Novel Approaches for Improving Vascular Function in Veterans With HFpEF
VA Office of Research and Development
Summary
This project will evaluate the impact of L-Citrulline, tetrahydrobiopterin (BH4), and atorvastatin administration on physical capacity and vascular function in Veterans with heart failure with preserved ejection fraction (HFpEF).
Description
The hospital admission rate for Veterans with heart failure with a preserved ejection fraction (HFpEF) continues to rise within the VA Health Care System, making HF the number one reason for hospital discharge Additionally, readmission rates of Veterans with HF tend to be higher than the national average, emphasizing the shortcomings of current therapeutic strategies Indeed, while optimized pharmacotherapy has led to a declining mortality in heart failure with reduced ejection fraction (HFrEF) patients, similar therapies in patients with HFpEF have been unsuccessful in altering the natural his…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age 18 years or older and able to give written informed consent. * New York Heart Association (NYHA) functional class I, II, or III. * Left Ventricular Ejection Fraction (LVEF) \> 50%. * Plasma Brain Natriuretic Peptide (BNP) equal to or greater than 150 pg/mL or NT-proBNP equal to or greater than 600 pg/mL at Visit 1, or a BNP equal to or great than 100 pg/mL (or NT-proBNP equal to or greater than 400 pg/mL) and a hospitalization for heart failure within the last 12 months. Exclusion Criteria: * History of hypersensitivity or allergy to any lipophilic statin. * Prior…
Interventions
- DrugL-Citrulline
100 mg tablet
- DrugPlacebo for L-Citrulline
L-Citrulline-matched Placebo tablet
- DrugBH4
10mg/kg
- DrugPlacebo for BH4
BH4-matched Placebo
- DrugAtorvastatin
10 mg tablet
- DrugPlacebo for Atorvastatin
Atorvastatin-matched Placebo
Location
- VA Salt Lake City Health Care System, Salt Lake City, UTSalt Lake City, Utah