Intravenous Allopurinol in Heart Failure

Johns Hopkins University18 enrolled

Overview

This study tests the hypothesis that allopurinol, a xanthine oxidase inhibitor, improves heart metabolism in patients with heart failure.

Xanthine oxidase have been reported to improve mechano-energetic coupling in failing hearts. The investigators developed a means to directly measure creatine kinase flux, the major energy reserve of the heart, in the human heart exploiting new magnetic resonance technologies. The investigators propose to study 10 healthy subjects and up to 25 with heart failure (dilated cardiomyopathy) before and after a single 300mg IV infusion of allopurinol.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Congestive Heart Failure

Interventions

AllopurinolDRUG

intravenous infusion of allopurinol (300mg)

PlaceboDRUG

intravenous infusion of 50 ml dose of 5% dextrose

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years * The patient is willing and able to provide informed consent * Clinical diagnosis of chronic heart failure * Ejection fraction (EF) \< 40% by echocardiography, nuclear multigated acquisition (MUGA) or cath ventriculography * No significant coronary disease at cardiac catheterization * New York Heart Association (NYHA) Class I-IV symptoms * Clinical stabilization for two weeks if following recent congestive heart failure (CHF) decompensation. Exclusion Criteria: * Metallic implant prohibiting magnetic resonance (MR) evaluation * Inability to lie flat for MR study * Administration of additional investigational drugs * Calculated creatinine clearance \< 50 mL/min * Allergy to allopurinol * Current gout flare * Currently taking oral allopurinol

Locations (1)

Johns Hopkins Hospital

Baltimore, Maryland, United States

Outcomes

Primary Outcomes

Myocardial Creatine Kinase (CK) Flux Pre Intravenous Allopurinol Infusion

Magnetic resonance spectroscopy (MRS) Measurement of Myocardial CK Flux Pre Intravenous Allopurinol Infusion

Time frame: Onset of imaging acquisition.

Myocardial CK Flux Post Intravenous Allopurinol Infusion.

The mean rate of adenosine triphosphate (ATP) flux through the creatine kinase reaction in the heart.

Time frame: acute (within 15 minutes of single infusion)

Secondary Outcomes

Cardiac PCr/ATP Pre Intravenous Infusion

The mean ratio of creatine phosphate (PCr) to ATP in the heart. This measure, as a ratio, is unitless.

Time frame: Onset of image acquisition.

Cardiac PCr/ATP Post Intravenous Infusion

The mean ratio of creatine phosphate (PCr) to ATP in the heart. This measure, as a ratio, is unitless.

Time frame: acute (within 15 minutes of single infusion)

Data from ClinicalTrials.gov

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