Ignite Creation Date:
2024-05-06 @ 7:51 PM
Last Modification Date:
2024-10-26 @ 3:15 PM
Study NCT ID:
NCT06168994
Status:
NOT_YET_RECRUITING
Last Update Posted:
2023-12-13
First Post:
2023-12-05
Brief Title:
Role of Eplerenone in Reducing Recurrence of Atrial Fibrillation in Patient With Structural Heart Disease
Sponsor:
Assiut University
Organization:
Assiut University
Study Overview
Official Title:
Role of Eplerenone in Reducing Recurrence of Atrial Fibrillation in Patient With Structural Heart Disease
Status:
NOT_YET_RECRUITING
Status Verified Date:
2023-12
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The aim of this study is to study synergistic effect of eplerenone as Selective aldosterone receptor antagonist with amiodarone compared with amiodarone only in reducing recurrence of atrial fibrillation in patient with structural heart disease
Detailed Description:
Atrial fibrillation is the most common sustained arrhythmia with a rising prevalence that substantially increases the risk of stroke and heart failure 12 The rate of recurrences without antiarrhythmic treatment is 71-84 and it can be reduced to 44-67 with antiarrhythmic drug therapy3 Mineralocorticoid receptor blockers MRBs are beneficial in systolic HF 456 Specifically the MRB eplerenone EPL has been shown to reduce new onset AF and recurrent AF in HF patients 7 Both angiotensin II and aldosterone elevations may lead to atrial fibrosis and contribute to human AF 8 Experimental results suggest that aldosterone may cause a substrate for atrial fibrosis and AF 9 Aldosterone increases the expression of 11β-hydroxysteroid dehydrogenase type 2 11b-HSD2 leading to up-regulation of profibrotic mediators and collagen synthesis which is prevented by MRBs 10
The European Society of Cardiology ESC guidelines identify AF as secondary to Structural heart diseases SHDswhen a left ventricle LV systolic or diastolic dysfunction is demonstrated or LV hypertrophy valvular disease andor other SHDs are documented 11currently SHD includes a heart failure with reduced ejection fraction HFrEF previously severe or moderate LV systolic dysfunction b heart failure with preserved ejection fraction HFpEF previously LV diastolic dysfunction c valvular heart disease VHD and d specific cardiomyopathies such as hypertrophic cardiomyopathy HCM 12
Electrical remodelling is the first mechanism that occurs at the onset of AF and promotes AF through a re-entry-prone substrate Changes in atrial frequency are determined by changes in the physiology of ion channel activation13 Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmiasit blocks the channels that are upregulated by remodelling such as inward-rectifying K1 current IK1 or by stimulation of the sympathetic nervous system14
The European Society of Cardiology ESC guidelines identify AF as secondary to Structural heart diseases SHDswhen a left ventricle LV systolic or diastolic dysfunction is demonstrated or LV hypertrophy valvular disease andor other SHDs are documented 11currently SHD includes a heart failure with reduced ejection fraction HFrEF previously severe or moderate LV systolic dysfunction b heart failure with preserved ejection fraction HFpEF previously LV diastolic dysfunction c valvular heart disease VHD and d specific cardiomyopathies such as hypertrophic cardiomyopathy HCM 12
Electrical remodelling is the first mechanism that occurs at the onset of AF and promotes AF through a re-entry-prone substrate Changes in atrial frequency are determined by changes in the physiology of ion channel activation13 Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmiasit blocks the channels that are upregulated by remodelling such as inward-rectifying K1 current IK1 or by stimulation of the sympathetic nervous system14
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None