Clinical Trial: Primary Hyperaldosteronism and Ischemia-reperfusion Injury

Study Status: Enrolling by invitation
Recruit Status: Enrolling by invitation
Study Type: Interventional

Official Title: Primary Hyperaldosteronism and Endothelial Ischemia-reperfusion Injury

Brief Summary:

Patients with primary hyperaldosteronism experience more cardiovascular events compared to patients with primary hypertension, independent of the blood pressure level.

In this research we hypothesize that patients with primary hyperaldosteronism are more susceptible to ischemia-reperfusion injury.


Detailed Summary: Patients with PHA have an increased risk of cardiovascular events, independent of blood pressure level. Also in patients suffering a myocardial infarction, circulating aldosterone levels are associated with increased mortality. In animal models of myocardial infarction, the administration of exogenous aldosterone increased infarct size, although other studies did not report this effect. In similar models, antagonists of the mineralocorticoid receptor (MR) reduced infarct size, which was completely abolished in ecto-5'-nucleotidase (CD73, the enzyme that catalyses extracellular formation of the endogenous nucleoside adenosine) and adenosine receptor knock-out mice. Therefore, we hypothesize that patients with PHA have an increased susceptibility for ischemia-reperfusion (IR)-injury due to down-regulation of the enzyme CD73. We will use the reduction in brachial flow-mediated dilation (FMD) by forearm IR as a well-validated endpoint for (endothelial) IR-injury.
Sponsor: Radboud University

Current Primary Outcome: brachial FMD [ Time Frame: 1 day morning ]

primary outcome measure is the reduction in brachial artery FMD after 20 minutes of forearm ischemia and 20 minutes of reperfusion in patients with primary hyperaldosteronism (compared to patients with primary hypertension)


Original Primary Outcome: Same as current

Current Secondary Outcome: CD73 and adenosine [ Time Frame: one day morning (just before FMD experiment) ]

Blood will be drawn to determine circulating adenosine concentration and the CD73 activity on mononuclear cells


Original Secondary Outcome: Same as current

Information By: Radboud University

Dates:
Date Received: October 31, 2013
Date Started: November 2013
Date Completion: July 1, 2017
Last Updated: April 14, 2017
Last Verified: April 2017