- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03092388
Leg Fluid Shift in Patients With Chronic Heart Failure and Obstructive or Central Sleep Apnea
Evaluation Eines Leg Fluid Shift Und Erörterung Der hämodynamischen Und Respiratorischen Auswirkungen Auf Patienten Mit Chronischer Herzinsuffizienz Und Obstruktiver Oder Zentraler Schlafapnoe
Study Overview
Status
Detailed Description
Chronic heart failure (CHF) is a common disease in general western population with high levels of morbidity and mortality. Prospective risk factors need to be identified and investigated. The prevalence for sleep disordered breathing (SDB) in patients with CHF is higher compared to general population. Especially the occurence of CSA with its special breathing pattern of Cheyne-Stokes-Respiration (CSR) is frequent in CHF patients.The pathophysiology and relation inbetween sleep apnea (SA) and CHF isn´t completely identified yet. Multiple theories with different strategies try to explain the pathophysics and development of SA. Following one of these theories, patients with CHF often develop edema in lower body compartments. The idea is a possible influence of retrograde nocturnal LFS from lower body to upper body compartments which could induce pulmonal congestion. Therefore, an increased pulmonary capillary wedge pressure (PCWP) could irritate special pulmonal receptors resulting in CSR with periods of hyperventilation, related hypocapnia and central apnea events. OSA could be induced by fluid accumulation in the upper airway by retrograde fluid shift.
Patients with known CHF receive fluid measurements by b multi frequency bioimpedance analysis (mfBIA) the evening before and the morning after sleep is recorded using polygraphy (PG) or polysomnography (PSG) in hospital. Sleep results are analyzed by physicians using current guidelines of the American Academy of Sleep Medicine (AASM).
Capillary blood gas (CBG) samples are taken before and after sleep to examine the relation of fluid shift and blood gas changes.
A subgroup of the study group undergo additional investigation. Hemodynamic effects (e.g. reduced cardiac output (CO)) as a cause of a potential fluid shift is measured during wakefulness by using a tilting table. Hemodynamically relevant parameters are recorded non-invasively.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
North - Rhine Westfalia
-
Bad Oeynhausen, North - Rhine Westfalia, Germany, 32545
- Heart - and Diabetes CenteHerz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum, Bad Oeynhausen
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Chronic Heart Failure
- reduced left ventricular ejection fraction (LVEF) ≤ 45%
- NYHA I - IV
Exclusion Criteria:
- current existing sleep apnoea breathing therapy
- significant chronic obstructive pulmonary disease (COPD) Tiffenau-Index: <70%
- respiratory insufficiency with need for a long time oxygen therapy
- hypercapnic state in rest at day time
- acute myocardial infarction at moment of study
- instable angina pectoris at moment of study
- cardiac surgery in last twelve weeks
- stroke or TIA in last twelve weeks
- implantable cardioverter-defibrillator, if there is no security clearance of the fabricator
- chronic kidney disease > Stage III
Study Plan
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Study Group Basic
Patients receive Multi Frequency Bioimpedance Analysis (mfBIA) before and after sleep recording by Polysomnography/Polygraphy (PSG/PG) in hospital.
Capillary Blood Gas Analysis (CBGA) is performed before and after sleep according to mfBIA.
|
Multi Frequency Bioimpedance Analysis (mfBIA) uses very small electric current at different frequencies (5, 50, 100 kHz) to measure the resistance and reactance of the entire body and different segmental body compartiments.
With a special software total body fluid can be calculated.
By analyzing raw data at different frequencies a detailed view on body and segments fluid distribution is possible.
Other Names:
Sleep is digital recorded by using PSG/PG in hospital and manually analyzed by physicians according to current AASM guidelines.
CBGA is a less invasive method to gain arterial blood like gas samples without the punctation of an artery.
After inducing a good capillary perfusion, capillary blood is taken by a small punctation of the tip of one ear.
The sample is automatically analysed in a blood gas analyzer.
|
EXPERIMENTAL: Study Group Extended
Patients receive Multi Frequency Bioimpedance Analysis (mfBIA) before and after sleep recording by Polysomnography/Polygraphy (PSG/PG) in hospital. Capillary Blood Gas Analysis (CBGA) is performed before and after sleep according to mfBIA. Additionally, during daytime a special test with random parts of the study group basic is performed: A tilting table with hemodynamic monitoring is used to induce an artificial LFS by moving patients from vertical into horizontal position. Bodyfluid changes are monitored by mfBIA during this procedure. |
Multi Frequency Bioimpedance Analysis (mfBIA) uses very small electric current at different frequencies (5, 50, 100 kHz) to measure the resistance and reactance of the entire body and different segmental body compartiments.
With a special software total body fluid can be calculated.
By analyzing raw data at different frequencies a detailed view on body and segments fluid distribution is possible.
Other Names:
Sleep is digital recorded by using PSG/PG in hospital and manually analyzed by physicians according to current AASM guidelines.
CBGA is a less invasive method to gain arterial blood like gas samples without the punctation of an artery.
After inducing a good capillary perfusion, capillary blood is taken by a small punctation of the tip of one ear.
The sample is automatically analysed in a blood gas analyzer.
A tilting table offers the opportunity to turn a study subject automatically from vertical into horizontal position and back.
By using non-invasive monitoring technique, hemodynamic parameters are recorded permanently.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
∆ Leg Fluid Shift (LFS)
Time Frame: one night
|
[%] Difference between the raw data of leg fluid volume before and after sleep.
|
one night
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Apnea-Hypopnea-Index (AHI)
Time Frame: one night
|
[/h], definition after current AASM guideline
|
one night
|
Cheyne-Stokes-Respiration
Time Frame: one night
|
[min] + [(%) of Total Sleep Time (TST)]
|
one night
|
Oxygen-Desaturation-Index (ODI)
Time Frame: one night
|
[/h], definition after current AASM guideline
|
one night
|
Time Oxygen Saturation < 90% (TSpO2<90%)
Time Frame: one night
|
[min] + [% (of TST)]
|
one night
|
Oxygen Saturation (SpO2)
Time Frame: one night
|
one night
|
|
Sleep Efficiency
Time Frame: one night
|
one night
|
|
Longest Apnea time
Time Frame: one night
|
[min]
|
one night
|
Longest Hypopnea time
Time Frame: one night
|
[min]
|
one night
|
∆ partial pressure in capillary blood of carbon dioxide (pcCO2)
Time Frame: one night
|
[mmHG] Difference of pcCO2 before and after sleep
|
one night
|
∆ partial pressure in capillary blood of oxygen (pcO2)
Time Frame: one night
|
[mmHG] Difference of pcO2 before and after sleep
|
one night
|
∆ Resistance
Time Frame: one night
|
[Ohm]
|
one night
|
∆ Reactance
Time Frame: one night
|
[Ohm]
|
one night
|
∆ Total Body Water (TBW)
Time Frame: one night
|
[l]
|
one night
|
Blood Pressure (systolic, diastolic, mean)
Time Frame: one night
|
[mmHg]
|
one night
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cardiac Index
Time Frame: one hour
|
[(l/min)/m²] Cardiac output from left ventricle related to body surface during tilting table
|
one hour
|
∆ pcCO2
Time Frame: one hour
|
[mmHG] Difference of pcCO2 before and after tilting table
|
one hour
|
∆ pcO2
Time Frame: one hour
|
[mmHG] Difference of pcO2 before and after sleep
|
one hour
|
Thoracic Fluid Content (TFC)
Time Frame: one hour
|
[1/kOhm]
|
one hour
|
∆ Leg Fluid Shift
Time Frame: one hour.
|
[%] Difference between the raw data of leg fluid volume before and after tilting table.
|
one hour.
|
∆ Total Body Water
Time Frame: one hour
|
[l]
|
one hour
|
Oxygen Saturation
Time Frame: one hour
|
one hour
|
|
Blood Pressure (systolic, diastolic and mean)
Time Frame: one hour
|
[mmHg]
|
one hour
|
∆ Resistance (legs, body)
Time Frame: one hour
|
[Ohm] electrical resistance
|
one hour
|
∆ Reactance (legs, body)
Time Frame: one hour
|
[Ohm] capacitive resitance
|
one hour
|
Collaborators and Investigators
Investigators
- Principal Investigator: Schindhelm Florian, Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum, Bad Oeynhausen, Germany
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HDZNRW-KA_004_TB
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Obstructive Sleep Apnoea
-
Papworth Hospital NHS Foundation TrustIceni Labs Ltd, Warwickshire, United KingdomCompletedObstructive Sleep Apnoea | Sleep ApnoeaUnited Kingdom
-
University of CreteCompleted
-
University of ZurichCompletedObstructive Sleep ApnoeaSwitzerland
-
ResMedCompletedObstructive Sleep Apnoea (OSA)Australia
-
ResMedCompleted
-
University of British ColumbiaCompleted
-
Air Liquide Santé InternationalClinactRecruitingObstructive Sleep Apnoea Syndrome (OSAS)Portugal
-
University of MalayaUnknownObstructive Sleep ApnoeaMalaysia
-
Wenzhou Medical UniversityCompletedObstructive Sleep ApnoeaChina
-
Chinese University of Hong KongCompleted
Clinical Trials on Multi Frequency Bioimpedance Analysis (mfBIA)
-
Sun Yat-sen UniversityCompletedEnd Stage Renal DiseaseChina
-
Instituto de Investigación Sanitaria de la Fundación...Completed
-
University Hospital, Clermont-FerrandCompleted
-
University Hospital, SaarlandCompletedRenal Insufficiency, ChronicGermany
-
Hospices Civils de LyonRecruiting
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)CompletedAdult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities | Adult Acute Myeloid Leukemia With Del(5q) | Adult Acute Myeloid Leukemia With Inv(16)(p13;q22) | Adult Acute Myeloid Leukemia With t(16;16)(p13;q22) | Adult Acute Myeloid Leukemia With t(8;21)(q22;q22) | Untreated Adult Acute Myeloid... and other conditionsUnited States
-
Catholic University of PelotasCompletedKidney Failure | Haemodialysis Fluid Adverse ReactionBrazil
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)TerminatedExtensive Stage Small Cell Lung CancerUnited States
-
Dita AditianingsihCompletedHemodynamic MonitoringIndonesia
-
Rio de Janeiro State UniversityCompletedOverweight | Pre Diabetes | Diabetes Mellitus Type 2 Without Complication