- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01154504
The Role of Adrenomedullin on the Outcome of Severe Heart Failure: a Clinical Randomized Study
Study Hypothesis:
- The decrease of plasma adrenomedullin (ADM) concentration by ultrafiltration and isovolumetric hemofiltration in patients with acute III and IV Class New York Heart Association Functional(NYHA) heart failure is more pronounced than a standard diuretic treatment and is related with clinical improvement.
- Outcome Measurements:
To correlate the adrenomedullin plasma levels with clinical treatment, ultrafiltration and hemofiltration related to:
- Brain natriuretic peptide (BNP) level
- angiotensin II level
- sympathetic nervous activity
- oxydative stress
- clinical outcome at the beginning, at discharge and 90 days after randomization.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Testing the hypothesis that adrenomedullin (ADM) is a important peptide in severe heart failure and that is related to clinical condition, we will study the effects of 3 different treatments (clinical usual treatment,ultrafiltration and isovolumetric hemofiltration with diuretics) to participants are followed until discharge to Adrenomedullin level and clinical outcomes,and also their relationship with angiotensin II level, brain natriuretic peptide(BNP), sympathetic nervous system and oxydative stress.
The patients will be randomized in three different treatment group and analyzed in three moments: on the randomization, at discharge and 90 days after randomization(plus or minus 3).
The clinical treatment will be optimized, the ultrafiltration will be done until clinically adequate fluid removal or until hematocrit increased 10% from basal level, and isovolumetric hemofiltration will be done for 8 hours- dose of 35 ml/kg/h in association with diuretic. All this dialytic procedures will be done with PAES membrane- filter HF1400 and automatic machine.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Rio Grande do Sul
-
Porto Alegre, Rio Grande do Sul, Brazil, 94801970
- Instituto de Cardiología
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
more than two item:
- more than eighteen years of age
- orthopnea
- Chest Rx with cardiomegaly and pulmonary infiltration
- edema
- diuretic resistance
Exclusion Criteria:
- insulin dependent diabetes
- hepatic cirrhosis
- vascular access problems
- creatinine more than 2,5 mg/dl before acute heart failure
- systemic infection
- aortic stenosis and heart transplantation
- radiologic contrast up to 72 hours prior randomization
- advanced neoplasia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: clinical treatment
Patients with previous diagnosis of decompensated III and IV Heart Failure will be included. The clinical treatment will be optimized. Clinical assessment, Adrenomedullin, Angiotensin II, Brain Natriuretic Peptide, oxydative stress, sympathetic nervous system activity will be evaluated at the beginning, at discharge and 90 days after randomization(plus or minus3). |
The clinical treatment will be optimized to gold standard international heart failure treatment
Other Names:
|
Experimental: ultrafiltration
ultrafiltration will be done on decompensated patients III and IV acute heart failure on Intensive Care Unit. This patients will have biochemical analysis, adrenomedullin, angiotensin II,Brain Natriuretic Peptide, oxydative stress measurements,sympathetic nervous system activity evaluated and clinical outcome analyzed at the beginning,at discharge and 90 days after randomization(plus or minus 3). Diuretic will be withdrawn during ultrafiltration. |
The ultrafiltration procedure will be done on Intensive Care Unit with automatic machine and HF 1400 filter.
The fluid will be removed until a increased of 10% in hematocrit or clinical improvement.
Other Names:
|
Experimental: isovolumetric hemofiltration
Patients randomized to this group will have isovolumetric hemofiltration on Intensive Care Unit.
They will have biochemical analysis, Adrenomedullin plasmatic level, Brain Natriuretic Peptide Level, Angiotensin II level, Oxydative stress measurement,sympathetic nervous system, and clinical outcome evaluated at the study beginning,at discharge and 90 days after randomization(plus or minus 3).
|
The isovolumetric hemofiltration will be done in Intensive Care Unit for 8 hours, and will be permitted the diuretic use.The dose will be 35 ml/kg/hour and will e used automatic machine and MF1400 filter.Diuretic use will be maintained.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Levels of Adrenomedullin plasma in different treatments- clinical,ultrafiltration and isovolumetric hemofiltration
Time Frame: 90 days after randomization (plus or minus 3 days).
|
The adrenomedullin level will be compared in three different treatments: clinical treatment, ultrafiltration treatment and isovolumetric hemofiltration.
|
90 days after randomization (plus or minus 3 days).
|
Levels of Adrenomedullin plasma in different treatments- clinical,ultrafiltration and isovolumetric hemofiltration
Time Frame: at discharge
|
The adrenomedullin level will be compared in three different treatments: clinical treatment, ultrafiltration treatment and isovolumetric hemofiltration.
The patients will be followed until discharge.
|
at discharge
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Adrenomedullin plasma levels in three different treatment approaches will be related to clinical outcome.
Time Frame: at discharge
|
The correlation of adrenomedullin plasma levels in all 3 arms related to optimized clinical outcome.
The patients will be followed until discharge
|
at discharge
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to clinical outcome.
Time Frame: 90 days after randomization (plus or minus 3)
|
The correlation of adrenomedullin plasma levels in all 3 arms related to optimized clinical outcome.
|
90 days after randomization (plus or minus 3)
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to oxydative stress
Time Frame: at discharge
|
The correlation of adrenomedullin plasma levels in all 3 arms related to oxydative stress.
The patients will be followed until discharge.
|
at discharge
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to oxydative stress
Time Frame: 90 days after randomization(plus or minus 3)
|
The correlation of adrenomedullin plasma levels in all 3 arms related to oxydative stress.
|
90 days after randomization(plus or minus 3)
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to angiotensin II plasma level
Time Frame: at discharge
|
The correlation of adrenomedullin plasma levels in all 3 arms related to angiotensin II level.
The patients will be followed until discharge.
|
at discharge
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to angiotensin II plasma level
Time Frame: 90 days after randomization(plus or minus 3)
|
The correlation of adrenomedullin plasma levels in all 3 arms related to angiotensin II plasma level.
|
90 days after randomization(plus or minus 3)
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to Brain natriuretic peptide plasma level
Time Frame: at discharge
|
The correlation of adrenomedullin plasma levels in all 3 arms related to Brain natriuretic peptide level.
The patients will be followed until discharge.
|
at discharge
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to Pro-Brain natriuretic peptide plasma level
Time Frame: 90 days after randomization(plus or minus 3)
|
The correlation of adrenomedullin plasma levels in all 3 arms related to Brain natriuretic peptide level, 90 days after randomization(plus or minus 3)
|
90 days after randomization(plus or minus 3)
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to sympathetic nervous system activity
Time Frame: at discharge
|
The correlation of adrenomedullin plasma levels in all 3 arms related to sympathetic nervous system.The patients will be followed until discharge.
|
at discharge
|
The Adrenomedullin plasma levels in three different treatment approaches will be related to sympathetic nervous system activity
Time Frame: 90 days after randomization(plus or minus 3)
|
The correlation of adrenomedullin plasma levels in all 3 arms related to sympathetic nervous system.
|
90 days after randomization(plus or minus 3)
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CEP1781/07
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.
Clinical Trials on Heart Failure
-
Tufts Medical CenterMetro West Medical CenterCompletedCongestive Heart Failure | Diastolic Heart Failure | Systolic Heart FailureUnited States
-
Abbott Medical DevicesCompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure NYHA Class II | Heart Failure NYHA Class III | Heart Failure With Reduced Ejection Fraction | Heart Failure NYHA Class IV | Heart Failure With Normal Ejection Fraction | Heart Failure; With Decompensation | Heart Failure...United States, Canada
-
Manipal UniversityUnknownHeart Failure | Decompensated Heart Failure | Acute Heart Failure | Diastolic Heart Failure | Systolic Heart FailureIndia
-
VA Eastern Colorado Health Care SystemNational Institute on Aging (NIA)CompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure With Reduced Ejection Fraction | Heart Failure With Preserved Ejection Fraction | Heart Failure; With Decompensation | Heart Failure,Congestive | Heart Failure AcuteUnited States
-
Lancaster General HospitalLouise von Hess Medical Research InstituteEnrolling by invitationDiastolic Heart FailureUnited States
-
University Hospital, MontpellierCompletedHeart Failure | Diastolic Heart Failure | Systolic Heart Failure Stage CFrance
-
Wake Forest UniversityCompletedHeart Failure, Congestive | Heart Failure With Preserved Ejection Fraction
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
-
US Department of Veterans AffairsCompleted
-
Giresun UniversityIstanbul University - Cerrahpasa (IUC)RecruitingHeart Failure | Diastolic Heart Failure | Systolic Heart FailureTurkey
Clinical Trials on clinical treatment
-
Vanderbilt University Medical CenterCompleted
-
Capital Medical UniversityRecruiting
-
Capital Medical UniversityRecruiting
-
Shanghai Mental Health CenterCompleted
-
Eastern Mediterranean UniversityCompleted
-
First People's Hospital of ChenzhouUnknownSevere Acute PancreatitisChina
-
Fondazione Italiana Linfomi ONLUSRecruitingClassical Hodgkin LymphomaItaly
-
Peking Union Medical College HospitalRecruitingOvarian CancerChina
-
Peking Union Medical College HospitalRecruiting
-
Mayo ClinicMinnesota Department of Health; Altru Health System; Iowa Department of Public... and other collaboratorsCompletedTraumatic Brain InjuryUnited States