress
- Heart failure related quality of life [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Minnesota Living With Heart Failure Questionnaire
- 24-hour blood pressure [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Mean and diurnal variation
- EndoPAT arterial endothelial function [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Plethysmographic measure of resistance arterial endothelial function
- Carotid-femoral pulse wave velocity [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
- Maximal exercise capacity and oxygen consumption [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
- Resting and post-exercise ventricular systolic and diastolic function [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Standard and novel echocardiographic measures including strain/strain rate
- Urinary 8-isoprostanes [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Measure of oxidative stress
- Heart failure related quality of life [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]Minnesota Living With Heart Failure Questionnaire
| Estimated Enrollment: | 25 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | November 2011 |
| Estimated Primary Completion Date: | August 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: grape seed extract capsule
Grape seed extract (MegaNatural BP, Polyphenolics, Inc.) 300 milligram capsules twice daily for six weeks
|
Drug: grape seed extract (MegaNatural BP, Polyphenolics, Inc.)
Subjects will be randomized in double-blind fashion to either grape seed extract (GSE) or maltodextrin placebo capsules for for 6 weeks. Patient will take 300 mg GSE/placebo twice a day for 6 weeks. Patient will have a 2 week washout period and then cross over to the opposite group for an additional 6 weeks.
Other Names:
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|
Placebo Comparator: maltodextrin capsule
Maltodextrin capsules (matched for appearance and taste to grape seed extract capsules) twice daily for six weeks
|
Drug: grape seed extract (MegaNatural BP, Polyphenolics, Inc.)
Subjects will be randomized in double-blind fashion to either grape seed extract (GSE) or maltodextrin placebo capsules for for 6 weeks. Patient will take 300 mg GSE/placebo twice a day for 6 weeks. Patient will have a 2 week washout period and then cross over to the opposite group for an additional 6 weeks.
Other Names:
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Eligibility| Ages Eligible for Study: | 50 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Inclusion:
- Signs and symptoms of heart failure
- Left ventricular ejection fraction ≥ 50% (contrast ventriculography, echocardiography, nuclear scintigraphy, MRI or CT imaging)
- Diastolic dysfunction on previous echocardiogram/catheterization, or indeterminate diastolic function with supporting evidence of heart failure (HF) (as per European Society of Cardiology guidelines)
- History of systemic hypertension
- Age ≥ 50 years
- Willing to adhere to prescribed course of supplementation
- Informed consent
Exclusion Criteria:
- Daily intake of antioxidant supplements or vitamins beyond that provided in a standard daily multivitamin (e.g. high-dose vitamin E or vitamin C)
- NYHA Class IV heart failure symptoms (except during previous hospitalization)
- Hospitalization for decompensated heart failure within past one month
- Severely uncontrolled hypertension (SBP ≥ 180 and.or DBP ≥ 100 at rest, on current antihypertensive regimen
- Uncontrolled diabetes mellitus (hemoglobin A1C > 9%)
- Severe renal (estimated GFR < 30 ml/min) or hepatic disease/failure
- Severe anemia (Hgb < 9)
- Primary exercise limitation due to severe pulmonary disease
- Unacceptably poor echocardiographic images for analysis
- Worse than moderate mitral or aortic stenosis or insufficiency.
- Non-hypertensive cause of HFpEF (e.g. valvular disease, congenital heart disease, amyloidosis, sarcoidosis, constrictive pericardial syndromes)
- Myocardial infarction or unstable angina, including new or worsening anginal syndrome, within the past three months
- Uncontrolled arrhythmia (including non rate-controlled atrial fibrillation)
- Terminal illness expected to result in death within six months or active solid-organ cancer
- Psychiatric disorder (or dementia) with potential to compromise adherence
- Changes in medical regimen for heart disease or hypertension within past 1 month (except diuretic dose adjustment)
Contacts and Locations| Contact: Joanna Wells | 734-232-6383 | joannamw@umich.edu |
| United States, Michigan | |
| University of Michigan | Recruiting |
| Ann Arbor, Michigan, United States, 48109 | |
| Contact: Scott L Hummel, MD MS 734-936-5265 scothumm@med.umich.edu | |
| Contact: Joanna M Wells 734 232 6383 joannamw@umich.edu | |
| Principal Investigator: Scott L Hummel, MD MS | |
| Principal Investigator: | Scott L Hummel, MD, MS | University of Michigan |
More Information
Publications:
| Responsible Party: | Scott L. Hummel MD MS, University of Michigan |
| ClinicalTrials.gov Identifier: | NCT01185067 History of Changes |
| Other Study ID Numbers: | HUM00029626 |
| Study First Received: | August 2, 2010 |
| Last Updated: | August 23, 2010 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Michigan:
|
Antioxidants Hypertension Endothelial function Oxidative stress Grapes Polyphenols Resveratrol Quercetin Anthocyanins |
Flavanols Flavonols Congestive heart failure Heart failure with normal ejection fraction Heart failure with preserved systolic function HFNEF HFPSF HFPEF DHF |
Additional relevant MeSH terms:
|
Antioxidants Heart Diseases Heart Failure Hypertension Heart Failure, Diastolic Cardiovascular Diseases Vascular Diseases Quercetin Resveratrol Grape Seed Extract Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Protective Agents Physiological Effects of Drugs Anti-Inflammatory Agents, Non-Steroidal |
Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Anti-Inflammatory Agents Therapeutic Uses Antirheumatic Agents Antineoplastic Agents, Phytogenic Antineoplastic Agents Enzyme Inhibitors Platelet Aggregation Inhibitors Hematologic Agents Antimutagenic Agents Anticarcinogenic Agents Central Nervous System Agents |
ClinicalTrials.gov processed this record on May 19, 2013