Influence of Exercise Therapy on Insulin Resistance in Patients With Heart Failure
The purpose of this study is to investigate the effects of a combined training programme on insulin resistance, exercise tolerance, muscle strength, body composition and cardiac function in chronic heart failure patients.
It is assumed that the above mentioned clinical parameters will improve due to physical exercise.
調査の概要
詳細な説明
- Background and study aims During the last decades, the prevalence of (pre)diabetes but also of chronic heart failure (CHF) has increased dramatically. Somehow, both conditions are linked, but the mechanisms involved have not been completely clarified yet. It is clear that the presence of (pre)diabetes in CHF patients affects morbidity and mortality. Although feasibility, safety and beneficial effects of exercise training in CHF are generally acknowledged, its effects on insulin resistance are not well understood. Therefore, the presented study aims to investigate the effect of ET on insulin resistance and the possible link with cardiac function, exercise tolerance, muscle strength and body composition in CHF patients.
What does the study involve?
A randomized controlled study (n=30) will be performed over a period of 12 weeks. Following study inclusion, baseline measurements will be performed in 1 week. They include:
- a maximal exercise test on a bicycle ergometer to assess exercise tolerance,
- two oral glucose tolerance tests to assess fasting and post-exercise insulin resistance,
- a venous blood sample to determine HbA1c, blood lipids, BNP,
- a muscle strength measurement on a isokinetic dynamometer,
- assessment of body composition via dual energy x-ray absorptiometry,
- cardiac echography,
- questionnaires to assess health-related quality of life,
- a questionnaire (IPAQ) and a pedometer (3 days) to assess physical activity. Following baseline measurements, subjects will be randomized to a control group (CON, n=10) and an exercise intervention group (EX, n=20), matching for gender and reduced/preserved ejection fraction and glucose tolerance. Hereafter, CON will receive usual care and will be advised to maintain their normal lifestyle, EX subjects will be enrolled in a 12-week training program. Following 6 (MID) and 12 (POST) weeks of exercise training including progressive training load adaptations, baseline measurements will be repeated in all patients.
What are the possible benefits and risks of participating?
- Benefits: patients receive a free training program with personal and professional supervision. After completing the study, they receive a report with personal results and evaluation of training effects.
- Risks: the usual risks of exercise tolerance testing and exercise training in a CHF population are limited because training sessions are held in the supervised conditions of the Jessa hospital and because training characteristics are according to guidelines of the European Society of Cardiology. Exposure to x-rays during body composition assessment is very low, almost negligible.
研究の種類
入学 (実際)
段階
- 適用できない
参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- diagnosis of chronic heart failure for at least 6 months
- clinically stable (not hospitalized) for more than 3 months prior to the onset of the study
- optimal medical therapy.
Exclusion Criteria:
- any contra-indication for exercise therapy,
- glucose lowering medical therapy,
- active lifestyle with regular physical activity.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:training
12 weeks (2 x 6 weeks) of combined exercise training programme (supervised)
|
他の名前:
|
介入なし:Control
Continued usual care, habitual lifestyle
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
insulin sensitivity (insulin profile)
時間枠:change from baseline to 12 weeks
|
glucose and insulin concentration measurements in blood during oral glucose tolerance test
|
change from baseline to 12 weeks
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Exercise tolerance
時間枠:change from baseline to 12 weeks
|
maximal cardiopulmonary exercise test on a bicycle ergometer
|
change from baseline to 12 weeks
|
HbA1c, blood lipids, BNP
時間枠:change from baseline to 12 weeks
|
change from baseline to 12 weeks
|
|
Muscle strength
時間枠:change from baseline to 12 weeks
|
maximal strength and strength endurance tested on a isokinetic dynamometer
|
change from baseline to 12 weeks
|
Body composition
時間枠:change from baseline to 12 weeks
|
dual energy x-ray absorptiometry
|
change from baseline to 12 weeks
|
cardiac function
時間枠:change from baseline to 12 weeks
|
echocardiography
|
change from baseline to 12 weeks
|
Health-related quality of life
時間枠:change from baseline to 12 weeks
|
MLHFQ and Eq5d
|
change from baseline to 12 weeks
|
協力者と研究者
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
慢性心不全の臨床試験
-
Novartis Pharmaceuticals完了EC-MPS による治療に関心があり、コア研究の 12 か月の治療期間を無事に完了した患者 (de novo Heart Recipients)
トレーニングの臨床試験
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VA Office of Research and Development募集
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University of MinnesotaNational Institute of Mental Health (NIMH)募集精神病性障害 | 統合失調症 | 統合失調症スペクトラムおよびその他の精神病性障害 | 統合失調感情障害 | 精神病 | 統合失調感情障害 | 統合失調症性障害 | 精神病、感情的 | 精神性気分障害 | 精神病患者番号/その他アメリカ
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University of WashingtonNational Institute on Aging (NIA); Kaiser Permanente完了
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Queens College, The City University of New York完了
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Diakonhjemmet HospitalThe Dam Foundation; The Norwegian Council for Musculoskeletal Health募集
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Children's Hospital Los AngelesRobert Wood Johnson Foundation募集