1. To determine if beta2-receptor polymorphisms influence the probability of recovery of heart failure.2. To determine possible other factors that influence the probability of recovery in our patient cohort.3. To determine the amount of LVEF…
ID
Source
Brief title
Condition
- Heart failures
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
1. The difference in occurrence of beta2-receptor haplotypes between the
recovered and the control group will serve as a primary outcome.
2. The difference in occurrence of beta2-receptor haplotypes in a good
responders group versus a bad responders group. Good responders will be defined
as a change in LVEF >15% and bad responders as a change in LVEF <15%, both
after an average treatment of 1.5 years.
3. The difference in mean change LVEF in each group of beta2-receptor
haplotypes.
4. All outcomes described above, but then assessed for the single-nucleotide
polymorphisms.
Secondary outcome
Not applicable.
Background summary
Systolic heart failure is common and has a bad prognosis. But this prognosis is
not applicable to all new patients with heart failure. A group of patients
fully recovers after initiation of therapy. Some predictors for recovery of
heart failure have been described, e.g. non-ischemic heart failure, an elevated
blood pressure at initial presentation, and shorter duration of period between
first complaints and time of presentation. Another possible predictor is a
different reaction on treatment. Use of beta-blockers improves LVEF in heart
failure with an average of 5%. Beta-blockers take their effect via cardiac
beta1-receptors, but also sympathetic beta2-receptor could have their
influence. The beta2-adrenergic receptor is an important mediator of the
vasodilatory response to adrenergic agonists in the vasculature, cardiac
function and blood pressure regulation. Two highly prevalent single-nucleotide
polymorphisms of the beta2-adrenergic receptor are associated with altered
receptor trafficking and down regulation. Besides, the beta2-receptor genotype
influences the response to carvedilol.
Hypothesis: The probability of recovery from heart failure is partially
influenced by beta2-receptor polymorphisms, in which the Arg16/Gln27 haplotype
has an unfavourable and the Gly16/Glu27 a favourable effect.
Study objective
1. To determine if beta2-receptor polymorphisms influence the probability of
recovery of heart failure.
2. To determine possible other factors that influence the probability of
recovery in our patient cohort.
3. To determine the amount of LVEF improvement for each common haplotype of the
beta2-receptor.
Study design
A retrospective case-control study in which a group of patients who have
recovered from their heart failure will be matched to a group of patients not
recovered from heart failure. Determined will be if certain beta2-receptor
polymorphisms are more prevalent in one group or the other. Besides for each
common haplotype the amount of LVEF improvement will be determined.
Study burden and risks
Participants are asked for only one visit in which blood will be drawn (max. 10
ml). Blood will only be drawn by skilled practitioners and is part of standard
medical care. Therefore no risks are associated with this study. Knowledge
about predictors for recovery of heart failure will make it easier to
categorise patients with different prognoses and in the future to adjust
medication for each category.
Meibergdreef 9
1105 AZ Amsterdam
Nederland
Meibergdreef 9
1105 AZ Amsterdam
Nederland
Listed location countries
Age
Inclusion criteria
Recovered gruop: Patients with systolic heart failure who initially had a LVEF < 45% and who reached a LVEF * 45% after a minimum treatment period of 1.5 years will be included.
Patients must be over 18 years of age and competent of giving informed consent.;Control group: Patients with heart failure who have had an initial LVEF <45% and have not recovered (a LVEF < 45%) after a minimum treatment period of 1.5 year will serve as controls.
Controls must be over 18 years of age and competent of giving informed consent
Exclusion criteria
1. Diastolic heart failure
2. Congenital causes of heart failure
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL21425.018.08 |