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The Role of Mitochondrial Respiration in the Cardioprotective Capacity of IPC in Diabetic and Non-diabetic Patients

Primary Purpose

Reperfusion Injuries, Myocardial

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Dimethyl Malonate
Ischemic preconditioning
Ischemia reperfusion
Sham
Sponsored by
University of Aarhus
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Reperfusion Injuries, Myocardial

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients undergoing CABG or other surgery where extracorporal circulation will be used.

Exclusion Criteria:

  • raise in ischemic markers within 4 weeks
  • ejection fraction <30
  • Atrial fibrilation
  • Oral opioid treatment

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm 7

    Arm 8

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    non-diabetic Sham control

    non-diabetic Ischemia reperfusion

    non-diabetic Ischemic preconditioning

    non-diabetic Dimethyl malonate

    Diabetic Sham control

    Diabetic Ischemia reperfusion

    Diabetic Ischemic preconditioning

    Diabetic Dimethyl malonate

    Arm Description

    Heart tissue obtained from non-diabetic patients undergoing surgery will not receive drugs or ischemia

    Heart tissue from non-diabetic patients undergoing surgery will not receive drugs but will receive ischemia

    Heart tissue from non-diabetic patients undergoing surgery will not receive drugs but will receive short periods of ischemia prior to index ischemia

    Heart tissue from non-diabetic patients undergoing surgery will receive a drug (Dimethyl Malonate) prior to index ischemia

    Heart tissue obtained from diabetic patients undergoing surgery will not receive drugs or ischemia

    Heart tissue from diabetic patients undergoing surgery will not receive drugs but will receive ischemia

    Heart tissue from diabetic patients undergoing surgery will not receive drugs but will receive short periods of ischemia prior to index ischemia

    Heart tissue from diabetic patients undergoing surgery will receive a drug (Dimethyl Malonate) prior to index ischemia

    Outcomes

    Primary Outcome Measures

    Mitochondrial respiration of individual complexes
    Mitochondrial respiration of individual complexes will serve as primary outcome and will be examined by oxygraph technique.

    Secondary Outcome Measures

    Hemodynamic performance
    Hemodynamic performance will be measured as contractile force of heart fibers before during and after ischemia.

    Full Information

    First Posted
    December 8, 2016
    Last Updated
    June 6, 2019
    Sponsor
    University of Aarhus
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02993484
    Brief Title
    The Role of Mitochondrial Respiration in the Cardioprotective Capacity of IPC in Diabetic and Non-diabetic Patients
    Official Title
    The Role of Mitochondrial Respiration in the Cardioprotective Capacity of IPC in Diabetic and Non-diabetic Patients
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2016 (undefined)
    Primary Completion Date
    February 1, 2019 (Actual)
    Study Completion Date
    February 1, 2019 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    University of Aarhus

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The overall aim of this study is to examine the role of mitochondrial respiration in human diabetic tissue before and after ischemia. Furthermore we will examine the ability of ischemic preconditioning (IPC) to preserve the mitochondrial function and hemodynamic performance of both non-diabetic and diabetic fibers after ischemia. To increase our understanding on the metabolic changes during ischemia in both non-diabetic and diabetic tissue we will use Dimethyl Malonate and examine the impact of this blockade on post-ischemic mitochondrial respiration.
    Detailed Description
    20 diabetic and 20 non-diabetic patients undergoing elective CABG surgery or other heart surgery where extracorporal circulation is used will be included in the study. The patiens will not be given any treatment prior to the operation. During the cardiac surgery a small sample of the heart is routinely removed when the patient is connection to the heart-lung machine. From this tissue sample it is possible to isolate muscle trabeculae which will be used in an atrial strip model and randomized to one of four types of treatment. Simultaneously with the isolation of the trabeculae, a fifth trabecular will be used to assess mitochondrial respiration at baseline. Group 1 will serve as a sham control, group 2 will serve as ischemic control and receive an extended period of hypoxia, Group 3 will be treated with ischemic preconditioning, where short periods of non lethal lack of oxygen will be given directly to the tissue (after removal from the patient) prior to the extended period of hypoxia, Group 4 will receive dimethyl malonate prior to the prolonged hypoxia.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Reperfusion Injuries, Myocardial

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Allocation
    Randomized
    Enrollment
    39 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    non-diabetic Sham control
    Arm Type
    Experimental
    Arm Description
    Heart tissue obtained from non-diabetic patients undergoing surgery will not receive drugs or ischemia
    Arm Title
    non-diabetic Ischemia reperfusion
    Arm Type
    Experimental
    Arm Description
    Heart tissue from non-diabetic patients undergoing surgery will not receive drugs but will receive ischemia
    Arm Title
    non-diabetic Ischemic preconditioning
    Arm Type
    Experimental
    Arm Description
    Heart tissue from non-diabetic patients undergoing surgery will not receive drugs but will receive short periods of ischemia prior to index ischemia
    Arm Title
    non-diabetic Dimethyl malonate
    Arm Type
    Experimental
    Arm Description
    Heart tissue from non-diabetic patients undergoing surgery will receive a drug (Dimethyl Malonate) prior to index ischemia
    Arm Title
    Diabetic Sham control
    Arm Type
    Experimental
    Arm Description
    Heart tissue obtained from diabetic patients undergoing surgery will not receive drugs or ischemia
    Arm Title
    Diabetic Ischemia reperfusion
    Arm Type
    Experimental
    Arm Description
    Heart tissue from diabetic patients undergoing surgery will not receive drugs but will receive ischemia
    Arm Title
    Diabetic Ischemic preconditioning
    Arm Type
    Experimental
    Arm Description
    Heart tissue from diabetic patients undergoing surgery will not receive drugs but will receive short periods of ischemia prior to index ischemia
    Arm Title
    Diabetic Dimethyl malonate
    Arm Type
    Experimental
    Arm Description
    Heart tissue from diabetic patients undergoing surgery will receive a drug (Dimethyl Malonate) prior to index ischemia
    Intervention Type
    Drug
    Intervention Name(s)
    Dimethyl Malonate
    Other Intervention Name(s)
    Dimethyl Malonate; PubChem Substance ID 24848281
    Intervention Description
    Heart tissue will be obtained from patients undergoing heart surgery. The tissue will be used to test the properties of ischemia and different cardioprotective interventions.
    Intervention Type
    Biological
    Intervention Name(s)
    Ischemic preconditioning
    Intervention Description
    Heart tissue will be obtained from patients undergoing heart surgery. The tissue will be used to test the properties of ischemia and different cardioprotective interventions.
    Intervention Type
    Other
    Intervention Name(s)
    Ischemia reperfusion
    Intervention Description
    Heart tissue will be obtained from patients undergoing heart surgery. The tissue will be used to test the properties of ischemia and different cardioprotective interventions.
    Intervention Type
    Other
    Intervention Name(s)
    Sham
    Intervention Description
    Heart tissue will be obtained from patients undergoing heart surgery. The tissue will be used to test the properties of ischemia and different cardioprotective interventions.
    Primary Outcome Measure Information:
    Title
    Mitochondrial respiration of individual complexes
    Description
    Mitochondrial respiration of individual complexes will serve as primary outcome and will be examined by oxygraph technique.
    Time Frame
    Outcome will be assessed within a year when the inclusion of patients is complete
    Secondary Outcome Measure Information:
    Title
    Hemodynamic performance
    Description
    Hemodynamic performance will be measured as contractile force of heart fibers before during and after ischemia.
    Time Frame
    Outcome will be assessed within a year when the inclusion of patients is complete

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients undergoing CABG or other surgery where extracorporal circulation will be used. Exclusion Criteria: raise in ischemic markers within 4 weeks ejection fraction <30 Atrial fibrilation Oral opioid treatment

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    The Role of Mitochondrial Respiration in the Cardioprotective Capacity of IPC in Diabetic and Non-diabetic Patients

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