[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100626099":3},{"organization":4,"armGroups":7,"interventions":19,"overallOfficials":27,"centralContacts":31,"locations":41,"responsibleParty":71,"collaborators":74,"id":78,"slug":79,"hasResults":80,"nctId":81,"briefTitle":82,"officialTitle":83,"acronym":84,"eligibilityCriteria":85,"healthyVolunteers":80,"sex":86,"minAge":87,"maxAge":35,"enrollmentInfo":88,"targetDuration":35,"studyType":91,"phases":92,"briefSummary":94,"conditions":95,"keywords":97,"overallStatus":44,"whyStopped":35,"lastUpdateSubmitDate":101,"lastUpdatePostDateStruct":102,"startDateStruct":105,"completionDateStruct":107,"leadSponsor":109,"locationsCount":110},{"fullName":5,"class":6},"Karolinska Institutet","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Inorganic nitrate","EXPERIMENTAL","14 cl of nitrate-rich beetroot juice",[13],"Dietary Supplement: nitrate-rich beetroot juice\u002Fplacebo beetroot juice",{"label":15,"type":16,"description":17,"interventionNames":18},"Placebo","PLACEBO_COMPARATOR","14 cl of visually and taste-matched placebo beetroot juice",[13],[20],{"type":21,"name":22,"description":23,"armGroupLabels":24,"otherNames":25},"DIETARY_SUPPLEMENT","nitrate-rich beetroot juice\u002Fplacebo beetroot juice","After written informed consent is obtained, all patients will undergo right heart catheterization to obtain invasive hemodynamic measurements at baseline. The experimental arm will drink 14 cl of nitrate-rich beetroot juice. The placebo comparator arm will drink 14 cl of visually and taste-matched placebo beetroot juice.",[9,15],[26],"right heart catheterization",[28],{"name":29,"affiliation":5,"role":30},"Jacob M Hollenberg, Professor","PRINCIPAL_INVESTIGATOR",[32,37],{"name":29,"role":33,"phone":34,"phoneExt":35,"email":36},"CONTACT","(+46) 070-4133442",null,"jacob.hollenberg@ki.se",{"name":38,"role":33,"phone":39,"phoneExt":35,"email":40},"Olle M Andersson, PhD","(+46) 072-9174349","olle.andersson@ki.se",[42,59],{"facility":43,"status":44,"city":45,"state":35,"zip":35,"country":46,"countryCode":47,"cosmosGeoPoint":48,"geoPoint":53,"contacts":54},"South hospital Stockholm","RECRUITING","Stockholm","Sweden","SE",{"type":49,"coordinates":50},"Point",[51,52],18.06871,59.32938,{"lat":52,"lon":51},[55,58],{"name":56,"role":33,"phone":57,"phoneExt":35,"email":40},"Olle M Andersson, MD","+46729174349",{"name":56,"role":30,"phone":35,"phoneExt":35,"email":35},{"facility":60,"status":61,"city":45,"state":35,"zip":35,"country":46,"countryCode":47,"cosmosGeoPoint":62,"geoPoint":64,"contacts":65},"Stockholm, Sweden","NOT_YET_RECRUITING",{"type":49,"coordinates":63},[51,52],{"lat":52,"lon":51},[66,70],{"name":67,"role":33,"phone":68,"phoneExt":35,"email":69},"Eric Rullman, Ass. Professor","+46739708096","eric.rullman@ki.se",{"name":67,"role":30,"phone":35,"phoneExt":35,"email":35},{"type":30,"investigatorFullName":72,"investigatorTitle":73,"investigatorAffiliation":5,"oldNameTitle":35,"oldOrganization":35},"Jacob Hollenberg","Profesor",[75],{"name":76,"class":77},"South Hospital Stockholm","UNKNOWN","100626099","inorganic-nitrates-in-intermediate-high-risk-pulmonary-embolism-100626099",false,"NCT07431229","Inorganic Nitrates in Intermediate High-risk Pulmonary Embolism","Inorganic Nitrates in Pulmonary Embolism With Hemodynamic Instability","NITRATE-PE","Inclusion Criteria:\n\nAcute PE with symptoms \\\u003C 14 days confirmed by computer tomography (CT) AND RV dilatation on CT or ECHO AND Troponin T \\> 45 pg\u002Fml\n\nExclusion Criteria:\n\nCardiac arrest with cardiopulmonary resuscitation, Thrombolysis or endovascular thrombectomy, \\\u003C 18 years of age, Pregnancy, INR \\> 2,5 or platelet count \\\u003C 100, DAPT or OAK, Inability to give informed consent to the study, Contraindications for right heart catheterization: mechanical devices, endocarditis, GUCH-patients, Short expected lifespan \\\u003C 120 days \u002F withdrawal of care, Imdur or other medications with nitrates, Daily usage of mouth wash prescribed by dentist or doctor","ALL","18 Years",{"count":89,"type":90},36,"ESTIMATED","INTERVENTIONAL",[93],"NA","Pulmonary embolism (PE) is a serious condition caused by blood clots blocking the blood vessels in the lungs. In some patients, PE leads to increased pressure in the lung circulation and strain on the right side of the heart. Patients with intermediate high-risk PE have signs of right heart stress and heart muscle injury and are at risk of clinical deterioration despite standard treatment with anticoagulation.\n\nIn addition to the mechanical obstruction caused by blood clots, pulmonary embolism also causes narrowing of the lung blood vessels due to vasoconstriction. This increases pulmonary vascular resistance and contributes to elevated pressure in the pulmonary arteries, which can worsen right heart function. Treatments that reduce pulmonary artery pressure and vascular resistance could therefore potentially improve heart function and stabilize patients in the acute phase of PE. However, there is limited clinical evidence regarding the safety and effectiveness of pulmonary vasodilator therapy in this patient group.\n\nInorganic nitrates, found naturally in foods such as beetroot, are converted in the body to nitric oxide, a substance that relaxes blood vessels. Inorganic nitrates have been shown to lower blood pressure and improve pulmonary hemodynamics in other cardiovascular conditions, and are generally considered safe. Their effects in patients with intermediate high-risk pulmonary embolism have not previously been studied in a randomized controlled trial.\n\nThe aim of this study is twofold: first, to describe invasive hemodynamic measurements in patients with intermediate high-risk pulmonary embolism using right heart catheterization; and second, to investigate the safety, feasibility, and physiological effects of treatment with oral inorganic nitrate compared with placebo.\n\nThis is a multicenter, double-blind, randomized controlled trial conducted at two hospitals in Sweden. Adult patients with confirmed acute pulmonary embolism, right ventricular dilation, and elevated cardiac troponin levels will be included after providing informed consent. All patients will receive standard care, including anticoagulation therapy. In addition, all participants will undergo right heart catheterization to measure pressures and blood flow in the heart and lungs.\n\nParticipants will be randomly assigned to receive either nitrate-rich beetroot juice or a placebo beetroot juice for five days. Neither the patients nor the treating clinicians or investigators will know which treatment is given. The primary outcome is mean pulmonary artery pressure measured three hours after administration of the study treatment. Secondary outcomes include additional hemodynamic measurements, blood biomarkers, and safety outcomes such as low blood pressure or need for vasopressor treatment.\n\nThe results of this study will improve understanding of pulmonary hemodynamics in intermediate high-risk pulmonary embolism and help determine whether inorganic nitrate therapy is safe and has beneficial physiological effects in this patient population.",[96],"Pulmonary Embolism (Diagnosis)",[98,99,100,26],"Pulmonary embolism","Pulmonary vasodilation","Invasive hemodynamics","2026-02-18",{"date":103,"type":104},"2026-02-24","ACTUAL",{"date":106,"type":104},"2026-02-17",{"date":108,"type":90},"2028-02-25",{"name":5,"class":6},2]