Effects of Losartan on Insulin Resistance in Patients With Heart Failure
Information source: Tottori University Hospital
Information obtained from ClinicalTrials.gov on June 20, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Heart Failure
Intervention: losartan (Drug)
Phase: Phase 4
Status: Completed
Sponsored by: Tottori University Hospital
Summary
The purpose of this study is to evaluate the effects of losartan, an ARB, on glucose
metabolism and inflammatory cytokines in CHF patients treated with ACE inhibitors.
Clinical Details
Official title: Losartan Improved Insulin Resistance and Decreased Inflammatory Cytokines in Patients With Chronic Heart Failure Treated With Angiotensin Converting Enzyme Inhibitors
Study design: Treatment, Randomized, Double Blind (Subject, Investigator), Placebo Control, Crossover Assignment, Efficacy Study
Primary outcome: insulin resistance
Secondary outcome: inflammatory cytokines
Detailed description:
Chronic heart failure (CHF) is associated with marked insulin resistance, characterized by
both fasting and stimulated hyperinsulinemia. Furthermore, insulin resistance is a predictor
of CHF and associated with more severe disease and a worse prognosis in patients with CHF.
In CHF patients, therefore, insulin resistance is not merely a function of adiposity and may
have implications in the pathophysiology of CHF disease progression. Angiotensin II
negatively modulates insulin-mediated actions by regulating multiple levels of the insulin
signaling cascade such as the insulin receptor, IRS, and PI3-kinase. Furthermore, both ACE
inhibitors and angiotensin II receptor blockers (ARB) improve glycemic status not only in
patients with type II diabetes but also in patients with hypertension and the metabolic
syndrome. On the other hand, it is well known that some cytokines, such as TNF-α, are
involved with pathophysiology of insulin resistance and CHF. However, it is still unclear
whether the ARB improves insulin resistance in CHF patients already treated with ACE
inhibitors and whether there is the relationship between insulin resistance and inflammatory
cytokines in CHF patients already treated with ACE inhibitors. Therefore, the purpose of
this study is to evaluate the effects of losartan, an ARB, on glucose metabolism and
inflammatory cytokines in CHF patients treated with ACE inhibitors.
Eligibility
Minimum age: N/A.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- chronic stable heart failure
Exclusion Criteria:
- renal dysfunction or under treatment with antidiabetic agents
Locations and Contacts
Additional Information
Starting date: April 2006
Ending date: March 2007
Last updated: April 18, 2008
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