Angina Pectoris
Conditions
Keywords
Glucagon-Like Peptide 1, Angina Pectoris, Percutaneous Coronary Intervention, Ischemic Preconditioning, Myocardial Reperfusion Injury
Brief summary
Ischaemic heart disease is the most common cause of death in the UK. Glucagon-like peptide-1 (GLP-1) has been demonstrated to protect the heart when it is deprived of blood supply (ischaemia). The mechanism for this protection is not clear. Similar protection occurs with ischaemic conditioning of the heart, which is dependent on potassium channel opening. The investigators intend to establish whether GLP-1 mediated protection shares a similar mechanistic pathway. In order to do this the investigators will measures pressure--volume loops generated in the main pumping chamber of the heart at the time of a percutaneous coronary intervention (stenting). Patients will be allocated to GLP-1 alone, GLP-1 with glibenclamide (a potassium channel blocking medication approved for human use), saline control or glibenclamide alone. The investigators hypothesis is that the effect of GLP-1 will be abrogated by use of glibenclamide.
Interventions
Infusion of GLP-1 (7-36) amide 1.2 pmol/Kg/min
DRUGGlibenclamide
Oral Glibenclamide 5mg
Sponsors
Papworth Hospital NHS Foundation Trust
Study design
Allocation
NON_RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age over 18 * Able to give informed consent * Elective percutaneous intervention for a single vessel coronary stenosis * Normal left ventricular function
Exclusion criteria
* Severe Co-morbidity * Type 2 Diabetes Mellitus * Nicorandil, Sulphonylureas, DPP4 inhibitors, GLP-1 agonists or Insulin use * Women of child bearing age * Myocardial infarction in previous three months * Previous coronary artery bypass grafts
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Isovlumetric Relaxation Constant - Tau (ms) | Measured at the time of procedure | The isovolumetric relaxation constant, Tau, a measure of left ventricular diastolic function, will be measured during the second balloon occlusion of the coronary artery. This will be measured on pressure-volume loop using a conductance catheter. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Left Ventricular Ejection Fraction (%) | Measured at the time of the procedure | Ejection fraction, a measure of left ventricular systolic function, will be measured during the second balloon occlusion of the coronary artery. This will be measured on pressure-volume loop using a conductance catheter. |
| Maximal rate of change with time of left ventricular pressure - dP/dt max (mmHg/s) | Measured at the time of the procedure | dP/dt max, a measure of left ventricular systolic function, will be measured during the second balloon occlusion of the coronary artery. This will be measured on pressure-volume loop using a conductance catheter. |
| Minimum rate of change with time of left ventricular pressure - dP/dt min (mmHg/s) | Measured at the time of procedure | dP/dt min, a measure of left ventricular diastolic function, will be measured during the second balloon occlusion of the coronary artery. This will be measured on pressure-volume loop using a conductance catheter. |
Countries
United Kingdom
Outcome results
None listed