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Sponsored by: |
University of Utah |
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Information provided by: | University of Utah |
ClinicalTrials.gov Identifier: | NCT00585091 |
There is now strong evidence from clinical trials that carvedilol therapy in heart failure is superior to therapy with metoprolol. Not only does carvedilol have superior effects on lipid profiles, insulin sensitivity, renal blood flow, and reversal of pathologic remodeling but also its use is associated with fewer deaths compared to metoprolol. These facts make it important to carefully define how metoprolol and carvedilol are pharmacologically different. One potential difference is α1-AR antagonism. If we demonstrate that these α1-AR effects are preserved with chronic therapy, then α1-AR blockade may have an important role in carvedilol favorably altering the natural history of heart failure. On the other hand, if we demonstrate that tolerance to the α1-AR blockade effect of carvedilol decreases with time, then it would be unlikely that this pharmacologic property contributes to the efficacy of carvedilol. In such a case other pharmacologic properties, such as antioxidant activity, would appear to be important.
These results will help guide future studies into CHF and AR blockade.
Condition | Intervention |
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Heart Failure |
Drug: phenylephrine |
Study Type: | Interventional |
Study Design: | Treatment, Open Label, Single Group Assignment |
Official Title: | The Development of Tolerance to α1-Adrenoceptor Blockade With Chronic Carvedilol Treatment |
Estimated Enrollment: | 15 |
Study Start Date: | October 2003 |
Estimated Study Completion Date: | August 2008 |
Estimated Primary Completion Date: | August 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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A
All patients undergo repeated phenylephrine infusions during standard up-titration and maintenance of carvedilol treatment.
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Drug: phenylephrine
All patients undergo repeated phenylephrine infusions during standard up-titration and maintenance of carvedilol treatment.
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Ages Eligible for Study: | 18 Years to 85 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Responsible Party: | Univerisity of Utah ( University of Utah ) |
Study ID Numbers: | 00011909, IRB# 00011909 |
Study First Received: | December 26, 2007 |
Last Updated: | January 2, 2008 |
ClinicalTrials.gov Identifier: | NCT00585091 History of Changes |
Health Authority: | United States: Institutional Review Board |
Pseudoephedrine Vasodilator Agents Heart Failure Neurotransmitter Agents Heart Diseases Adrenergic alpha-Agonists Adrenergic Agents Adrenergic alpha-Antagonists Cardiovascular Agents Antihypertensive Agents Adrenergic Agonists |
Nasal Decongestants Oxymetazoline Mydriatics Phenylephrine Vasoconstrictor Agents Adrenergic beta-Antagonists Adrenergic Antagonists Ephedrine Peripheral Nervous System Agents Carvedilol |
Respiratory System Agents Vasodilator Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Adrenergic Agents Cardiotonic Agents Physiological Effects of Drugs Adrenergic Agonists Nasal Decongestants Phenylephrine Therapeutic Uses Vasoconstrictor Agents Adrenergic beta-Antagonists Cardiovascular Diseases Carvedilol |
Heart Failure Adrenergic alpha-Agonists Heart Diseases Sympathomimetics Adrenergic alpha-Antagonists Cardiovascular Agents Antihypertensive Agents Protective Agents Pharmacologic Actions Oxymetazoline Mydriatics Autonomic Agents Adrenergic Antagonists Peripheral Nervous System Agents |