- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00423553
Collection of Heart Tissue Sample During Open Heart Surgery
Modifying Tolerance to Ischemic Injury in Human Atrial Tissue
This study will collect heart tissue that is routinely removed and discarded during open-heart surgery. The Cardiology Branch of the NHLBI is conducting a variety of laboratory experiments that require a sample of heart tissue. A segment of tissue is routinely cut out of the right atrial appendage of the heart during open-heart surgery to allow the heart-lung bypass machine to be attached to the heart for protection during surgery. This small tissue sample is not re-attached after the bypass machine is removed, but usually destroyed as medical waste.'
People between 18 and 80 years of age who are scheduled to undergo coronary artery bypass surgery or aortic valve replacement surgery may be eligible for this study.
Participants donate the right atrial appendage of the heart, which would normally be destroyed after their open-heart surgery. The tissue will be used by NHLBI investigators in studies directed at learning how to make the heart less sensitive to damage from a heart attack. The samples may be used, for example, to evaluate the effectiveness of known therapies, refine treatment approaches, identify potential new therapies, or explore opportunities for disease prevention.
Study Overview
Status
Conditions
Detailed Description
Transient non-lethal ischemia followed by reperfusion activates a cell survival program resulting in increased tolerance to subsequent ischemic injury. This biological phenomenon is termed ischemic preconditioning and is a powerful cell survival program that is operational in the human heart. This program is triggered by signaling intermediates activated in response to the transient ischemia/hypoxia and reperfusion of preconditioning. Characterization of these signaling intermediates should enable us to identify therapeutic agents to augment tissue tolerance to ischemia.
Interestingly, nitrite, which is an endogenous reservoir for nitric oxide (NO), undergoes bioconversion to NO via hypoxia-dependent signaling. Whether nitrite accumulation and bioconversion are components of the ischemic preconditioning program is unknown. Recently Dr. Gladwin and colleagues in the Vascular Medicine Branch unequivocally demonstrated that exogenous nitrite administration is cytoprotective against ischemia-reperfusion injury in murine liver and heart and in the canine heart. Establishing a mechanistic link between the ischemic preconditioning program and nitrite biology would promote nitrite as an attractive compound for future therapeutic interventions. To evaluate this link, we propose to use cardiac right atrial appendage tissue that is routinely excised to facilitate right atrial cannulation for heart-lung bypass. This excised tissue is then usually discarded as medical waste.
We hypothesize that nitrite administration to atrial tissue in an ex-vivo study will demonstrate increased tolerance to ischemic stress compared to atrial tissue not exposed to nitrite. Furthermore, we propose that this cytoprotective effect of nitrite administration will demonstrate equivalency to cytoprotection in response to ischemic preconditioning. Finally, we would employ this tissue to identify nitrite mediated genomic, proteomic and metabolomic modifications in human myocardium, thereby identifying the biological programs orchestrating the cytoprotective properties of nitrite in the human heart.
Study Type
Contacts and Locations
Study Locations
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Maryland
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Bethesda, Maryland, United States, 20814
- Suburban Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
- INCLUSION CRITERIA:
Subjects must be 18-80 years of age.
Subjects must provide informed, written consent to donate tissue that would otherwise be discarded post-cardiac surgery.
Subjects undergoing elective coronary artery bypass surgery and or aortic valve replacement surgery.
EXCLUSION CRITERIA:
Subjects currently on oral sulfonylurea therapy for diabetes mellitus
Subjects in atrial fibrillation or having had a history of atrial fibrillation in the 2-week period prior to surgery
Subjects in clinical right heart failure as evidenced by greater than trace pedal edema, an elevated JVP and or by evidence of hepatic congestion.
Subjects unable to give informed consent
Study Plan
How is the study designed?
Collaborators and Investigators
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 070057
- 07-H-0057
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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