A Randomized, Double-blind, Placebo-controlled Study of Ranolazine in Patients With Heart Failure With Preserved Ejection Fraction
Overview
- Phase
- Phase 2
- Intervention
- Ranolazine
- Conditions
- Diastolic Heart Failure
- Sponsor
- Gilead Sciences
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Change from baseline to 30 minutes in cardiac catheterization hemodynamic parameters at both resting and paced conditions
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
Patients with CAD and clinical symptoms of heart failure or patients with suspected heart failure with preserved ejection fraction (HFpEF) will be enrolled. Study drug will be given as continuous IV infusion followed by oral treatment for 13 days. LV pressures and hemodynamic data will be measured prior to and after administration of study drug. In addition, Doppler ECHO, cardiopulmonary exercise testing (CPET), and NT-pro-BNP determination will be performed. Adverse events and safety labs will be collected and monitored.
Detailed Description
This is a randomized, double-blind, placebo-controlled proof-of-concept study of ranolazine in patients with heart failure with preserved ejection fraction (HFpEF). Patients will be randomized to receive ranolazine or placebo in a 1.5:1 ratio (12 ranolazine: 8 placebo). Treatment will consist of intravenous infusion of study drug followed by oral treatment for a total of 14 days treatment period. Study contact will be made approximately 14 days after the treatment period to assess safety. Cardiac catheterization will be performed for LV pressures and hemodynamic measurements before and after drug administration. Doppler ECHO, CPET, and NT-pro-BNP determination will be performed at screening and at end of study. Adverse events and safety labs will be monitored and collected.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Males or females aged \> 40 years
- •Clinical symptoms of heart failure (NYHA class II-III) at time of screening (e.g., dyspnea, paroxysmal nocturnal dyspnea, orthopnea, bilateral lower extremity edema)
- •Left ventricular ejection fraction (LVEF) \> 45% at screening
- •E/E' \> 15 measured by Tissue Doppler echocardiography at screening
- •NT-pro-BNP \> 220pg/mL at screening
- •Average resting LVEDP \>18 mm Hg (refer to continued eligibility criteria),
- •Average resting time constant of relaxation (tau) \> 50 ms at time of cardiac catheterization (refer to continued eligibility criteria)
- •Signed informed consent
Exclusion Criteria
- •Acute cardiac decompensation requiring mechanical ventilation
- •Hypotension with blood pressure \< 90/50 mm Hg
- •Primary hypertrophic or restrictive cardiomyopathy or systemic illness associated with infiltrative heart disease (e.g., cardiac amyloidosis)
- •Pericardial constriction
- •Hemodynamically significant uncorrected obstructive or regurgitant valvular disease
- •Cor pulmonale or other causes of right heart failure not associated with left ventricular dysfunction
- •Clinically significant pulmonary disease in the opinion of the Investigator or requiring home oxygen or oral steroid therapy
- •History of serious cardiac dysrrhythmias including atrial fibrillation with resting heart rate of \> 100 beats per minute
- •Need for treatment with Class I or III antiarrhythmic medications
- •Implantable pacemaker, cardioverter-defibrillator, or left ventricular assist device
Arms & Interventions
Ranolazine
Intervention: Ranolazine
Saline 0.9%
Saline 0.9% and placebo tablet
Intervention: Saline 0.9% and placebo tablet
Outcomes
Primary Outcomes
Change from baseline to 30 minutes in cardiac catheterization hemodynamic parameters at both resting and paced conditions
Time Frame: Baseline to 30 minutes
Change from baseline to 30 minutes from initiation of study drug bolus No.1 in cardiac catheterization hemodynamic parameters at both resting and paced conditions: Time-constant of relaxation (tau) Left ventricular end-diastolic pressure (LVEDP) dP/dtmin (minimal rate of LV pressure change)
Secondary Outcomes
- Change from baseline to Day 14 in mitral E wave velocity/mitral annular velocity (E/E') ratio(Baseline to Day 14)
- Change from baseline to Day 14 in VO2 max(Baseline to Day 14)
- Change from baseline to Day 14 in N-terminal pro-brain B-type natriuretic peptide (NT-pro-BNP)(Baseline to Day 14)