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Regression of Myocardial Steatosis by Nebivolol

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified May 2011 by Cedars-Sinai Medical Center.
Recruitment status was:  Not yet recruiting
Forest Laboratories
Information provided by:
Cedars-Sinai Medical Center Identifier:
First received: May 20, 2011
Last updated: NA
Last verified: May 2011
History: No changes posted
Within large number of patients with obesity, it is crucial to determine who is at the greatest risk for development of chronic heart disease. The investigators previous studies suggest that an excessive accumulation of fat in heart cells precedes the development of obesity-related pathologies and may serve as a biomarker of heart disease in high-risk population. Until now, the evaluation of fat in the human heart was possible postmortem or by biopsy. The investigators novel magnetic resonance spectroscopy technique enables the quantification of intracellular lipid content non-invasively and repeatedly in humans in vivo. It could be used to better screen and treat obese patients at risk for the development of metabolic disease. The investigators hypothesize that in obese humans with elevated myocardial triglycerides, treatment with Nebivolol will reduce myocardial fat and will improve heart function.

Condition Intervention
Cardiac Steatosis and Lipotoxicity
Drug: Nebivolol

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment

Resource links provided by NLM:

Further study details as provided by Cedars-Sinai Medical Center:

Primary Outcome Measures:
  • Myocardial triglyceride content [ Time Frame: 6 months ]
    Regression of myocadial triglycerides using MR spectroscopy at two time points, one prior to receiving Nebivolol and six months after continuous low dose Nebivolol treatment.

Secondary Outcome Measures:
  • Cardiac function [ Time Frame: 6 months ]
    Cardiac systolic and diastolic function will be assessed with cardiac MRI at two time points, one prior to receiving low dose Nebivolol treatment and once after six months of Nebivolol treatment.

  • Regression of concentric cardiac remodeling [ Time Frame: 6 months ]
    Cardiac concentric remodeling will be assessed with cardiac MRI at two time points, one prior to receiving low dose Nebivolol treatment and once after six months of Nebivolol treatment.

  • Regression of steatosis in other non-adipocyte tissue [ Time Frame: 6 months ]
    Regression of steatosis in other non-adipocyte tissue, including skeletal muscle, liver, and pancreas, will be assessed with MR spectroscopy at two time points, one prior to receiving low dose Nebivolol treatment and once after six months of Nebivolol treatment.

  • Regression of subcutaneous fat [ Time Frame: 6 months ]
    Regression of subcutaneous fat will be assessed with cardiac MRI at two time points, one prior to receiving low dose Nebivolol treatment and once after six months of Nebivolol treatment.

Estimated Enrollment: 30
Study Start Date: June 2011
Estimated Study Completion Date: June 2013
Estimated Primary Completion Date: June 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Nebivolol
Nebivolol (Bystolic® by Forest/Mylan) is a third-generation beta-blocker; it selectively blocks β1-adrenergic receptors and increases peripheral vasodilation.
Drug: Nebivolol
Day 1 - Patients will start Nebivolol 5 mg PO daily; after one month, if the subject has tolerated 5 mg PO Nebivolol, the dose will be increased to 10 mg PO daily. If the patients is unable to tolerate 5 mg PO Nebivolol, he/she will be discontinued from the study. After six months, medication will be tapered to 5 mg PO daily for two weeks. Medication will then be tapered to 2.5 mg PO daily for two additional weeks.
Other Name: Bystolic® by Forest/Mylan

  Show Detailed Description


Ages Eligible for Study:   18 Years to 59 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Mexican American men and women
  • Age 18 - 59
  • Metabolic Syndrome*
  • Myocardial TG > or = to 0.5% by localized MR spectroscopy

    *Metabolic syndrome in our study will follow the NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) Guidelines which include > or = to 3 of the following:

  • Fasting blood glucose > or = to 100 mg/dL
  • Waist circumference: Men > 102 cm, Women > 88 cm
  • Triglycerides > or = to 150 mg/dL
  • BP > 130/85

Exclusion Criteria:

  • Current use of a beta-blocker
  • HR < 50 beats/min or BP < 130/85
  • Contraindication to beta-blocker therapy such as asthma, reactive airway disease, heart block, or depression
  • CHF (any NYHA class) by history, physical examination, or current use of CHF medication including beta-blockers, ACE inhibitors, angiotensin receptor blockers (ARBs), diuretics, calcium channel blockers, digitoxin, hydralazine, nitrates (including sublingual nitroglycerin), and inotropic agents
  • LVEF < 50% by cardiac MRI
  • Hepatic insufficiency or current use of another medication that is also metabolized by the CYP2D6 isozyme (paroxetine, fluoxetine, quinidine, propafenone).
  • Any contraindication to MRI, e.g. metallic implants, metallic tattoos, claustrophobia, weight > 350 pounds (the MRI weight limit)
  • Pregnancy at any time during the study
  • A recent weight loss (>10% of body weight within the past year) or plans to undergo significant weight reduction (>10% of body weight) during the experimental protocol.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01358409

United States, California
Cedars-Sinai Medical Center Not yet recruiting
Los Angeles, California, United States, 90048
Contact: Gonzalez    310-248-8094   
Contact: Szczepaniak   
Sponsors and Collaborators
Cedars-Sinai Medical Center
Forest Laboratories
Principal Investigator: Lidia S Szczepaniak, PhD Cedars-Sinai Heart Institute
  More Information

Responsible Party: Lidia Szczepaniak, principle investigator, Cedars-Sinai Medical Center Identifier: NCT01358409     History of Changes
Other Study ID Numbers: MTG_Neb01
Study First Received: May 20, 2011
Last Updated: May 20, 2011

Keywords provided by Cedars-Sinai Medical Center:
MR spectroscopy
cardiac MRI

Additional relevant MeSH terms:
Fatty Liver
Liver Diseases
Digestive System Diseases
Antihypertensive Agents
Vasodilator Agents
Adrenergic beta-1 Receptor Agonists
Adrenergic beta-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs processed this record on April 28, 2017