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- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT01919918
Muscle Afferent Feedback Effects in Patients With Heart Failure
Muscle Afferent Feedback Effects in Patients With Heart Failure: The Development of Central Fatigue
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
A substantial part in limiting exercise and/or physical activity in humans results from the development of peripheral and central fatigue during physical activity. Peripheral fatigue comprises biochemical changes within the metabolic milieu of the working muscle leading to an attenuated response to neural excitation, while central fatigue comprises a failure of the central nervous system to drive motoneurons.
Patients with HF have overactive group III/IV muscle afferents and an exaggerated development of central fatigue during physical activity that is not explained by their reduced physical conditioning or cardiac insufficiency caused by their failing heart. The exact mechanisms accounting for the exaggerated central fatigue in HF remains elusive, however, the development of central fatigue during exercise has recently been linked to signaling by group III/IV muscle afferents. This makes the heightened neural feedback in HF a likely candidate for these patients' increased susceptibility to central fatigue.
Lower pH, increased lactate and increased adenosine triphosphate has been shown to activate group III/IV afferents in a physiological manner and thus induce, in a rested and unfatigued muscle, the intramuscular milieu associated with moderate to heavy exercise. The objective of this study is to quantitate and compare the sensitivity of group III/IV afferents and associated effects on central fatigue in HF patients and healthy controls when skeletal muscle is subject to controlled lower pH, increased lactate and increased adenosine triphosphate.
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 1
Contactos y Ubicaciones
Ubicaciones de estudio
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Utah
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Salt Lake City, Utah, Estados Unidos, 84148
- Veterans Affairs Salt Lake City Heath Care System
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Salt Lake City, Utah, Estados Unidos, 84148
- George E Wahlen Vetern Affairs Medical Center
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Heart Failure Inclusion Criteria:
- Subjects with a history of stable cardiomyopathy (ischemic and non-ischemic, greater than 1 year duration, ages 20-79 years)
- New York Heart Association class I through IV symptoms
- Left ventricular ejection fraction less than 35 percent (heart failure patients with reduced left ventricular ejection fraction) or greater than 50 percent (heart failure patients with preserved left ventricular ejection fraction)
- Sedentary, no regular physical activity for at least 6 months prior
- Post-menopausal for at least 2 years and follicle stimulating hormone greater than 40
Heart Failure Exclusion Criteria:
- Patients with atrial fibrillation or heart failure believed to be secondary to atrial fibrillation
- Morbidly obese patients with a body mass index greater than 35
- Patients with uncontrolled hypertension, greater than 160/100
- Anemia with a hemoglobin less than 9
- Severe renal insufficiency (creatinine clearance less than 30 by the Cockcroft-Gault formula)
- Patients with significant non-cardiac comorbidities
- Orthopedic limitations that would prohibit them from performing the elbow-flexor exercise
- Current smoker or smoking history of 15 packs or more per year
- Women currently taking hormone replacement therapy
Healthy Control Inclusion Criteria:
- Ages 20-75 years
- Sedentary, no regular physical activity for at least 6 months prior
- Post-menopausal for at least 2 years and follicle stimulating hormone greater than 40
Healthy Control Exclusion Criteria:
- History of cardiovascular related abnormalities or pulmonary abnormalities
- Morbidly obese patients with a body mass index greater than 35
- Patients with uncontrolled hypertension, greater than 160/100
- Anemia with a hemoglobin less than 9
- Orthopedic limitations that would prohibit them from performing the elbow-flexor exercise
- Current smoker or smoking history of 15 packs or more per year
- Women currently taking hormone replacement therapy
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Ciencia básica
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Otro: Heart Failure Patients
Patients with heart failure will undergo intervention of muscle contraction with metabolite solution administration.
Maximal voluntary muscle contraction exercise with varying metabolite solution administration of adenosine triphosphate, lactate, and protons with phosphate buffer.
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Participants will perform maximal elbow flexor or knee extensor contractions before and after administration of metabolite solutions of pH 7.2, pH 7.0 and pH 6.6
Otros nombres:
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Otro: Control Participants
Healthy control participants will undergo intervention of muscle contraction with metabolite solution administration.
Maximal voluntary muscle contraction exercise with varying metabolite solution administration of adenosine triphosphate, lactate, and protons with phosphate buffer.
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Participants will perform maximal elbow flexor or knee extensor contractions before and after administration of metabolite solutions of pH 7.2, pH 7.0 and pH 6.6
Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
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Elbow Flexor Maximal Voluntary Contraction in newton-meters
Periodo de tiempo: 2 minutes
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2 minutes
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Markus Amann, PhD, University of Utah
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
- Enfermedades cardíacas
- Enfermedades cardiovasculares
- Insuficiencia cardiaca
- Efectos fisiológicos de las drogas
- Agentes neurotransmisores
- Mecanismos moleculares de acción farmacológica
- Agentes antiarrítmicos
- Agentes vasodilatadores
- Agentes del sistema nervioso periférico
- Analgésicos
- Agentes del sistema sensorial
- Agentes Purinérgicos
- Agonistas purinérgicos del receptor P1
- Agonistas purinérgicos
- Adenosina
Otros números de identificación del estudio
- 62914
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
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