A Study to Evaluate the Effects of EECP in Patients With Heart Failure
An Open-label Study to Evaluate the Effects of Enhanced External Counterpulsation on Tapering Inotropic Agents, Reduction of Brain Natriuretic Peptide and Rehospitalization in Patients With Heart Failure
調査の概要
詳細な説明
Chronic heart failure (CHF) patients dependent on intravenous infusion of positive inotropic agents have not only high mortality rate but also high morbidity in the prolonged hospital course. Medications such as angiotensin conversion enzyme inhibitor or angiotensin II receptor blocker may improve the survival of CHF patients. However, their implication is limited by the presence of hypotension secondary to low cardiac output. External enhanced counterpulsation (EECP), which generates the arterial and intracoronary hemodynamics similar to those of the intra-aortic balloon pump, is a recently approved treatment modality for patients with angina and heart failure. It can improve exercise capacity, quality of life and functional status.
Forty patients of (1) impaired left ventricular systolic function (LVEF 40%) and are dependent on intravenous infusion of positive inotropic agents but (2) without significant aortic regurgitation, overt fluid overload, or symptomatic peripheral arterial insufficiency will be included. They will be randomly allocated into EECP or control groups (n=20 for each). The EECP therapy was given as a 1-hour session, once daily, for a total of 35 sessions. The daily urine amount, blood pressure, time for taper off positive inotropic agents, length of hospital stay, and will be monitored daily in the hospital stay. Patients will be followed-up if he or she can be released from hospital and the mortality, readmission for heart failure, and 6-minute walking distance will be checked at the end of 6th month. Plasma natriuretic peptide (BNP) levels will be checked at enrollment, day 35, and 6th month.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究場所
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Taipei、台湾、10002
- 募集
- National Taiwan University Hospital
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コンタクト：
- Chii-Ming Lee
- 電話番号：0972-651-087
- メール：chiiminglee@ntu.edu.tw
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参加基準
適格基準
就学可能な年齢
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 All answers must be "Yes" for study entry.
- Male or female patients between 21-80 years of age.
- Patients who have documented evidence of HF.
Evidence of HF required at least one of the following:
LVEF <40%. As assessed with 3 months prior to enrollment, and LVEF can be measured through echocardiogram or radionuclide angiocardiography (RNA); Clinical symptoms of HF, namely the presence of 2 major criteria or 1 major criterion + 2 minor criteria according to the Framingham score; NYHA Fc III or IV ACC/AHA stage D 3. Treated with inotropic agents. Inotropic agents include dopamine, dobutamine, milrinone, norepinephrine. Low dose is included as well. 4. Patients who sign the informed consent . Exclusion criteria All answers must be "No" for study entry.
- Patients who had MI or coronary artery bypass grafting (CABG) within three months prior to the initiation of EECP treatment.
- Patients who had transcatheter intervention (PCI) within 2 weeks prior to the initiation of EECP treatment.
- Significant valvular heart disease, acute myocarditis.
- Uncontrolled hypertension (blood pressure 180/100 mmHg).
- Permanent pacemakers or implantable cardioverter defibrillators.
- Non bypassed left main coronary with a luminal stenosis greater than 50%.
- Severe symptomatic peripheral vascular disease.
- History of deep vein thrombosis.
- Phlebitis or stasis ulcer.
- Bleeding diathesis, warfarin use with International Normalized Ratio 2.0.
- Arial fibrillation or frequent ventricular premature beats that interferes with enhanced external counterpulsation triggering.
- Baseline ECG abnormalities that would interfere with interpretation of exercise ECG.
- Pregnant women, or women of childbearing potential but not using adequate birth control.
- Any medical, psychological, cognitive, social or legal condition that would interfere with the ability of patient to give an Informed Consent and/or his or her capacity to comply with all study requirements, including the necessary time commitment.
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 |
|---|---|
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実験的：Enhanced External Counterpulsation
Subjects of Heart failure with 'Enhanced External Counterpulsation" therapy
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The EECP therapy was given as a 1-hour session, once daily, for a total of 35 sessions.
The daily urine amount, blood pressure, time for taper off positive inotropic agents, length of hospital stay, and will be monitored daily in the hospital stay.
Patients will be followed-up if he or she can be released from hospital and the mortality, readmission for heart failure, and 6-minute walking distance will be checked at the end of 6th month.
Plasma natriuretic peptide (BNP) or N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels will be checked at enrollment, day 35, and 6th month.
他の名前：
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介入なし：No 'Enhanced External Counterpulsation"
Subjects of Heart failure without 'Enhanced External Counterpulsation" therapy
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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 |
|---|---|---|
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the natriuretic peptide (NT-pro-BNP) level will be reduced.
時間枠：7 week
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the natriuretic peptide (NT-pro-BNP) level will be reduced
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7 week
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Weaning from intravenous infusion of positive inotropic agent
時間枠：24 week
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Weaning from intravenous infusion of positive inotropic agent
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24 week
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Decrease the length of hospital stay.
時間枠：24 week
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Decrease the length of hospital stay.
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24 week
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協力者と研究者
捜査官
- 主任研究者：Chii-Ming Lee, PhD、National Taiwan Unerversity Hospital
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
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 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
本研究に関する用語
その他の研究ID番号
- 201805058DIPA
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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。
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