- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT02131428
Depression and Heart Failure Disease Progression
연구 개요
상태
정황
상세 설명
There are over five million Americans living with heart failure (HF), and another 670,000 new cases being diagnosed each year. HF is a characteristically unstable condition that is the most costly diagnosis in the Medicare population and is the most common cause for hospitalization. The instability of HF disease is reflected in short-term fluctuations of the HF disease biomarker, B-Type Natriuretic Peptide (BNP). Patient self-management behaviors are important for minimizing HF disease instability. Depression is often comorbid with HF, and elevated depressive symptoms are associated with a marked increase in adverse clinical outcomes. For both depressed and non-depressed HF patients, worsening depressive symptoms mark a substantially increased risk of cardiovascular hospitalization or death. Despite the risk associated with depressive symptoms, the nature of their association with a worsening HF disease trajectory and adverse clinical outcomes is poorly understood.
Converging evidence suggests that the association between depressive symptoms and accelerated HF disease progression may involve multiple behavioral and pathophysiological pathways. This study proposes an innovative, prospective bio-behavioral monitoring study of 220 HF patients that is designed to address the issue of how depressive symptoms and their bio-behavioral manifestations are implicated in worsening HF disease. Using home-monitoring biotechnology, we propose to track fluctuations in HF disease severity using biweekly assessments of BNP over a 16-week period. Symptoms of depression and HF-related health behaviors also will be assessed biweekly via concurrent monitoring. This biweekly bio-behavioral monitoring will be framed by comprehensive baseline and 4-month assessments of depression, HF disease severity, and pathophysiological mechanisms that have been related to the presence of depressive symptoms and implicated in the progression of HF disease. Clinical outcomes also will be assessed over a 5 year follow-up period. This study will create a unique data structure that will allow us to use contemporary statistical methods that will serve to elucidate causal associations between depressive symptoms, self-management health behaviors, pathophysiological processes, and HF disease progression and clinical outcomes. The study findings are expected to yield important advances in our understanding of why depressive symptoms may be particularly detrimental in the presence of HF and will help to inform the design of future clinical trials.
연구 유형
등록 (실제)
연락처 및 위치
연구 장소
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North Carolina
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Durham, North Carolina, 미국, 27710
- Duke University Medical Center
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
설명
Inclusion Criteria:
- Men or women aged 21 years or older
- Heart Failure of at least 3-months duration
- Left ventricular Ejection Fraction (EF) ≤ 45% by left ventricular angiography, nuclear wall motion study, or echocardiography, Or
- Preserved ejection fraction with either: Hospitalization within the previous 12 months with management of heart failure as a major component of the care provided; or Elevated natriuretic peptide level (NT-proBNP ≥ 360 pg/ml or BNP ≥ 100 pg/ml) within 6 months of enrollment.
- Undergoing treatment with a stable medication regimen.
Exclusion Criteria:
- Myocardial Infarction (MI), within 1 month of enrollment
- Percutaneous Transluminal Coronary Angioplasty(PTCA), Coronary Artery Bypass Graft (CABG) within 3 month of enrollment
- HF due to correctable cause or condition such as uncorrected primary valvular disease
- Alcohol or drug abuse within 12 months
- Illness such as malignancies that are associated with a life-expectancy of < 12 months
- Current pregnancy
- Inability to provide informed consent
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Time to Hospitalization or Death
기간: 5 years
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Time to hospitalization or death
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5 years
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Change in Quality of Life
기간: Bi-weekly of a 4-month period, 4 months, 1 year
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Psychosocial measures of Quality of Life
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Bi-weekly of a 4-month period, 4 months, 1 year
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Change in Self-Management Behaviors
기간: Bi-weekly of a 4-month period, 4 months, 1 year
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Health Behaviors
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Bi-weekly of a 4-month period, 4 months, 1 year
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Change in Heart Failure Disease Biomarkers
기간: Bi-weekly of a 4-month period, 4 months, 1 year
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Disease Biomarkers
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Bi-weekly of a 4-month period, 4 months, 1 year
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공동 작업자 및 조사자
스폰서
수사관
- 수석 연구원: Andrew Sherwood, PhD, Duke University
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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