Influence of Neurohormonal Blockade on Natriuresis in Heart Failure Patients (uGDMT)
Heart failure is a condition that can affect a person's health and daily life. In this study, we aim to investigate how diuretic medications work and how they affect patients with heart failure.
Our main objective is to understand how the body responds to these medications and whether treatment can be adjusted to make it more effective and safer for patients.
Fluid and electrolyte imbalances are an important aspect of heart diseases. In heart failure, the body may retain excessive amounts of sodium and water, leading to symptoms of the condition. Excessive sodium retention is associated with disease severity and hormonal disturbances. One of the best ways to assess this phenomenon is to measure the amount of sodium in the urine. Although medications for heart failure are available, we do not fully understand how they affect sodium excretion. A better understanding of this mechanism may help improve and individualize treatment.
Our objectives are:
- To determine the levels of sodium and other urinary components before the administration of diuretic medication.
- To assess the body's response to diuretic medication in terms of sodium excretion.
- To investigate whether the body's response to diuretic medication affects the dose of medication required by the patient.
- To examine how the response to diuretic medication changes over time.
- To determine whether treatment intensification affects sodium retention and the volume and composition of urine following the administration of diuretic medication.
Three study visits are planned. During each visit, the first morning urine sample will be analyzed before the administration of diuretic medication. Another sample will be obtained after the medication is administered, followed by a three-hour urine collection. Blood samples will also be collected for laboratory testing.
The second visit will take place 7-14 days after the first visit, and the patient's treatment will be intensified. The third visit will take place 14 days after the second visit and will follow a procedure similar to that of the first visit.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Tidlig fase 1
Kontakter og lokationer
Studiesteder
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Wroclaw, Polen, 50-556
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Chronic heart failure
Exclusion Criteria:
- GFR <25 ml/min/1,73 m2
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Aktiv komparator: Eplerenone
25mg 1x/day
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During the second visit, neurohormonal blockade was intensified by either initiating or up-titrating treatment with eplerenone or finerenone, according to the assigned study group.
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Eksperimentel: Finerenone
The dose is determined based on the patient's GFR - either 10mg or 20mg
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During the second visit, neurohormonal blockade was intensified by either initiating or up-titrating treatment with eplerenone or finerenone, according to the assigned study group.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change in pre-diuretic sodium avidity
Tidsramme: After two weeks of MRA intensification treatment
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Change in pre-diuretic sodium avidity, defined as the change in pre-diuretic spot urinary sodium concentration (uNa⁺) in response to MRA intensification.
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After two weeks of MRA intensification treatment
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Change in post-diuretic sodium avidity
Tidsramme: After 2 weeks of MRA intensification treatment
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Change in post-diuretic sodium avidity, defined as the change in post-diuretic uNa⁺ in response to MRA intensification.
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After 2 weeks of MRA intensification treatment
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studiestol: Jan Biegus, MD, PhD, Wroclaw Medical University
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 229/2024
- SUBK.A460.25.041 (Andet bevillings-/finansieringsnummer: Wroclaw Medical University, Poland)
- IDUB.A46B.24.002 (Andet bevillings-/finansieringsnummer: Wroclaw Medical University, Poland)
Plan for individuelle deltagerdata (IPD)
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IPD-planbeskrivelse
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