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Sponsors and Collaborators: |
University Hospital Birmingham British Heart Foundation University College London Hospitals University of Oxford |
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Information provided by: | University Hospital Birmingham |
ClinicalTrials.gov Identifier: | NCT00500552 |
Hypertrophic Cardiomyopathy (HCM) is a relatively common inherited heart muscle disease. Many patients experience symptoms of breathlessness, fatigue and chest pain. These symptoms are not always controlled with current therapies.
Recently we showed that a drug called Perhexiline markedly improved exercise capacity and symptoms in patients with heart failure. In this proposal we wish to test whether Perhexiline improves exercise capacity and relieves symptoms in patients with HCM
Condition | Intervention | Phase |
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Hypertrophic Cardiomyopathy |
Drug: Perhexiline/Placebo |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Efficacy Study |
Official Title: | Metabolic Alteration With Perhexiline Therapy in Patients With Hypertrophic Cardiomyopathy (METAL-HCM Study) |
Estimated Enrollment: | 44 |
Study Start Date: | December 2006 |
Background:
Hypertrophic cardiomyopathy (HCM) is a complex and relatively common genetic cardiac disease and it is the most common cause of sudden cardiac death in young people, including trained athletes. In a recent study using in vivo cardiac MR spectroscopy resting PCr/ATP ratio was diminished in patients with sarcomeric HCM, indicating reduced energy availability. Importantly patients with genotypic HCM who did not yet have hypertrophy had a similar degree of impairment of cardiac PCr/ATP ratio as do patients with marked hypertrophy, implying that the disturbance may be an early feature of the disease and is not simply due to the hypertrophy. In medically refractory patients with obstruction, surgical myectomy or alcohol septal ablation may be very effective. However in patients with non obstructive HCM with symptoms refractory to standard drug therapy, there are no therapeutic options (apart from cardiac transplant in very severe cases). Recently, our group showed that Perhexiline, an antianginal agent with an oxygen-sparing metabolic effect which increases the efficiency of energy production by shifting substrate utilisation from free fatty acids towards glucose, was highly effective in improving symptoms, exercise capacity (Vo2max) and cardiac function in patients with systolic heart failure of both ischaemic and non ischaemic aetiology.
Hypothesis:
We postulate that Perhexiline will improve symptomatic status, peak oxygen consumption, resting and exercise diastolic function and that this will be associated with improvement in myocardial energetic status in highly symptomatic medically refractory patients with non obstructive HCM.
Methods and design:
The study is a multi-centre randomised double blind placebo controlled trial. 50 patients who meet the entry criteria and provide written informed consent will be recruited to the study. Patients will be recruited from cardiomyopathy clinics in London, Birmingham and Oxford.
The primary end point will be peak oxygen consumption (Vo2max). Secondary end points will be resting myocardial energetics (31P Cardiac MR Spectroscopy), resting and exercise diastolic function (Myocardial Nuclear studies), Symptomatic Status (Minnesota questionnaire)and LV function (Speckle Tracking Echo measurements).
After the investigations have been performed, subjects will be randomised to receive either 100 mg of Perhexiline a day or placebo for 3 months. Following completions of three months therapy, these investigations will be repeated.
Ages Eligible for Study: | 18 Years to 80 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Michael Frenneaux, MD | +44(0)121-414 6926 | m.p.frenneaux@bham.ac.uk |
Contact: Khalid Abozguia, MRCP | +44(0)121-414-5916 | k.abozguia@bham.ac.uk |
United Kingdom | |
University of Oxford | Not yet recruiting |
Oxford, United Kingdom, OX3 9DU | |
Contact: Hugh Watkins +44(0)1865 220257 hugh.watkins@cardiov.ox.ac.uk | |
Principal Investigator: Hugh Watkins | |
heart Hospital, University College of London NHS | Recruiting |
London, United Kingdom, W1G 8PH | |
Contact: Perry Elliott +44(0)207-573 8888 perry.elliott@uclh.nhs.uk | |
Principal Investigator: Perry Elliott | |
United Kingdom, West Midlands | |
University of Birmingham | Recruiting |
Birmingham, West Midlands, United Kingdom, B15 2TT | |
Contact: Michael Frenneaux, MD +44(0)121-414 6926 M.P.Frenneaux@bham.ac.uk | |
Contact: Khalid Abozguia, MRCP +44(0)121-414 5916 k.abozguia@bham.ac.uk | |
Principal Investigator: Michael Frenneaux, MD |
Principal Investigator: | Michael Frenneaux, MD | University of Birmingham |
Study ID Numbers: | RRK 2848, 05/Q2707/325, PG/05/087 |
Study First Received: | July 10, 2007 |
Last Updated: | July 10, 2007 |
ClinicalTrials.gov Identifier: | NCT00500552 |
Health Authority: | United Kingdom: Research Ethics Committee |
Perhexiline Hypertrophic Cardiomyopathy |
Pathological Conditions, Anatomical Calcium, Dietary Hypertrophy Heart Diseases Cardiomyopathy, Hypertrophic Perhexiline |
Constriction, Pathologic Aortic valve stenosis Aortic Valve Stenosis Cardiomyopathies Heart Valve Diseases |
Membrane Transport Modulators Vasodilator Agents Aortic Stenosis, Subvalvular Molecular Mechanisms of Pharmacological Action Therapeutic Uses |
Calcium Channel Blockers Cardiovascular Diseases Cardiovascular Agents Pharmacologic Actions |