Cardiovascular Prehabilitation in Patients Awaiting Heart Transplantation (PREHAB HTx Study) (PREHAB)
Cardiovascular Prehabilitation in Patients Awaiting Heart Transplantation - Addressing Clinical Needs (PREHAB HTx Study)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Heart failure affects more than 6.2 million people living in North America. Approximately 10% of patients with heart failure have advanced heart failure. Heart transplantation is an effective life-saving treatment for patients with advanced heart failure. The cardiovascular rehabilitation programs are integral to heart failure management.
This study is being done to evaluate, in adults with advanced heart failure awaiting heart transplantation, the effects of cardiovascular rehabilitation (including high-intensity interval training, stress management and nutrition workshops) on functional capacity, aerobic power, frailty, quality of life, and mental health.
This study compares pre-transplant cardiovascular rehabilitation with usual pre-transplant care in patients with advanced heart failure awaiting heart transplant.
All participants will be randomized into 2 study groups: Group 1 (rehab), and Group 2 (no rehab). Those randomized to Group 1 will receive usual care, 12 weeks of rehab (exercise training, and attend stress and nutrition course through the Heart Failure Clinic and the Division of Prevention and Rehabilitation at the University of Ottawa Heart Institute). Those randomized to Group 2 will receive regular visits through the Heart Failure Clinic; patients are encouraged to remain physically active, although they do not participate in a regular structured exercise training program.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Ontario
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Ottawa, Ontario, Canada, K1Y4W7
- University of Ottawa Heart Institute
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Toronto, Ontario, Canada
- University Health Network
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Advanced heart failure and listed for heart transplantation.
- Able to perform a symptom-limited exercise test.
- Age =>18 years old.
- Able to provide informed consent.
Exclusion Criteria:
- Currently participating in a structured exercise training program (> 2 times per week)
- Status 4 priority listing for heart transplantation.
- Myocardial infarction =<7 days.
- Heart failure with hemodynamic instability.
- Hypertrophic obstructive cardiomyopathy with symptomatic left ventricular outflow tract gradient =>30 mmHg.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Interventional
Group 1. Usual care + High-Intensity Interval Training, Nutritional Workshop, Stress Management Course.
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Participants will complete supervised exercise sessions.
Participants will attend on-site high-intensity interval training two times weekly for 12 weeks.
Participants will complete six-minute walk test, cardiopulmonary exercise test, and six questionnaires: Short Form 36 Health Survey Questionnaire (SF-36), Minnesota Living with Heart Failure Questionnaire (MLHFQ), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Montreal Cognitive Assessment (MOCA), and Impact of Events Scale-Revised (IES-R) at baseline (week 1) and follow-up (after 12 weeks of intervention).
|
|
No Intervention: Non interventional
Group 2. Usual care.
Patients are encouraged to remain physically active, although they do not participate in a regular structured exercise training program.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in functional capacity
Time Frame: Baseline to 12 weeks
|
Change in in functional capacity from baseline to 12 weeks as measured by six-minute walk test distance.
Distance walked will be measured in meters.
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Baseline to 12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in aerobic power
Time Frame: Baseline to 12 weeks
|
Measured using expired VO2 gas samples, measured in L/min, ml/kg/min
|
Baseline to 12 weeks
|
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Change in frailty
Time Frame: Baseline to 12 weeks
|
Measured by the Fried criteria.
Measured by presence of 3 out of 5 frailty symptoms.
|
Baseline to 12 weeks
|
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Change in general quality of life
Time Frame: Baseline to 12 weeks
|
Measured by the Short Form 36 Health Survey Questionnaire (SF-36).
The SF-36 consists of 8-scaled scores which are the weighted sums of the questions in their section.
|
Baseline to 12 weeks
|
|
Change in disease-specific quality of life
Time Frame: Baseline to 12 weeks
|
Measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
MLHFQ is a 21-item scale that measures the effects of heart failure on quality of life using a 6-point scale.
|
Baseline to 12 weeks
|
|
Change in depressive symptoms
Time Frame: Baseline to 12 weeks
|
Measured by the Beck Depression Inventory II (BDI-II).
It contains 21-questions, each answer being scored on a scale of 0 to 3.
|
Baseline to 12 weeks
|
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Change in anxiety
Time Frame: Baseline to 12 weeks
|
Measured by the Beck Anxiety Inventory (BAI).
The BAI is a 21-item validated self-reported measure.
A total score is calculated by summing the items; maximum score is 62.
|
Baseline to 12 weeks
|
|
Change in cognitive function
Time Frame: Baseline to 12 weeks
|
Measured by the Montreal Cognitive Assessment (MOCA).
The MOCA is made up of 8 subscales, scores are totaled; maximum score is 30 points.
|
Baseline to 12 weeks
|
|
Change in response to a specific traumatic event
Time Frame: Baseline to 12 weeks
|
Measured by the Impact of Events Scale- Revised (IES-R).
IES-R is 22 items, zero to four scale.
Scores above 23 are of concern; scores above 32 indicate a probable diagnosis of PTSD.
|
Baseline to 12 weeks
|
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Short term post-heart transplantation outcomes
Time Frame: One year post-heart transplantation
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Data collected from medical records: length of hospital stay, adverse events (infection, treated rejection, bleeding, and stroke), survival to hospital discharge, and 30 day hospital readmissions.
|
One year post-heart transplantation
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jennifer Reed, Ph.D, R.Kin, Ottawa Heart Institute Research Corporation
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 20160753-01H
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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