Control of Sinus Node Tachycardia as an Additional Therapy in Patients With Decompensated Heart Failure

NCT ID: NCT02236247

Last Updated: 2017-01-02

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

UNKNOWN

Clinical Phase

PHASE1/PHASE2

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-05-31

Study Completion Date

2017-08-31

Brief Summary

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Study aims to compare the I(f) inhibitor ivabradine with placebo as strategy of heart rate control in patients with decompensated heart failure (DHF).

Detailed Description

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Sympathetic hyperactivity and consequent increase in heart rate (HR) are physiological responses to low cardiac output in patients with decompensated heart failure (DHF). However, elevated HR may become inappropriate in these patients, increasing myocardial oxygen demand and decreasing diastolic filling time and might lead to hemodynamic deterioration, ventricular dysfunction (tachycardiomyopathy) and clinical deterioration.

Studies show the elevated HR is a predictor of poor prognosis in DHF. Subanalyses of large clinical trials using beta blockers (BBs) demonstrate the adequate control of HR correlates with a better outcome in patients with stable chronic heart failure (HF). However, use of BBs in patients with DHF is limited due to negative inotropic and hypotensive effects of these drugs.

As alternative to BBs, ivabradine has shown to increase survival of patients with chronic stable systolic HF. Compared to BBs, ivabradine has the advantage of "pure" negative chronotropic effect, no effect on myocardial contractility or peripheral vascular resistance. Despite the inhibition of I (f) has been validated as a therapeutic option in patients with stable HF, there are no studies available on this strategy in patients with DHF.

We hypothesized that HR control by ivabradine might improve clinical, hemodynamic and neurohormonal parameters in patients with DHF. The aim of this study was to evaluate the efficacy of HR control with ivabradine in patients with DHF.

Conditions

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Decompensated Heart Failure

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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ivabradine

I(f) inhibitor, heart rate controller

Group Type EXPERIMENTAL

ivabradine

Intervention Type DRUG

5 mg oral twice daily

placebo

placebo pill will be administered orally twice daily

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

A placebo pill (identical to ivabradine) will be administered twice daily

Interventions

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ivabradine

5 mg oral twice daily

Intervention Type DRUG

Placebo

A placebo pill (identical to ivabradine) will be administered twice daily

Intervention Type DRUG

Other Intervention Names

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procoralan

Eligibility Criteria

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Inclusion Criteria

* Sinus node rhythm
* HR\> 80 bpm
* Hospitalization for DHF
* Ejection fraction ≤ 40%
* Sign informed consent

Exclusion Criteria

* Systolic blood pressure \<85 mmHg
* Signs of hypoperfusion
* Dobutamine\>15 mcg/Kg/min
* Acute myocarditis
* Primary valvular disease requiring surgery
* Stroke in the last three months
* Hypertrophic or restrictive cardiomyopathy
* Sinus node disease
* Atrial fibrillation or flutter
* Second or third degree atrio-ventricular blockade
* Long QT syndrome
* Severe pulmonary disease
* Pulmonary embolism in the last three months
* Need for invasive ventilatory support
* Septicemia or septic shock
* Hepatic failure
* Creatinine \> 2.5 mg/dL
* Hemodialysis
* Advanced malignancy
* Pregnancy or lactation
* Immunosuppressive therapy
* Use of cytochrome P450 inhibitors
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundação de Amparo à Pesquisa do Estado de São Paulo

OTHER_GOV

Sponsor Role collaborator

University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Marco Stephan Lofrano Alves

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Edimar A Bocchi, MD-PHD

Role: STUDY_CHAIR

Heart Failure Unit, Heart Institute, University of Sao Paulo Medical School

Locations

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Heart Failure Unit, Heart Institute, University of Sao Paulo Medical School

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Marco S. Alves, MD

Role: CONTACT

+55 11 981431512

Edimar A. Bocchi, MD-PHD

Role: CONTACT

+55 11 2661-5419

Facility Contacts

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Marco S Alves, MD

Role: primary

+55 11 981431512

Edimar A Bocchi, MD-PHD

Role: backup

+55 11 2661-5419

References

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Lofrano-Alves MS, Issa VS, Biselli B, Chizzola P, Ayub-Ferreira SM, Bocchi EA. Control of sinus tachycardia as an additional therapy in patients with decompensated heart failure (CONSTATHE-DHF): A randomized, double-blind, placebo-controlled trial. J Heart Lung Transplant. 2016 Oct;35(10):1260-1264. doi: 10.1016/j.healun.2016.06.005. Epub 2016 Jun 7. No abstract available.

Reference Type RESULT
PMID: 27469019 (View on PubMed)

Other Identifiers

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2012/06163-6

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

CAAE:09145612.8.0000.0068

Identifier Type: -

Identifier Source: org_study_id

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