Effects of Losartan on Insulin Resistance in Patients With Heart Failure

Phase 4

Completed

• Conditions: Heart Failure

• Registration Number: NCT00663377
• Lead Sponsor: Tottori University Hospital

Brief Summary

The purpose of this study is to evaluate the effects of losartan, an ARB, on glucose metabolism and inflammatory cytokines in CHF patients treated with ACE inhibitors.

Detailed Description

Chronic heart failure (CHF) is associated with marked insulin resistance, characterized by both fasting and stimulated hyperinsulinemia. Furthermore, insulin resistance is a predictor of CHF and associated with more severe disease and a worse prognosis in patients with CHF. In CHF patients, therefore, insulin resistance is not merely a function of adiposity and may have implications in the pathophysiology of CHF disease progression. Angiotensin II negatively modulates insulin-mediated actions by regulating multiple levels of the insulin signaling cascade such as the insulin receptor, IRS, and PI3-kinase. Furthermore, both ACE inhibitors and angiotensin II receptor blockers (ARB) improve glycemic status not only in patients with type II diabetes but also in patients with hypertension and the metabolic syndrome. On the other hand, it is well known that some cytokines, such as TNF-α, are involved with pathophysiology of insulin resistance and CHF. However, it is still unclear whether the ARB improves insulin resistance in CHF patients already treated with ACE inhibitors and whether there is the relationship between insulin resistance and inflammatory cytokines in CHF patients already treated with ACE inhibitors. Therefore, the purpose of this study is to evaluate the effects of losartan, an ARB, on glucose metabolism and inflammatory cytokines in CHF patients treated with ACE inhibitors.

Study Timeline

• Study Start: 2006-04
• Study Completion: 2007-03
• Status Verified: 2008-04
• Study First Submitted: 2008-04-18
• Study First Submitted QC: 2008-04-18
• Last Update Submitted: 2008-04-18
• Study First Posted: 2008-04-22
• Last Update Posted: 2008-04-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 16

Inclusion Criteria

• chronic stable heart failure

Exclusion Criteria

• renal dysfunction or under treatment with antidiabetic agents

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Primary Outcome Measures

Name	Time	Method
insulin resistance	16 weeks

Secondary Outcome Measures

Name	Time	Method
inflammatory cytokines	16 weeks