Comparing the role of the carotid body in human heart failure
- Conditions
- Heart failureCirculatory System
- Registration Number
- ISRCTN14684459
- Lead Sponsor
- niversity of Bristol
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Suspended
- Sex
- All
- Target Recruitment
- 55
All participants:
1. Aged 18-90 years
HFrEF participants:
As per the European Society of Cardiology (ESC) guidelines:
1. Signs and symptoms of heart failure AND
2. Raised natriuretic peptides AND
3. Evidence of reduced ejection fraction (EF < 40%)
HFpEF participants:
As per the European Society of Cardiology (ESC) guidelines:
1. Signs and symptoms of heart failure AND
2. Raised natriuretic peptides (e.g. NTproBNP) AND
3. Evidence of preserved ejection fraction (EF > 50%) AND
4. Objective evidence of cardiac functional and structural alterations
All participants:
1. Requirement for oxygen therapy to maintain oxygen saturation
2. Oxygen saturations at rest < 92%
3. Chronic obstructive pulmonary disease (COPD) and known structural lung disease
4. Current smoker (within the last 2 months)
5. Acute coronary syndrome, coronary revascularisation or unstable angina in last 6 months
6. HF related hospitalisation in the last 1 month.
7. Transient ischaemic attack or stroke in the last 6 months
8. Surgery under general anaesthesia in the last 3 months
9. Change in regular medications within the last 1 month
10. Clinically significant neurological disorder, including peripheral neuropathy
11. Type 1 Diabetes Mellitus
12. Heart transplant
13. Haemodialysis or peritoneal dialysis
14. Pregnancy, breast feeding or recent unprotected intercourse
15. Palliative care/chemotherapy
16. Recreational drug use and/or intravenous drug use
17. Alcohol intake > 28 units/week
18. Febrile illness/clinically significant infection within two weeks of participation
19. Contraindications to dopamine administration:
19.1. Known phaeochromocytoma
19.2. Known hyperthyroidism
19.3. Known uncontrolled atrial or ventricular tachyarrhythmias
19.4. Known hypersensitivity to dopamine or any of the excipients
19.5. Participants on the following medications:
19.5.1. Monoamine oxidase I inhibitors
19.5.2. Phenytoin
19.5.3. Ergot alkaloids
19.5.4. Tricyclic antidepressants
19.5.5. Guanethidine
Healthy controls:
1. No history of hypertension
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <br> 1. CB chemosensitivity and tonicity and levels of sympathetic activity in HFrEF & HFpEF patients compared to healthy controls at rest:<br> 1.1. Hypoxic ventilatory response (HVR) in litre/minute/%SpO2<br> 1.2. Change in minute ventilation during dopamine infusion (l/min)<br> 1.3. Muscle sympathetic nerve activity (burst frequency, usually quantified as bursts per 100 heartbeats) at baseline<br> 2. Change in exercise tolerance and perceived rate of exertion in HFpEF patients as a result of dopamine administration vs saline during VO2 Peak Test:<br> 2.1. BORG score at peak<br> 2.2. VO2 peak measurement, overall VE/VCO2 slope<br>
- Secondary Outcome Measures
Name Time Method <br> Differences between healthy controls, HFrEF & HFpEF groups at rest during carotid body chemosensitivity testing:<br> 1. BP responses to hypoxia<br> 2. BP response to dopamine and hypoxia (small subset of participants)<br> 3. HR responses to hypoxia<br> 4. HR responses to dopamine and hypoxia (small subset of participants)<br> 5. Inflammatory markers<br> 6. Pulse Wave Analysis<br>