Acute Hemodynamic Effect of Acetazolamide in Pulmonary Hypertension
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 33
- 试验地点
- 1
- 主要终点
- Pulmonary vascular resistance (PVR) AZA vs. Placebo (rest)
研究概览
简要总结
To study the acute effect of acetazolamide (AZA) on pulmonary hemodynamics in patients with pulmonary hypertension (PH) undergoing clinically indicated right heart catheterisation (RHC).
详细描述
Pulmonary hypertension (PH) of various etiologies causes dyspnea, impairs exercise performance and is associated with reduced quality of life (QoL) and survival. Treatment options include therapy for any underlying causes, pulmonary vasodilator drugs, oxygen and, in selected cases, pulmonary endarterectomy or lung transplantation. Unfortunately, PH specific drugs are expensive, associated with side effects and even combined pharmacological treatment is often not sufficient to achieve clinical benefits. Therefore, novel therapeutic drugs are needed. The investigators have recently demonstrated that sleep related breathing disorders, which are common in PH patients, can be improved by both nocturnal oxygen therapy and acetazolamide (AZA). AZA is a carbonic anhydrase (CA) inhibitor that acts as a respiratory stimulant thereby improving oxygenation and possibly PH. There are even data suggesting that CA-inhibitors have a direct pulmonary vasodilator effect. However, the potential role of AZA in the treatment of PH has not been conclusively studied. Therefore, the purpose of the current project is to investigate, the acute hemodynamic clinical effects of AZA in PH patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 20 Years 至 80 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients undergoing RHC for a clinical indication and who are diagnosed with precapillary PH (mPAP ≥25 mmHg, pulmonary wedge pressure (PAWP) ≤15mmHg)
排除标准
- •Patients in whom a RHC is clinically not indicated
- •pregnant women
- •PH in left heart disease or with more than mild chronic obstructive pulmonary disease or restrictive lung disease.
研究组 & 干预措施
Placebo
Placebo Saline injection (1x)
干预措施: Placebo (Drug)
Acetazolamide
Diamox 500mg i.v. (1x)
干预措施: Acetazolamide (Drug)
结局指标
主要结局
Pulmonary vascular resistance (PVR) AZA vs. Placebo (rest)
时间窗: 60 minutes
At the end of phase at rest
PVR AZA vs. Placebo (exercise)
时间窗: 60 minutes
At the end of phase at exercise
PVR AZA vs. Placebo (hypoxia)
时间窗: 60 minutes
At the end of phase under hypoxia
次要结局
- cardiac output(60 minutes)
- cardiac index(60 minutes)
- pulmonary wedge pressure(60 minutes)
- Borg scale dyspnea and leg effort(15 minutes)
- partial pressure of the oxygen(60 minutes)
- Oxygen uptake(15 minutes)
- minute ventilation(15 minutes)
- arterial oxygenation(60 minutes)
- tissue oxygenation(60 minutes)
- mean pulmonary arterial pressure(60 minutes)
