Actively Recruiting

Phase 4
Age: 18Years - 85Years
All Genders
ID05030545

Cardiovascular Manifestations of MR Activation in Primary Aldosteronism: Pilot Clinical Study

Led by Brigham and Women's Hospital · Updated on 2025-02-07

40

Participants Needed

1

Research Sites

17 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are studying how the hormone aldosterone affects the heart, especially in people with primary aldosteronism, a condition where the adrenal glands produce too much aldosterone. This hormone can cause high blood pressure and increase the risk of heart and kidney problems. The study aims to find out if blocking aldosterone with medication can improve heart function for those affected by this condition. Participants will receive treatment with eplerenone, a medication that blocks the mineralocorticoid receptor, for six months. Before starting treatment, cardiac imaging tests including a PET stress test and echocardiogram will be done to assess heart blood flow and structure. These tests will be repeated after the six-month treatment period to evaluate changes. The medication dose starts at 50 mg daily and may increase to 100 mg daily, depending on tolerance. During the study, participants will undergo heart imaging tests before and after treatment to measure blood flow and heart function changes. Researchers will track heart blood flow, heart muscle strain, and heart size using echocardiograms and PET scans. The main outcome is the change in myocardial flow reserve over six months. Safety evaluations and monitoring of kidney function and potassium levels will be conducted throughout the study. Participation lasts for at least six months of treatment and follow-up testing.

CONDITIONS

Brief Title

Cardiovascular Manifestations of MR Activation in Primary Aldosteronism: Pilot Clinical Study

Who Can Participate

Age: 18Years - 85Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Adults aged 18 to 85 years
  • Able to provide informed consent and willing to comply with the study
  • Able to fit safely in PET/CT scanner (weight limit 500 pounds; diameter 70 cm; circumference 220 cm)
  • Hypertension treated with at least one antihypertensive medication
  • Cohort A: Clinically confirmed diagnosis of primary aldosteronism not yet treated with mineralocorticoid receptor antagonists
  • Cohort B: Clinically indicated cardiac PET perfusion scan within preceding 3 months and echocardiogram within preceding 6 months
Not Eligible

You will not qualify if you...

  • History of heart attack, coronary artery bypass graft, known cardiomyopathy (ejection fraction less than 40%, hypertrophic cardiomyopathy, and/or amyloid), or cardiac transplantation
  • Allergy or contraindication to eplerenone or spironolactone
  • Current pregnancy or breastfeeding
  • Estimated glomerular filtration rate less than 45 mL/min/1.73m2 or potassium level above 5.1 on recent labs
  • Cohort A: Planned adrenalectomy within the next 6 months
  • Cohort B: 10% or greater burden of ischemia on qualifying PET scan
  • Cohort B: Planned coronary angiogram or revascularization within the next 6 months

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 screening and enrollment visit

Treatment

Duration - 6 months

Participants receive eplerenone treatment for 6 months to assess its impact on heart blood flow and structure through cardiac PET stress tests and echocardiograms.

1 baseline visit and 1 follow-up visit after treatment

Trial Site Locations

Total: 1 location

1

Brigham and Women's Hospital

Boston, Massachusetts, United States, 02115

Actively Recruiting

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Research Team

J

Jenifer M Brown, MD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

TREATMENT

Number of Arms

1

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