Levosimendan Versus Dobutamine for Renal Function in Heart Failure

NCT ID: NCT02133105

Last Updated: 2020-02-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2017-05-31

Brief Summary

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Although inotropes have a favorable effect on central hemodynamics in patients with heart failure, their effect on renal hemodynamics is incompletely defined. The purpose of this study is to evaluate the efficacy of a 75 min intravenous infusion of levosimendan compared to a 75 min infusion of dobutamine on renal hemodynamics and function in patients with chronic heart failure and signs of cardiorenal syndrome. The investigators hypothesis is that patients treated with levosimendan will show greater increases in renal blood flow and glomerular filtration rate (GFR) than those treated with dobutamine.

Detailed Description

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Conditions

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Cardiorenal Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Levosimendan

Levosimendan administration is initiated with a loading dose of 12μg/kg given over 10 min followed by a continuous infusion of 0.1 μg/kg/min for 65 min.

Group Type ACTIVE_COMPARATOR

Levosimendan

Intervention Type DRUG

Dobutamine

Dobutamine is given as a continuous infusion without a bolus dose. The infusion rate is started at 5.0 μg/kg/min for 10 minutes, and thereafter increased to 7,5 μg/kg/min for 65 min.

Group Type ACTIVE_COMPARATOR

Dobutamine

Intervention Type DRUG

Interventions

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Levosimendan

Intervention Type DRUG

Dobutamine

Intervention Type DRUG

Other Intervention Names

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Simdax Dobutrex

Eligibility Criteria

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Inclusion Criteria

* Written, signed and dated informed consent
* Male and Female subjects ≥18 years of age
* Chronic congestive heart failure scheduled for right sided cardiac catheterization
* Left ventricular ejection fraction ≤ 40% determined by echocardiography
* Elevation of N Terminal-proBNP ≥ 500 ng/L
* Cardiorenal syndrome (30ml/min ≤ estimated GFR ≤ 80 ml/min (MDRD)

Exclusion Criteria

* Acute heart failure, untreated
* Systolic blood pressure \< 80 mmHg
* Tachycardia above 100 bpm
* Angina Canadian Cardiovascular Society (CCS) class III or higher
* Aortic stenosis
* Hypertrophic cardiomyopathy
* Restrictive cardiomyopathy
* The presence of kidney disease diagnosed before heart failure
* Administration of radiographic contrast \< 1 week
* Radiographic contrast allergy
* In the Investigator's opinion, the patient has a clinically significant disease that could be adversely affected by study participation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Göteborg University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kristjan Karason, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Sahlgrenska University Hospital, Department of Cardiology

Locations

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Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Countries

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Sweden

References

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Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017 Apr;3(1):7-11. doi: 10.15420/cfr.2016:25:2.

Reference Type RESULT
PMID: 28785469 (View on PubMed)

Hillege HL, Nitsch D, Pfeffer MA, Swedberg K, McMurray JJ, Yusuf S, Granger CB, Michelson EL, Ostergren J, Cornel JH, de Zeeuw D, Pocock S, van Veldhuisen DJ; Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Investigators. Renal function as a predictor of outcome in a broad spectrum of patients with heart failure. Circulation. 2006 Feb 7;113(5):671-8. doi: 10.1161/CIRCULATIONAHA.105.580506.

Reference Type RESULT
PMID: 16461840 (View on PubMed)

Smith GL, Shlipak MG, Havranek EP, Masoudi FA, McClellan WM, Foody JM, Rathore SS, Krumholz HM. Race and renal impairment in heart failure: mortality in blacks versus whites. Circulation. 2005 Mar 15;111(10):1270-7. doi: 10.1161/01.CIR.0000158131.78881.D5.

Reference Type RESULT
PMID: 15769768 (View on PubMed)

Hillege HL, Girbes AR, de Kam PJ, Boomsma F, de Zeeuw D, Charlesworth A, Hampton JR, van Veldhuisen DJ. Renal function, neurohormonal activation, and survival in patients with chronic heart failure. Circulation. 2000 Jul 11;102(2):203-10. doi: 10.1161/01.cir.102.2.203.

Reference Type RESULT
PMID: 10889132 (View on PubMed)

Lannemyr L, Ricksten SE, Rundqvist B, Andersson B, Bartfay SE, Ljungman C, Dahlberg P, Bergh N, Hjalmarsson C, Gilljam T, Bollano E, Karason K. Differential Effects of Levosimendan and Dobutamine on Glomerular Filtration Rate in Patients With Heart Failure and Renal Impairment:A Randomized Double-Blind Controlled Trial. J Am Heart Assoc. 2018 Aug 21;7(16):e008455. doi: 10.1161/JAHA.117.008455.

Reference Type DERIVED
PMID: 30369310 (View on PubMed)

Other Identifiers

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2013-000986-36

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

2013-000986-36

Identifier Type: -

Identifier Source: org_study_id

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