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Trial of Angiotensin Converting Enzyme Inhibition in Infants With Single Ventricle--Pediatric Heart Network (ISV)
This study has been completed.
Study NCT00113087   Information provided by National Heart, Lung, and Blood Institute (NHLBI)

First Received on June 3, 2005.   Last Updated on September 16, 2010   History of Changes
Results First Received: September 4, 2009  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Double Blind (Subject, Investigator, Outcomes Assessor);   Primary Purpose: Treatment
Conditions: Heart Defects, Congenital
Heart Failure, Congestive
Interventions: Drug: Enalapril
Drug: Placebo

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
No text entered.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
No text entered.

Reporting Groups
  Description
Enalapril ACE (Angiotensin-converting enzyme) inhibitor enalapril, initial dose 0.1 mg/kg/day; Uptitrated as tolerated to target dose of 0.4 mg/kg/day given in two divided doses
Placebo Placebo suspension

Participant Flow:   Overall Study
    Enalapril     Placebo  
STARTED     115     115  
COMPLETED     91     94  
NOT COMPLETED     24     21  
Death or Transplant                 14                 16  
Family or MD withdrew subject                 10                 5  



  Baseline Characteristics
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Reporting Groups
  Description
Enalapril ACE (Angiotensin-converting enzyme) inhibitor enalapril, initial dose 0.1 mg/kg/day; Uptitrated as tolerated to target dose of 0.4 mg/kg/day given in two divided doses
Placebo Placebo suspension

Baseline Measures
    Enalapril     Placebo     Total  
Number of Participants  
[units: participants]
  115     115     230  
Age  
[units: participants]
     
<=18 years     115     115     230  
Between 18 and 65 years     0     0     0  
>=65 years     0     0     0  
Age  
[units: days]
Mean ± Standard Deviation
  20.1  ± 8.9     20.7  ± 9.1     20.4  ± 9.0  
Gender  
[units: participants]
     
Female     40     28     68  
Male     75     87     162  
Race/Ethnicity, Customized  
[units: participants]
     
White     96     89     185  
Black/African-American     12     20     32  
Asian     4     3     7  
Other     3     3     6  
Region of Enrollment  
[units: participants]
     
United States     104     105     209  
Canada     11     10     21  



  Outcome Measures
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1.  Primary:   Weight-for-age Z-score at 14 Months of Age   [ Time Frame: Measured at baseline, 2 weeks after starting study drug, just prior to the Glenn surgery, 7 days after restarting drug following the Glenn surgery, at 10 months of age, and at 14 months of age ]

2.  Secondary:   Height-for-age Z-score   [ Time Frame: Measured at baseline, 2 weeks after starting study drug, just prior to the Glenn surgery, 7 days after restarting drug following the Glenn surgery, at 10 months of age, and at 14 months of age ]

3.  Secondary:   Head Circumference-for-age Z-score   [ Time Frame: Measured at baseline, 2 weeks after starting study drug, just prior to the Glenn surgery, 7 days after restarting drug following the Glenn surgery, at 10 months of age, and at 14 months of age ]

4.  Secondary:   Number of Participants With Ross Heart Failure Class I   [ Time Frame: Just prior to the pre-Glenn surgery ]

5.  Secondary:   Number of Participants With Ross Heart Failure Class I   [ Time Frame: Measured at 14 months of age ]

6.  Secondary:   B-Type Natriuretic Peptide   [ Time Frame: Measured just prior to the Glenn surgery ]

7.  Secondary:   B-type Natriuretic Peptide Level   [ Time Frame: at the time of the 14 month visit ]

8.  Secondary:   Neurodevelopmental Status (PDI): the Bayley Scales of Infant Development,Psychomotor Development Index Z-score   [ Time Frame: at 14 months of age ]

9.  Secondary:   Neurodevelopmental Status(MDI): Bayley Scales of Infant Development, Mental Developmental Index Z-score   [ Time Frame: at 14 months of age ]

10.  Secondary:   Neurodevelopmental Status (FSII)   [ Time Frame: at 14 months of age ]

11.  Secondary:   MacArthur-Bates Inventory -Phrases Understood   [ Time Frame: at 14 months of age ]

12.  Secondary:   MacArthur-Bates Inventory -Words Understood   [ Time Frame: at 14 months of age ]

13.  Secondary:   MacArthur-Bates Inventory -Total Gestures   [ Time Frame: at 14 months of age ]

14.  Secondary:   MacArthur-Bates Inventory -Words Produced   [ Time Frame: at 14 months of age ]

15.  Secondary:   Ejection Fraction (%)   [ Time Frame: just before the Glenn surgery ]

16.  Secondary:   Ejection Fraction (%)   [ Time Frame: at 14 months of age ]

17.  Secondary:   Ventricular Mass   [ Time Frame: just before the Glenn surgery ]

18.  Secondary:   Ventricular Mass   [ Time Frame: At 14 months of age ]

19.  Secondary:   Ventricular Mass Z-score   [ Time Frame: just before the Glenn surgery ]

20.  Secondary:   Ventricular Mass Z-score   [ Time Frame: at 14 months of age ]

21.  Secondary:   End-diastolic Volume   [ Time Frame: just before the Glenn surgery ]

22.  Secondary:   End-diastolic Volume   [ Time Frame: at 14 months of age ]

23.  Secondary:   End Diastolic Volume Z-score   [ Time Frame: just before the Glenn surgery ]

24.  Secondary:   End-diastolic Volume Z-score   [ Time Frame: at 14 months of age ]

25.  Secondary:   Ventricular Mass to Volume Ratio   [ Time Frame: Measured just before the Glenn surgery ]

26.  Secondary:   Ventricular Mass to Volume Ratio   [ Time Frame: Measured at 14 months of age ]

27.  Secondary:   Ventricular Filling Pressure   [ Time Frame: just before the Glenn surgery ]

28.  Secondary:   Number of Participants With Moderate to Severe AV Valve Regurgitation   [ Time Frame: just before the pre-Glenn surgery ]

29.  Secondary:   Number of Participants With Moderate to Severe AV Valve Regurgitation   [ Time Frame: at age 14 months ]


  Serious Adverse Events
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  Other Adverse Events
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  More Information
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Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.


Limitations and Caveats
Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.  


Results Point of Contact:  
Name/Title: Lynn Sleeper
Organization: New England Research Institute
phone: 617-972-3235
e-mail: lsleeper@neriscience.com


No publications provided by National Heart, Lung, and Blood Institute (NHLBI)

Publications automatically indexed to this study:
Williams RV, Zak V, Ravishankar C, Altmann K, Anderson J, Atz AM, Dunbar-Masterson C, Ghanayem N, Lambert L, Lurito K, Medoff-Cooper B, Margossian R, Pemberton VL, Russell J, Stylianou M, Hsu D; Pediatric Heart Network Investigators. Factors affecting growth in infants with single ventricle physiology: a report from the Pediatric Heart Network Infant Single Ventricle Trial. J Pediatr. 2011 Dec;159(6):1017-22.e2. Epub 2011 Jul 23.
Mital S, Chung WK, Colan SD, Sleeper LA, Manlhiot C, Arrington CB, Cnota JF, Graham EM, Mitchell ME, Goldmuntz E, Li JS, Levine JC, Lee TM, Margossian R, Hsu DT; Pediatric Heart Network Investigators. Renin-angiotensin-aldosterone genotype influences ventricular remodeling in infants with single ventricle. Circulation. 2011 May 31;123(21):2353-62. Epub 2011 May 16.
Hsu DT, Zak V, Mahony L, Sleeper LA, Atz AM, Levine JC, Barker PC, Ravishankar C, McCrindle BW, Williams RV, Altmann K, Ghanayem NS, Margossian R, Chung WK, Border WL, Pearson GD, Stylianou MP, Mital S; Pediatric Heart Network Investigators. Enalapril in infants with single ventricle: results of a multicenter randomized trial. Circulation. 2010 Jul 27;122(4):333-40. Epub 2010 Jul 12.
Hsu DT, Mital S, Ravishankar C, Margossian R, Li JS, Sleeper LA, Williams RV, Levine JC, McCrindle BW, Atz AM, Servedio D, Mahony L; Pediatric Heart Network Investigators. Rationale and design of a trial of angiotensin-converting enzyme inhibition in infants with single ventricle. Am Heart J. 2009 Jan;157(1):37-45.


Responsible Party: Lynn Sleeper, PI, New England Research Institutes
ClinicalTrials.gov Identifier: NCT00113087     History of Changes
Other Study ID Numbers: 177, U01HL068270, U01HL068279, U01HL068281, U01HL068285, U01HL068288, U01HL068290, U01HL068292, U01HL068269
Study First Received: June 3, 2005
Results First Received: September 4, 2009
Last Updated: September 16, 2010
Health Authority: United States: Food and Drug Administration