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Aldosterone Blockade in Heart Failure (ARCTIC-D)

This study has been completed.
Information provided by:
University of Alberta Identifier:
First received: August 29, 2007
Last updated: April 5, 2010
Last verified: April 2010

Heart failure causes significant morbidity and mortality and is the most rapidly increasing cardiovascular diagnosis in North America overall prevalence is estimated at 0.4% to 2.4%. Recently, heart failure with a preserved ejection fraction (HFNEF) was found in up to 50% of patients with symptomatic heart failure. Many studies have demonstrated that HFNEF has a poor prognosis with a mortality rate of up to 8% per year and a 50% chance of needing to be admitted to hospital in the next year. There are no proven therapies for this type of heart failure.

Aldosterone blockers (these drugs block a hormone that is elevated in patients with heart failure) are used in other types of heart failure. Our goal is to see if this type of drug improves the function of the heart by looking at the thickness of the heart muscle using MRI. Also we will measure the amount of tissue formation and breakdown in the heart. The trial will be done using both the drug and a placebo so that we can see what effects are due to the drug.

Condition Intervention Phase
Heart Failure Drug: Spironolactone Drug: Placebo Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Aldosterone-blockade Randomized Controlled Trial In CHF - Diastolic

Resource links provided by NLM:

Further study details as provided by University of Alberta:

Primary Outcome Measures:
  • LVH [ Time Frame: 4 months ]

Estimated Enrollment: 10
Study Start Date: August 2007
Study Completion Date: April 2010
Arms Assigned Interventions
Experimental: 1
Drug: Spironolactone
Placebo Comparator: 2 Drug: Placebo

Detailed Description:

Aldosterone antagonists have shown efficacy in systolic heart failure and in patients with post-myocardial infarction systolic dysfunction in three major randomized placebo controlled trials. Together these trials have demonstrated a reduction in mortality, hospitalization and a regression in left ventricular mass by MRI.

Primary Objective The primary objective of this study will be to assess the change in markers of collagen turnover and correlate this with specific measures of left ventricular mass regression and diastolic function on MRI after 4 months of aldosterone blockade.

Study Design and Methods This study is a double-blind, concealed allocation, randomized trial at the University of Alberta where patients with diastolic heart failure will be randomized to spironolactone or matching placebo for 4 months. Outcomes assessed include LV mass by MRI, collagen markers, other biomarkers, clinical outcomes, quality of life and exercise testing


Ages Eligible for Study:   18 Years to 90 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. HF by Framingham criteria
  2. At least one admission to hospital for HF within the last 180 days
  3. New York Heart Association Class II thru IV
  4. Echocardiographic criteria:At least moderate diastolic dysfunction, Ejection fraction >45%

Exclusion Criteria:

  1. Creatinine clearance <40 mls/min/1.73m2
  2. Potassium >5.0 mmol/L
  3. Recent acute coronary syndrome in the prior 4 weeks
  4. Planned revascularization, defibrillator or pacemaker in next 4 months
  5. Known previous intolerance to aldosterone antagonist
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Please refer to this study by its identifier: NCT00523757

Canada, Alberta
University of Alberta Hospital
Edmonton, Alberta, Canada
Sponsors and Collaborators
University of Alberta
Principal Investigator: Justin Ezekowitz, MBBCh MSc University of Alberta
  More Information Identifier: NCT00523757     History of Changes
Other Study ID Numbers: UHF-G533000207
Study First Received: August 29, 2007
Last Updated: April 5, 2010

Keywords provided by University of Alberta:
heart failure
diastolic function

Additional relevant MeSH terms:
Heart Failure
Heart Diseases
Cardiovascular Diseases
Mineralocorticoid Receptor Antagonists
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Diuretics, Potassium Sparing
Natriuretic Agents processed this record on August 18, 2017