Intravenous Allopurinol in Heart Failure

Effects of Xanthine Oxidase Inhibition on Mechano-Energetic Coupling in Heart Failure

This study tests the hypothesis that allopurinol, a xanthine oxidase inhibitor, improves heart metabolism in patients with heart failure.

Xanthine oxidase have been reported to improve mechano-energetic coupling in failing hearts. The investigators developed a means to directly measure creatine kinase flux, the major energy reserve of the heart, in the human heart exploiting new magnetic resonance technologies.

The investigators propose to study 10 healthy subjects and up to 25 with heart failure (dilated cardiomyopathy) before and after a single 300mg IV infusion of allopurinol.

Inclusion Criteria:

• Age > 18 years
• The patient is willing and able to provide informed consent
• Clinical diagnosis of chronic heart failure
• Ejection fraction (EF) < 40% by echocardiography, nuclear multigated acquisition (MUGA) or cath ventriculography
• No significant coronary disease at cardiac catheterization
• New York Heart Association (NYHA) Class I-IV symptoms
• Clinical stabilization for two weeks if following recent congestive heart failure (CHF) decompensation.

Exclusion Criteria:

• Metallic implant prohibiting magnetic resonance (MR) evaluation
• Inability to lie flat for MR study
• Administration of additional investigational drugs
• Calculated creatinine clearance < 50 mL/min
• Allergy to allopurinol
• Current gout flare
• Currently taking oral allopurinol