Hypertension, Pulmonary Clinical Trial
Official title:
Clevidipine for Vasoreactivity Evaluation of the Pulmonary Arterial Bed (CARVE)
Pulmonary arterial hypertension (PAH) is a rare blood vessel disorder of the lung in which
the pressure in the pulmonary artery (PA) rises above normal levels and may become life
threatening. PAH is frequently misdiagnosed and has often progressed to late stage by the
time it is accurately diagnosed. PAH has been historically chronic and incurable with a poor
survival rate. However, new treatments are available which have significantly improved
prognosis. Right-heart catheterization (RHC) is the most accurate and useful test for PAH,
and the only test that directly measures the pressure inside the PA. It is performed in all
patients at least once, to get a definitive diagnosis of PAH.
The most commonly used medication for this purpose is intravenous nitroprusside, however
this medication in about 25-30% of patients is not well tolerated as it cause fast heart
rates, which is not well tolerated by patients with pulmonary hypertension and/or heart
failure. The CARVE study assesses the effect of Clevidipine, an ultra-short acting
vasoselective calcium antagonist, on pulmonary vascular resistance (PVR) and its utility for
pulmonary vasoreactivity testing during right heart catheterization (RHC) of patients with
pulmonary hypertension (PAH).
CARVE is a Phase 4 open-label descriptive observational trial in PAH patients undergoing
invasive vasoreactivity testing in the cath lab at the Dallas VA Medical Center. Patients
clinically indicated for RHC and assessment of pulmonary artery vasoreactivity will be
enrolled if they meet the inclusion/exclusion criteria. The study will involve the following
tests:
1. Performance of clinically indicated RHC with assessment of pulmonary hypertension and
pulmonary vascular resistance (PVR).
2. Performance of clinically indicated pulmonary vasoreactivity assessment with IV
Nitroprusside (standard of care)
3. For patients who are responsive to Nitroprusside, or those who have an inconclusive
result because of intolerability to Nitroprusside, pulmonary vasoreactivity assessment
with study drug (IV) will be conducted.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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