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Evaluation of Myocardial Improvement in Patients Supported by Ventricular Assist Device Under Optimal Pharmacological Therapy

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ClinicalTrials.gov Identifier: NCT00402376
Recruitment Status : Terminated
First Posted : November 22, 2006
Last Update Posted : August 30, 2011
Sponsor:
Collaborators:
Service de Chirurgie Cardiaque
Institut de Physiologie, Strasbourg, France
Institut National de la Santé Et de la Recherche Médicale, France
Information provided by:
University Hospital, Strasbourg, France

Brief Summary:

Cardiac function may improve in patients with end-stage heart failure who receive long-term support with ventricular assist devices (VAD). Reverse left ventricular remodeling may be sufficient in some cases to allow explantation of the VAD. However, some questions continue to await definitive answers. This study is designed to assess the myocardial recovery under VAD support with optimal pharmacological therapy (high doses [group I] of statins, beta-blockers, angiotensin-converting enzyme inhibitors versus standard doses [group II]).

The study is a randomized, single-blind trial performed at the Department of Cardiac Surgery, University of Strasbourg, France. Twenty patients with end-stage heart failure who will be supported by VAD (Thoratec paracorporeal device) as a bridge to heart transplantation will be included. Reverse left ventricular remodeling and myocardial function will be studied by: echocardiography, respiratory mitochondrial function, exercise testing, cardiac hormonal function, and inflammatory response. Myocardial biopsies will be obtained at the time of VAD implantation and heart transplantation. The follow-up will be performed every 4 weeks during the VAD support period. The hypothesis of this trial is that reverse left ventricular remodeling and myocardial function will improve under optimal medical therapy especially by a high dose statin.


Condition or disease Intervention/treatment Phase
Heart Failure Drug: Pravastatin, Carvedilol, Perindopril Device: Biventricular assist device (Thoratec paracorporeal assist device) Phase 4

Detailed Description:
Evaluation of Myocardial Improvement (Reverse Left Ventricular Remodeling, Mitochondrial Respiratory Function) in Patients Supported by Ventricular Assist Device Under Optimal Pharmacological Therapy

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single
Primary Purpose: Treatment
Official Title: Effects of Combined Ventricular Unloading and Pharmacological Therapy on Left Ventricular Metabolic Dysfunction in Heart Failure
Study Start Date : April 2007

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure
U.S. FDA Resources




Primary Outcome Measures :
  1. Mitochondrial function [ Time Frame: at implantation and explantation of VAD ]

Secondary Outcome Measures :
  1. Inflammation: IL-6; IL-8; IL-10, IL-18, TNF-α
  2. Exercise testing : stress echocardiography, peak oxygen consumption
  3. Hormonal cardiac function: ANP, BNP
  4. Ventricular remodelling: echocardiography
  5. All those parameters will be measured in the post-operative course and every 4 weeks during all the VAD support period.


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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with end-stage heart failure refractory to medical therapy and who fulfill criteria for VAD implantation as a bridge to heart transplantation
  • Age > 18

Exclusion Criteria:

  • Myocarditis

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00402376


Locations
France
Service de Chirurgie Cardiovasculaire - Hôpital Civil
Strasbourg, France, 67091
Service de Physiologie Clinique - Hôpital Civil
Strasbourg, France, 67091
Sponsors and Collaborators
University Hospital, Strasbourg, France
Service de Chirurgie Cardiaque
Institut de Physiologie, Strasbourg, France
Institut National de la Santé Et de la Recherche Médicale, France
Investigators
Study Director: Bernard Geny, MD Hôpitaux Universitaires de Strasbourg

ClinicalTrials.gov Identifier: NCT00402376     History of Changes
Other Study ID Numbers: 3212
First Posted: November 22, 2006    Key Record Dates
Last Update Posted: August 30, 2011
Last Verified: August 2011

Keywords provided by University Hospital, Strasbourg, France:
End-stage heart failure
heart failure;
ventricular assist device;
statin;
heart transplantation;
myocardial function;
mitochondrial respiratory function;

Additional relevant MeSH terms:
Heart Failure
Heart Diseases
Cardiovascular Diseases
Carvedilol
Perindopril
Pravastatin
Adrenergic beta-Antagonists
Adrenergic Antagonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Antihypertensive Agents
Vasodilator Agents
Adrenergic alpha-1 Receptor Antagonists
Adrenergic alpha-Antagonists
Anticholesteremic Agents
Hypolipidemic Agents
Antimetabolites
Lipid Regulating Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Enzyme Inhibitors
Angiotensin-Converting Enzyme Inhibitors
Protease Inhibitors