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Rationale:
Recently, sunitinib (a tyrosine kinase inhibitor that is used for treatment of metastatic renal carcinoma and gastrointestinal stroma tumors) has been associated with development of heart failure, possibly by off-target inhibition of AMP-protein kinase. The investigators hypothesize that sunitinib reduces the contractile ability of myocardium and the tolerance against ischemia-reperfusion and that activators of AMP-protein kinase such as atorvastatin and AICAR reverse this unwanted effect of sunitinib.
Objectives:
The primary objective of the study is to investigate the effect of sunitinib on ex-vivo atrial contractile force in absence and presence of ischemia-reperfusion.
A secondary objective is to explore if atorvastatin or AICAR prevent sunitinib-induced deterioration of contractile function of human atrial trabeculas. Study design: Lab
Study population: 44 (+22) patients undergoing CABG cardiac surgery with extracorporal circulation Intervention (if applicable): none (pharmacological interventions will only be performed ex-vivo in isolated atrial tissue) Main study parameters/endpoints The developed force in ex vivo atrial trabeculas during standardized stimulation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| With/without sunitinib | Two trabeculas will be isolated and one will be exposed to sunitinib and the other to normal buffer solution. Both will be stimulated to contraction during 200 minutes. | ||
| With/without sunitinib IP | Two trabeculas will be isolated and one will be exposed to sunitinib and the other to normal buffer solution. Both will be stimulated to contraction and ischemia/reperfusion |
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| Measure | Description | Time Frame |
|---|---|---|
| Force | The developed force in ex vivo atrial trabeculae during standardized stimulation. | 200 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Speed | The difference in averaged maximal speed of tension reduction during relaxation between two trabeculae | 200 minutes |
| Maximal Speed | The difference in averaged maximal speed of tension development during contraction between two trabeculae. |
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Inclusion Criteria:
Exclusion Criteria:
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44 patients undergoing cardiac surgery with extracorporal circulation
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| Name | Affiliation | Role |
|---|---|---|
| G. A. Rongen | Radboud University Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Radboud University Nijmegen Medical Centre | Nijmegen | 6500HB | Netherlands |
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| ID | Term |
|---|---|
| D066126 | Cardiotoxicity |
| D007511 | Ischemia |
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Atrial tissue
| 210 minutes |
| D064420 | Drug-Related Side Effects and Adverse Reactions |
| D064419 | Chemically-Induced Disorders |
| D011832 | Radiation Injuries |
| D014947 | Wounds and Injuries |