The Effect of Trimetazidine on Mitochondrial Function, Myocardial Performance, and Invasive Hemodynamics in Patients Diagnosed With Wild-Type Transthyretin Cardiac Amyloidosis (CACTuS - TMZ)
Wild-type transthyretin cardiac amyloidosis (ATTRwt) is a deposition disorder in which one of the proteins of the body misfolds and accumulates at various places in the body, including the heart, leading to both mechanical and cellular damage. The gradual development of the disease will ultimately lead to heart failure and death
The protein which deposits in the heart of patients, damages both the heart mechanically as the myocardium becomes rigid and hypertrophic over time but also at the cellular level. Cell damage can be observed by elevated blood tests for cell damage (Troponin) and during exercise tests that show patients' hearts burning oxygen inefficiently when exposed to physical stress compared with the hearts of healthy individuals . No one has, however, intimately studied this cellular damage.
Vastarel® (Trimetazidine, TMZ) is an already known drug for the treatment of chest pain. The mechanism of action indicates that it may have an effect on patients with cardiac amyloidosis.
The study aims to investigate the effects of TMZ on the mitochondrial function, myocardial performance, and invasive hemodynamics in patients with ATTRwt with a randomized, double-blinded, crossover-trial.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Bertil T Ladefoged, MD
- Phone Number: +4540927245
- Email: berlad@rm.dk
Study Contact Backup
- Name: Steen H Poulsen, MD
- Phone Number: +4530922309
- Email: hvitfeldt@indbakke.dk
Study Locations
-
-
Danmark
-
Aarhus N, Danmark, Denmark, 8200
- Aarhus University Hospital, Department of Cardiology
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Wild-type transthyretin cardiac amyloidosis
- NAC stage I
- NYHA class of I or II
- Informed consent
Exclusion Criteria:
- Other, similar diagnoses
- Hereditary transthyretin cardiac amyloidosis
- Light chain amyloidosis
- Morbus Waldenstrøm
- Myelomatosis
- Medical treatment with loop diuretics in standard doses (40 mgx1 daily)
- Contraindications to trimetazidine
- Significant comorbidity assessed by the investigators
- Unable to provide informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Active Drug
Study participants receiving Trimetazidine
|
Oral intake of capsules
|
|
Placebo Comparator: Placebo
Study participants receiving placebo (calcium)
|
Oral intake of capsules
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change: pulmonary capillary wedge pressure (PCWP)
Time Frame: Four weeks of treatment
|
We hypothesize a change in PCWP of 5 mmHg between the active drug and placebo using right heart catheterization.
|
Four weeks of treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change: cardiac index (CI)
Time Frame: Four weeks of treatment
|
We hypothesize a change in CI of 0.5 L/min between the active drug and placebo using right heart catheterization.
|
Four weeks of treatment
|
Collaborators and Investigators
Sponsor
Sponsor
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 (Actual)
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
Other Study ID Numbers
Other Study ID Numbers
- 72864
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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