Cardiac Output, Low Clinical Trial
— HYPEROfficial title:
Myocardial Protection With Perhexiline in Left Ventricular Hypertrophy
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.
Status | Recruiting |
Enrollment | 220 |
Est. completion date | December 2012 |
Est. primary completion date | September 2012 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
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 |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United Kingdom | University Hospital Birmingham | Birmingham | West Midlands |
Lead Sponsor | Collaborator |
---|---|
University Hospital Birmingham | Brighton and Sussex University Hospitals NHS Trust, British Heart Foundation, University of Birmingham |
United Kingdom,
Ashrafian H, Horowitz JD, Frenneaux MP. Perhexiline. Cardiovasc Drug Rev. 2007 Spring;25(1):76-97. Review. — View Citation
Quinn DW, Pagano D, Bonser RS, Rooney SJ, Graham TR, Wilson IC, Keogh BE, Townend JN, Lewis ME, Nightingale P; Study Investigators. Improved myocardial protection during coronary artery surgery with glucose-insulin-potassium: a randomized controlled trial. J Thorac Cardiovasc Surg. 2006 Jan;131(1):34-42. — View Citation
Ranasinghe AM, Quinn DW, Pagano D, Edwards N, Faroqui M, Graham TR, Keogh BE, Mascaro J, Riddington DW, Rooney SJ, Townend JN, Wilson IC, Bonser RS. Glucose-insulin-potassium and tri-iodothyronine individually improve hemodynamic performance and are associated with reduced troponin I release after on-pump coronary artery bypass grafting. Circulation. 2006 Jul 4;114(1 Suppl):I245-50. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Absolute difference in Cardiac Index (>0.3 l/min/m2) | 6 hours post-removal of aortic X-clamp | No | |
Secondary | Incidence of Low Cardiac Output Syndrome | 6 hours post-removal of aortic X-clamp | No | |
Secondary | Incidence of inotrope use according to protocol | 6 and 12 hours post-removal of aortic X-clamp | No | |
Secondary | Peak and total release of Troponin | 12 and 24 hours post-release of aortic X-clamp | No |
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