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Endothelial Derived Hyperpolarization Factor and Vascular Control

Endothelial Derived Hyperpolarization Factor and Regulation of Cerebral and Muscle Blood Flow

Status
Recruiting
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05176379
Enrollment
30
Registered
2022-01-04
Start date
2022-02-19
Completion date
2025-05-31
Last updated
2024-07-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Healthy

Keywords

brain blood flow, muscle blood flow, endothelial function

Brief summary

Most cardiometabolic diseases are characterized by increased muscle sympathetic nerve activity (MSNA) during rest and exercise which contributes to poor health outcomes. In healthy humans during muscle contraction, there is a blunting of skeletal muscle vascular responsiveness to increases in MSNA. However, the exact mechanisms involved are unknown although, best evidence suggests that the mechanism is endothelium derived, but nitric oxide (NO) and prostaglandin (PG) independent. Endothelium-derived hyperpolarizing factor (EDHF) is a NO and PG independent vasodilator in both cerebral and skeletal muscle circulations, however, it is unknown if EDHF contributes to vascular responsiveness during elevated MSNA. The application of lower body negative pressure (LBNP) is a safe and non-invasive manipulation that can be used to increase MSNA causing vasoconstriction in humans. Therefore, the purpose of this experiment is to determine if acute inhibition of EDHF alters central and peripheral vascular responses to LBNP at rest and during dynamic exercise. Thereby, providing evidence by which EDHF contributes to vascular control in healthy humans and identify it's potential as a therapeutic target for cardiometabolic diseases that are characterized by elevated MSNA

Detailed description

The purpose of this study is to investigate the importance of the endothelium-derived hyperpolarizing factor (EDHF) in regulation of muscle and brain blood flow during rest, sympathetic activation via lower body negative pressure (LBNP), and during rhythmic exercise. We hypothesize that acute inhibition of EDHF will blunt cardiovascular responses and decrease peripheral tissue oxygenation (specifically in the brain and muscle) in response to LBNP during rest and during exercise. This work will provide evidence that EDHF counter acts sympathetic nervous activity in healthy humans, thereby highlighting EDHF as a potentially crucial mechanism in human vascular control. Ultimately this work will provide basic knowledge need to open longer treatment windows and potentially novel therapies for cardiovascular complications from cardiometabolic diseases. To test these hypotheses, we will complete two specific aims: I) To test the hypothesis whether EDHF inhibition alters sympathetic restraint muscle vasculature (termed, sympatholysis), we will compare changes in oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), Cardiac Output (CO) and Mean Arterial Pressure (MAP), Total Peripheral Resistance (TPR), Tissue Oxygen Saturation Index (TSI) during sympathetic activation (LBNP) and Handgrip exercise in two conditions: placebo vs. acute EDHF inhibition (Fluconazole). II) To test the hypothesis whether EDHF inhibition alters regulation of cerebral blood flow during rest and sympathetic activation (LBNP), we will compare changes in cerebral vascular conductance index (CVCi), cerebral TSI as well as gain, coherence, and phase in transfer functional analysis during the exposure to Lower Body Negative Pressure (LBNP) in two conditions: placebo vs. acute EDHF inhibition (Fluconazole)

Interventions

A single acute 150 mg dose

Sponsors

University of Oklahoma
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)

Masking description

Participants will receive a placebo instead of fluconazole

Intervention model description

Randomized, single-blind, Placebo controlled, crossover design

Eligibility

Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes

Inclusion criteria

* Normotensive (systolic blood pressure \< 130 mmHg and/or diastolic blood pressure \< 85 mmHg) individuals * Individuals free of cardiovascular disease and metabolic disease * Individuals free of any form of autonomic dysfunction * Individuals with a BMI under 30 kg/m² * Women that are premenopausal with a regular menstrual cycle (26-30 days)

Exclusion criteria

* Smokers, tobacco users (regular use in the last 6 months) * Individuals with a blood pressure greater than 130/85 * Subjects who use Amiodarone, Sulphaphenazole * Subjects who use S-warfarin, Tolbutamine, Phenytoin, Lonafarnib * Cardiometabolic medication use (e.g. anti-hypertensives, insulin-sensitizing, statins) * Sex hormone replacement medical use (e.g. testosterone, estrogen, progesterone) * Pregnancy

Design outcomes

Primary

MeasureTime frameDescription
Near-Infrared Spectroscopyup to 4 hoursConcentrations of Oxygen, deoxy, and Total Hemoglobin (micro molar)
Transcranial Doppler Ultrasoundup to 4 hoursmiddle cerebral artery blood velocity

Secondary

MeasureTime frameDescription
Wireless electrocardiogramup to 4 hoursheart rate
Finger photoplethysmographyup to 4 hoursMean Arterial Pressure

Countries

United States

Contacts

Primary ContactJeremy M Kellawan, PhD
kellawan@ou.edu4053259028

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026