- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01503671
Effects of Atorvastatin Treatment on Left Ventricular Diastolic Function in Peritoneal Dialysis Patients (ALEVENT)
Effects of Atorvastatin Treatment on Left Ventricular Diastolic Function in Peritoneal Dialysis Patients (ALEVENT)
Background
Heart failure is the final consequence of various heart disease and is also the leading cause of mortality worldwide. Diastolic dysfunction refers to an abnormality of diastolic distensibility, filling, or relaxation of the left ventricle. Patients with hypertensive left ventricular hypertrophy and an echocardiogram showing a normal ejection fraction and abnormal left ventricular filling can be said to have diastolic dysfunction. If pulmonary edema or effort dyspnea developed in such a patient. The term diastolic heart failure would be appropriate.
Pathology leading to diastolic heart failure include: impaired relaxation, increased passive stiffness, endocardial and pericardial disorders, microvascular flow and neurohormonal regulation. Among them, the association of pro-inflammatory system and diastolic dysfunction are already established. The investigators therefore hypothesized that the change of serum inflammatory markers might be associated with the change of left ventricular diastolic function and the investigators thus conducted a randomized case-control trial with this regard.
Method and materials
This is a case-control randomized study. The definition of left ventricular diastolic function is according to Guideline from the ACC and AHA. The investigators will evaluate left ventricular diastolic function noninvasively by echocardiography before and after the intervention. Exclusion criteria include coronary artery disease, significant valvular heart disease, cardiomyopathy, pericardial disease and renal insufficiency. The investigators would like to enroll 50 cases and the same numbers of the controls. The inclusion criteria are subjects who underwent peritoneal dialysis at the investigators hospital for more than 6 months with higher pro-inflammation serum cytokine levels (C-reactive protein > 0.2mg/dL). Atorvastatin (40mg/day) would be given to those who were allocated to the intervention group. The investigators will than follow up cardiac diastolic function by echocardiography and also the change of serum markers. The investigators would also genotype the inflammation-associated genes and their promoter region and find the association between genetic polymorphisms and the treatment effects of statins.
Study Overview
Detailed Description
We will evaluate left ventricular diastolic function noninvasively by echocardiography before and after the intervention. Exclusion criteria include coronary artery disease, significant valvular heart disease, cardiomyopathy, pericardial disease and renal insufficiency. We would like to enroll 50 cases and the same numbers of the controls. The inclusion criteria are subjects who underwent peritoneal dialysis at our hospital for more than 6 months with higher pro-inflammation serum cytokine levels (C-reactive protein > 0.2mg/dL). Atorvastatin (40mg/day) would be given to those who were allocated to the intervention group. We will than follow up cardiac diastolic function by echocardiography and also the change of serum markers. We would also genotype the inflammation-associated genes and their promoter region and find the association between genetic polymorphisms and the treatment effects of statins.
Patients population and Monitoring The study population will consist of patients with CAPD and DHF (NYHA Class II-IV), aged 18 years or older without reduced systolic function, defined as left ventricular EF ≤ 45%, Patients fulfilling the inclusion and exclusion criteria will be randomized in a 1:1 ratio into the study from the single medical centers.
Inclusion criteria:
- Outpatients ≥ 20 year of age, male or female with essential hypertension
- Patients must be on a stable condition of CAPD for at least 6 months.
Exclusion Criteria:
- History of hypersensitivity to any of the study drugs.
- Current acute decompensated HF (exacerbation of chronic HF manifested by signs & symptoms that may require IV therapy).
- Acute coronary syndrome, stroke, transient ischemic attack, cardiac, carotid or major vascular surgery, percutaneous coronary intervention (PCI) or carotid angioplasty, within the past 3 months prior to visit 1.
- Coronary or carotid artery disease likely to require surgical or percutaneous intervention within the 6 months after Visit 1.
- Right heart failure due to severe pulmonary disease.
- Diagnosis of peripartum or chemotherapy induced cardiomyopathy within the 12 months prior to visit 1.
- Patients with a history of heart transplant or who are on a transplant list or with left ventricular assistance device (LVAD device).
- Documented ventricular arrhythmia with syncopal episodes within past 3 months, prior to visit 1, that is untreated.
- Symptomatic bradycardia or second or third degree heart block without a pacemaker.
- Implantation of a CRT (cardiac resynchronization therapy) device within the prior 3 months from visit 1 or intent to implant a CRT device.
- Presence of hemodynamically significant mitral and/or aortic valve disease, except mitral regurgitation secondary to left ventricular dilatation.
- Presence of other hemodynamically significant obstructive lesions of left ventricular outflow tract, including aortic and sub-aortic stenosis.
- Severe primary pulmonary, renal or hepatic disease judged by physicians.
- Presence of any other disease with a life expectancy of < 1 year.
- Chronic long-term requirement for NSAIDs (high dose) or COX2 inhibitors, with the exception of aspirin at doses used for CV prophylaxis (≤325 mg o.d.).
- Subjects are now breast feeding, get pregnant or will be pregnant within 6 months.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Cho-Kai Wu, MD
- Phone Number: 62152 886-23123456
- Email: chokaiwu@yahoo.com.tw
Study Locations
-
-
-
Taipei, Taiwan, 100
- Recruiting
- National Taiwan University Hospital
-
Contact:
- Cho-Kai Wu, MD
- Phone Number: 62152 886-23123456
- Email: chokaiwu@yahoo.com.tw
-
Principal Investigator:
- Cho-Kai Wu, MD
-
Sub-Investigator:
- Jenq-Wen Huang, MD
-
Sub-Investigator:
- Chia-Ti Tsai, MD, PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Outpatients ≥ 20 year of age, male or female with essential hypertension
- Patients must be on a stable condition of CAPD for at least 6 months.
Exclusion Criteria:
- History of hypersensitivity to any of the study drugs.
- Current acute decompensated HF (exacerbation of chronic HF manifested by signs & symptoms that may require IV therapy).
- Acute coronary syndrome, stroke, transient ischemic attack, cardiac, carotid or major vascular surgery, percutaneous coronary intervention (PCI) or carotid angioplasty, within the past 3 months prior to visit 1.
- Coronary or carotid artery disease likely to require surgical or percutaneous intervention within the 6 months after Visit 1.
- Right heart failure due to severe pulmonary disease.
- Diagnosis of peripartum or chemotherapy induced cardiomyopathy within the 12 months prior to visit 1.
- Patients with a history of heart transplant or who are on a transplant list or with left ventricular assistance device (LVAD device).
- Documented ventricular arrhythmia with syncopal episodes within past 3 months, prior to visit 1, that is untreated.
- Symptomatic bradycardia or second or third degree heart block without a pacemaker.
- Implantation of a CRT (cardiac resynchronization therapy) device within the prior 3 months from visit 1 or intent to implant a CRT device.
- Presence of hemodynamically significant mitral and/or aortic valve disease, except mitral regurgitation secondary to left ventricular dilatation.
- Presence of other hemodynamically significant obstructive lesions of left ventricular outflow tract, including aortic and sub-aortic stenosis.
- Severe primary pulmonary, renal or hepatic disease judged by physicians.
- Presence of any other disease with a life expectancy of < 1 year.
- Chronic long-term requirement for NSAIDs (high dose) or COX2 inhibitors, with the exception of aspirin at doses used for CV prophylaxis (≤325 mg o.d.).
- Subjects are now breast feeding, get pregnant or will be pregnant within 6 months.
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 |
---|---|
Experimental: Atorvastatin
Atorvastatin 40 mg/day for high inflammation CAPD patient
|
Atorvastatin 40 mg/day
Other Names:
|
No Intervention: No intervention arm
Placebo arm without intervention
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Left ventricular diastolic function
Time Frame: 1 year
|
We will arrange UCG follow up to delineate the change of LV diastolic function after intervention
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mortality
Time Frame: 1 year
|
Total Mortality differences
|
1 year
|
Major cardiovascular events
Time Frame: 1 year
|
Check the MACE differences
|
1 year
|
Side effects
Time Frame: 1 year
|
Follow up the number of rhabdomyolyis, hepatitis
|
1 year
|
Collaborators and Investigators
Investigators
- Study Chair: Cho-Kai Wu, MD, National Taiwan University Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 201108035MD
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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