Ischemia-reperfusion Injury Clinical Trial
Official title:
The Effect of Eplerenone on Ischemia Reperfusion Injury in Human Myocardium (EPLICARD Study)
In the laboratory, the researchers will investigate whether the drug eplerenone improves contractile function after ischemia and reperfusion in heart tissue.
In animal studies, the mineralocorticoid receptor antagonist eplerenone appears to limit
myocardial infarct size. This cardioprotective effect might explain, at least in part, the
beneficial effect on mortality of eplerenone in patients with heart failure. Previous animal
studies suggest that this cardioprotective effect is mediated by an increased formation of
the endogenous nucleoside adenosine.
Our objective is to study for the first time in human myocardial tissue ex vivo wether
eplerenone limits ischemia reperfusion injury and whether this is mediated by adenosine
receptor stimulation.
From patients undergoing open heart surgery, the right atrial appendage will be harvested by
the cardiothoracic surgeon. In the laboratory, two trabeculae will be dissected and
suspended in an organ bath. Contraction will be induced by electrical field stimulation.
Recovery of contractile force after a period of simulated ischemia and reperfusion will be
used as an endpoint of ischemia-reperfusion injury.
The trabeculae of each patient will be randomized to pretreatment with A)ischemic
preconditioning (IP) of no IP as a positive control experiment; B)eplerenone or vehicle;
C)eplerenone with or without caffeine; and D)aldosterone with and without eplerenone.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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