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Physiological Effects of Grape Seed Extract in Diastolic Heart Failure (GRAPEVINE-HF)
This study is currently recruiting participants.
Verified July 2010 by University of Michigan

First Received on August 2, 2010.   Last Updated on August 23, 2010   History of Changes
Sponsor: University of Michigan
Information provided by: University of Michigan
ClinicalTrials.gov Identifier: NCT01185067
  Purpose

Diastolic heart failure (also known as "heart failure with normal ejection fraction" or "heart failure with preserved ejection fraction") occurs even though the heart muscle's pumping function is normal. In many cases diastolic heart failure is related to stiffening of the heart and blood vessels in people who have high blood pressure. Current guidelines suggest that patients should limit the salt content of their diet, as too much salty food can cause fluid retention and other problems in diastolic heart failure. Studies in animals with diastolic heart failure suggest that antioxidant chemicals found in grapes can block some of the harmful effects of salty diets. Because it is often difficult for patients with diastolic heart failure to maintain a low salt diet, the investigators are researching the effects of the antioxidant properties of grape seed extract, a natural supplement made from grape seeds. The investigators hypothesize that supplementing the diet with grape seed extract (GSE) can decrease the levels of harmful chemicals and improve heart and blood vessel function in patients with diastolic heart failure and a history of high blood pressure.

The University of Michigan research group plans to enroll 25 patients with a history of high blood pressure and diastolic heart failure in a research study. The study will assess the effects of GSE on hormones and other chemicals that can cause heart and blood vessel damage. The investigators will also study the effects of GSE on the ability of the blood vessels and heart muscles to relax at the proper time and speed. Finally, the investigators will observe how GSE affects participants' overall ability to exercise, quality of life, and blood pressure control. Study participants will be randomly assigned to take either GSE or placebo (looks like but does not contain GSE) capsules twice a day for six weeks. After a two-week break, all subjects will cross over to the opposite group of capsules for an additional six-week period. At the start of the study and at the end of each six-week time period study participants will have non-invasive heart and blood vessel testing, blood work and urine tests, and blood pressure monitoring.


Condition Intervention Phase
Diastolic Heart Failure
Hypertensive Heart Disease
Heart Failure With Preserved Ejection Fraction
Hypertension
Oxidative Stress
 Drug: grape seed extract (MegaNatural BP, Polyphenolics, Inc.)
 Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Crossover Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: GRAPe Seed Extract and Ventriculovascular Investigation in Normal Ejection-Fraction Heart Failure

Resource links provided by NLM:

MedlinePlus related topics: Antioxidants Exercise and Physical Fitness Heart Diseases Heart Failure High Blood Pressure
U.S. FDA Resources

Further study details as provided by University of Michigan:

Primary Outcome Measures:
  • Brachial artery flow-mediated dilation (FMD) [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Ultrasound measure of conduit artery endothelial function

  • Brachial artery flow-mediated dilation (FMD) [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Ultrasound measure of conduit artery endothelial function


Secondary Outcome Measures:
  • 24-hour blood pressure [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Mean and diurnal variation

  • EndoPAT arterial endothelial function [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Plethysmographic measure of resistance arterial endothelial function

  • Carotid-femoral pulse wave velocity [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
  • Maximal exercise capacity and oxygen consumption [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
  • Resting and post-exercise ventricular systolic and diastolic function [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Standard and novel echocardiographic measures including strain/strain rate

  • Urinary 8-isoprostanes [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Measure of oxidative stress

  • Heart failure related quality of life [ Time Frame: Pre-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Minnesota Living With Heart Failure Questionnaire

  • 24-hour blood pressure [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Mean and diurnal variation

  • EndoPAT arterial endothelial function [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Plethysmographic measure of resistance arterial endothelial function

  • Carotid-femoral pulse wave velocity [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
  • Maximal exercise capacity and oxygen consumption [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
  • Resting and post-exercise ventricular systolic and diastolic function [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Standard and novel echocardiographic measures including strain/strain rate

  • Urinary 8-isoprostanes [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Measure of oxidative stress

  • Heart failure related quality of life [ Time Frame: Post-six weeks of investigational drug and placebo intervention ] [ Designated as safety issue: No ]
    Minnesota Living With Heart Failure Questionnaire


Estimated Enrollment: 25
Study Start Date: August 2010
Estimated Study Completion Date: November 2011
Estimated Primary Completion Date: August 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: grape seed extract capsule
Grape seed extract (MegaNatural BP, Polyphenolics, Inc.) 300 milligram capsules twice daily for six weeks
 Drug: grape seed extract (MegaNatural BP, Polyphenolics, Inc.)
Subjects will be randomized in double-blind fashion to either grape seed extract (GSE) or maltodextrin placebo capsules for for 6 weeks. Patient will take 300 mg GSE/placebo twice a day for 6 weeks. Patient will have a 2 week washout period and then cross over to the opposite group for an additional 6 weeks.
Other Names:
  • grapes
  • wine
  • polyphenols
  • resveratrol
  • quercetin
  • anthocyanins
  • flavonoids
  • flavanols
  • flavonols
  • antioxidants
Placebo Comparator: maltodextrin capsule
Maltodextrin capsules (matched for appearance and taste to grape seed extract capsules) twice daily for six weeks
 Drug: grape seed extract (MegaNatural BP, Polyphenolics, Inc.)
Subjects will be randomized in double-blind fashion to either grape seed extract (GSE) or maltodextrin placebo capsules for for 6 weeks. Patient will take 300 mg GSE/placebo twice a day for 6 weeks. Patient will have a 2 week washout period and then cross over to the opposite group for an additional 6 weeks.
Other Names:
  • grapes
  • wine
  • polyphenols
  • resveratrol
  • quercetin
  • anthocyanins
  • flavonoids
  • flavanols
  • flavonols
  • antioxidants

  Eligibility

Ages Eligible for Study:   50 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Inclusion:

  • Signs and symptoms of heart failure
  • Left ventricular ejection fraction ≥ 50% (contrast ventriculography, echocardiography, nuclear scintigraphy, MRI or CT imaging)
  • Diastolic dysfunction on previous echocardiogram/catheterization, or indeterminate diastolic function with supporting evidence of heart failure (HF) (as per European Society of Cardiology guidelines)
  • History of systemic hypertension
  • Age ≥ 50 years
  • Willing to adhere to prescribed course of supplementation
  • Informed consent

Exclusion Criteria:

  • Daily intake of antioxidant supplements or vitamins beyond that provided in a standard daily multivitamin (e.g. high-dose vitamin E or vitamin C)
  • NYHA Class IV heart failure symptoms (except during previous hospitalization)
  • Hospitalization for decompensated heart failure within past one month
  • Severely uncontrolled hypertension (SBP ≥ 180 and.or DBP ≥ 100 at rest, on current antihypertensive regimen
  • Uncontrolled diabetes mellitus (hemoglobin A1C > 9%)
  • Severe renal (estimated GFR < 30 ml/min) or hepatic disease/failure
  • Severe anemia (Hgb < 9)
  • Primary exercise limitation due to severe pulmonary disease
  • Unacceptably poor echocardiographic images for analysis
  • Worse than moderate mitral or aortic stenosis or insufficiency.
  • Non-hypertensive cause of HFpEF (e.g. valvular disease, congenital heart disease, amyloidosis, sarcoidosis, constrictive pericardial syndromes)
  • Myocardial infarction or unstable angina, including new or worsening anginal syndrome, within the past three months
  • Uncontrolled arrhythmia (including non rate-controlled atrial fibrillation)
  • Terminal illness expected to result in death within six months or active solid-organ cancer
  • Psychiatric disorder (or dementia) with potential to compromise adherence
  • Changes in medical regimen for heart disease or hypertension within past 1 month (except diuretic dose adjustment)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01185067

Contacts
Contact: Joanna Wells 734-232-6383 joannamw@umich.edu

Locations
United States, Michigan
University of Michigan Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Scott L Hummel, MD MS     734-936-5265     scothumm@med.umich.edu    
Contact: Joanna M Wells     734 232 6383     joannamw@umich.edu    
Principal Investigator: Scott L Hummel, MD MS            
Sponsors and Collaborators
University of Michigan
Investigators
Principal Investigator: Scott L Hummel, MD, MS University of Michigan
  More Information

Publications:
Seymour EM, Singer AA, Bennink MR, Parikh RV, Kirakosyan A, Kaufman PB, Bolling SF. Chronic intake of a phytochemical-enriched diet reduces cardiac fibrosis and diastolic dysfunction caused by prolonged salt-sensitive hypertension. J Gerontol A Biol Sci Med Sci. 2008 Oct;63(10):1034-42.
Ma L, Gao HQ, Li BY, Ma YB, You BA, Zhang FL. Grape seed proanthocyanidin extracts inhibit vascular cell adhesion molecule expression induced by advanced glycation end products through activation of peroxisome proliferators-activated receptor gamma. J Cardiovasc Pharmacol. 2007 May;49(5):293-8.
Sivaprakasapillai B, Edirisinghe I, Randolph J, Steinberg F, Kappagoda T. Effect of grape seed extract on blood pressure in subjects with the metabolic syndrome. Metabolism. 2009 Dec;58(12):1743-6. Epub 2009 Jul 15.
Kar P, Laight D, Rooprai HK, Shaw KM, Cummings M. Effects of grape seed extract in Type 2 diabetic subjects at high cardiovascular risk: a double blind randomized placebo controlled trial examining metabolic markers, vascular tone, inflammation, oxidative stress and insulin sensitivity. Diabet Med. 2009 May;26(5):526-31.

Responsible Party: Scott L. Hummel MD MS, University of Michigan
ClinicalTrials.gov Identifier: NCT01185067     History of Changes
Other Study ID Numbers: HUM00029626
Study First Received: August 2, 2010
Last Updated: August 23, 2010
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Michigan:
Hypertension
Endothelial function
Antioxidants
Oxidative stress
Grapes
Polyphenols
Resveratrol
Quercetin
Anthocyanins
 Flavanols
Flavonols
Congestive heart failure
Heart failure with normal ejection fraction
Heart failure with preserved systolic function
HFNEF
HFPSF
HFPEF
DHF

Additional relevant MeSH terms:
Heart Diseases
Heart Failure
Hypertension
Heart Failure, Diastolic
Cardiovascular Diseases
Vascular Diseases
Antioxidants
Quercetin
Resveratrol
Grape Seed Extract
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Protective Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents, Non-Steroidal
 Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Anti-Inflammatory Agents
Therapeutic Uses
Antirheumatic Agents
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Enzyme Inhibitors
Platelet Aggregation Inhibitors
Hematologic Agents
Antimutagenic Agents
Anticarcinogenic Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on May 24, 2012



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