Levosimendan Versus Dobutamine for Renal Function in Heart Failure (ELDOR)
Efficacy of Intravenous Levosimendan Compared With Dobutamine on Renal Hemodynamics and Function in Chronic Heart Failure
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Gothenburg, Sweden, 41345
- Sahlgrenska University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Written, signed and dated informed consent
- Male and Female subjects ≥18 years of age
- Chronic congestive heart failure scheduled for right sided cardiac catheterization
- Left ventricular ejection fraction ≤ 40% determined by echocardiography
- Elevation of N Terminal-proBNP ≥ 500 ng/L
- Cardiorenal syndrome (30ml/min ≤ estimated GFR ≤ 80 ml/min (MDRD)
Exclusion Criteria:
- Acute heart failure, untreated
- Systolic blood pressure < 80 mmHg
- Tachycardia above 100 bpm
- Angina Canadian Cardiovascular Society (CCS) class III or higher
- Aortic stenosis
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy
- The presence of kidney disease diagnosed before heart failure
- Administration of radiographic contrast < 1 week
- Radiographic contrast allergy
- In the Investigator's opinion, the patient has a clinically significant disease that could be adversely affected by study participation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Levosimendan
Levosimendan administration is initiated with a loading dose of 12μg/kg given over 10 min followed by a continuous infusion of 0.1 μg/kg/min for 65 min.
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Other Names:
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Active Comparator: Dobutamine
Dobutamine is given as a continuous infusion without a bolus dose.
The infusion rate is started at 5.0 μg/kg/min for 10 minutes, and thereafter increased to 7,5 μg/kg/min for 65 min.
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Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in renal blood flow
Time Frame: 75 min minus baseline
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Para-aminohippuric acid (PAH) infusion clearance
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75 min minus baseline
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Change in glomerular filtration rate
Time Frame: 75 min minus baseline
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Chrome-ethylenediaminetetraacetic acid (EDTA) infusion clearance
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75 min minus baseline
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in renal vascular resistance
Time Frame: 75 min minus baseline
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Renal blood flow divided by the difference between renal arterial pressure and renal venous pressure
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75 min minus baseline
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Change in central hemodynamics
Time Frame: 75 min minus baseline
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Right atrial pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, mean arterial pressure, cardiac output, pulmonary vascular resistance and systemic vascular resistance measured with a pulmonary artery thermodilution catheter.
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75 min minus baseline
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Change in renal oxygen consumption and oxygen extraction
Time Frame: 75 min minus baseline
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Oxygen consumption: Renal blood flow multiplied by arterial-renal venous oxygen difference. Oxygen extraction: Ratio of renal oxygen consumption to renal oxygen delivery |
75 min minus baseline
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Change in filtration fraction
Time Frame: 75 min minus baseline
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Ratio of glomerular filtration rate to renal plasma flow
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75 min minus baseline
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Kristjan Karason, MD, PhD, Sahlgrenska University Hospital, Department of Cardiology
Publications and helpful links
General Publications
- Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017 Apr;3(1):7-11. doi: 10.15420/cfr.2016:25:2.
- Hillege HL, Nitsch D, Pfeffer MA, Swedberg K, McMurray JJ, Yusuf S, Granger CB, Michelson EL, Ostergren J, Cornel JH, de Zeeuw D, Pocock S, van Veldhuisen DJ; Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Investigators. Renal function as a predictor of outcome in a broad spectrum of patients with heart failure. Circulation. 2006 Feb 7;113(5):671-8. doi: 10.1161/CIRCULATIONAHA.105.580506.
- Smith GL, Shlipak MG, Havranek EP, Masoudi FA, McClellan WM, Foody JM, Rathore SS, Krumholz HM. Race and renal impairment in heart failure: mortality in blacks versus whites. Circulation. 2005 Mar 15;111(10):1270-7. doi: 10.1161/01.CIR.0000158131.78881.D5.
- Hillege HL, Girbes AR, de Kam PJ, Boomsma F, de Zeeuw D, Charlesworth A, Hampton JR, van Veldhuisen DJ. Renal function, neurohormonal activation, and survival in patients with chronic heart failure. Circulation. 2000 Jul 11;102(2):203-10. doi: 10.1161/01.cir.102.2.203.
- Lannemyr L, Ricksten SE, Rundqvist B, Andersson B, Bartfay SE, Ljungman C, Dahlberg P, Bergh N, Hjalmarsson C, Gilljam T, Bollano E, Karason K. Differential Effects of Levosimendan and Dobutamine on Glomerular Filtration Rate in Patients With Heart Failure and Renal Impairment:A Randomized Double-Blind Controlled Trial. J Am Heart Assoc. 2018 Aug 21;7(16):e008455. doi: 10.1161/JAHA.117.008455.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Kidney Diseases
- Urologic Diseases
- Renal Insufficiency
- Heart Failure
- Cardio-Renal Syndrome
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Vasodilator Agents
- Autonomic Agents
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Protective Agents
- Adrenergic Agonists
- Cardiotonic Agents
- Phosphodiesterase Inhibitors
- Adrenergic beta-Agonists
- Sympathomimetics
- Adrenergic beta-1 Receptor Agonists
- Phosphodiesterase 3 Inhibitors
- Simendan
- Dobutamine
Other Study ID Numbers
Other Study ID Numbers
- 2013-000986-36 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Informed Consent Form (ICF)
- Clinical Study Report (CSR)
- Analytic Code
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