Hypertrophic Cardiomyopathy Clinical Trial
Official title:
Effect of Losartan in Patients With Nonobstructive Hypertrophic Cardiomyopathy
The purpose of this study is to determine whether taking losartan helps people with hypertrophic nonobstructive cardiomyopathy feel better by decreasing the amount of heart muscle thickening and/or the amount of heart muscle scarring.
Hypertrophic cardiomyopathy (HCM) is characterized by idiopathic cardiac hypertrophy, heart
failure, ischemia even in the absence of epicardial coronary artery disease, and
arrhythmias. The pathological features of HCM include hypertrophy and disarray, interstitial
fibrosis, and increased arteriolar wall thickness. Hypertrophy and fibrosis are major
determinants of morbidity and mortality in hypertrophic cardiomyopathy. Some investigators
have demonstrated that interstitial fibrosis and hypertrophy occur secondarily, in response
to trophic and mitotic factors in the heart. Therefore, blocking trophic factors may
attenuate or potentially reverse hypertrophy and fibrosis in HCM.
Angiotensin II has trophic and profibrotic effects on the heart, and blockade of angiotensin
II type I receptors has been shown to attenuate myocardial hypertrophy and fibrosis in
acquired cardiac disease in humans and animal models.
We hypothesize that treatment with the selective angiotensin II type receptor antagonist,
losartan, will decrease both hypertrophy and fibrosis, improve diastolic function, reduce
symptoms, and improve functional status in patients with HCM.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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