Larger Dose of Spironolactone for the Treatment of Patients With Nonischemic Cardiomyopathy
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Purpose
The purpose of this study is to determine whether a larger dose of the aldosterone antagonist spironolactone combined with a lower dose of an ACE inhibitor is more effective in reverse left ventricular remodeling in severe congestive heart failure in patients with nonischemic cardiomyopathy.
| Condition | Intervention |
|---|---|
|
Heart Failure, Congestive |
Drug: spironolactone |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind Primary Purpose: Treatment |
| Official Title: | Safety and Efficacy of Larger Dose of Spironolactone for the Treatment of Patients With Nonischemic Cardiomyopathy |
- Proportion of patients whose dilated ventricle reversed to normal (left ventricular end diastolic dimension [LVEDD] defined as <55 mm in males or <50 mm in females and cardiothoracic ratio <50% is normal)
- Left ventricular ejection fraction (LVEF)
- New York Heart Association (NYHA) functional class
- Six-minute walking distance
- Cardiogenic death
- Cardiac thoracic ratio
| Estimated Enrollment: | 200 |
| Study Start Date: | September 2005 |
| Estimated Study Completion Date: | September 2009 |
In the investigators' recent daily clinical practice, they found that the larger dose of the aldosterone antagonist spironolactone combined with a lower dose of an ACE inhibitor and the highest tolerable dose of beta blockers could reverse left ventricular remodeling more effectively than a smaller dose of spironolactone. The ventricular remodeling could get back to normal, especially in patients with none-ischaemic cardiomyopathy. The investigators hypothesize that long term use of a larger dose of the aldosterone antagonist spironolactone could reverse left ventricular remodeling by stimulating new myocyte formation. Thus, they designed this study to verify its efficacy and safety in reversing left ventricular remodeling in severe congestive heart failure in patients with nonischemic cardiomyopathy. To avoid hyperkalemia, the investigators routinely use larger doses of diuretics in combination with a lower dose of an ACE inhibitor to offset the potassium-sparing effects of spironolactone and follow the patients closely.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- New York Heart Association (NYHA) Functional class Ⅲ or Ⅳ
- Left Ventricular Ejection Fraction (LVEF) <35%
- Nonischemic cardiomyopathy
- Preserved renal function: Cr ≤2.5 mg/dL in males; Cr ≤2.0mg/dL in females
Exclusion Criteria:
- Hyperkalemia (≥5.0 mEg/L)
- Left ventricular systolic dysfunction with pericardial diseases, congenital heart diseases, pulmonary heart diseases, heart valvular diseases, acute coronary syndrome and short life expectancy.
Contacts and Locations| China, Hebei | |
| The First Hospital of Hebei Medical University | |
| Shijiazhuang, Hebei, China, 050031 | |
| Principal Investigator: | Kunshen Liu, M.D. | Hebei Medical University First Hospital |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00125437 History of Changes |
| Other Study ID Numbers: | 05276101D-84 |
| Study First Received: | July 29, 2005 |
| Last Updated: | July 13, 2009 |
| Health Authority: | China: Food and Drug Administration |
Keywords provided by Hebei Medical University:
|
aldosterone antagonists spironolactone left ventricular remodeling |
Additional relevant MeSH terms:
|
Heart Failure Cardiomyopathies Heart Diseases Cardiovascular Diseases Aldosterone Antagonists Spironolactone Hormone Antagonists |
Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Diuretics Natriuretic Agents Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 21, 2013