Deze pagina is automatisch vertaald en de nauwkeurigheid van de vertaling kan niet worden gegarandeerd. Raadpleeg de Engelse versie voor een brontekst.

Effects of Hormonal Anabolic Deficiency and Neurovascular Alterations on Mortality in Male Patients With Heart Failure (TestoHF)

29 april 2021 bijgewerkt door: Maria Janieire de Nazaré Nunes Alves, University of Sao Paulo General Hospital

Hormonal Anabolic Deficiency Associated With Neurovascular Alterations Predict Poor Prognosis in Male Patients With Heart Failure

Heart failure (HF) has been associated with chronic deleterious effects on skeletal muscle, endocrine system, vasculature and sympathetic nervous system. These alterations have a significant impact on quality of life, leading to a reduction in functional capacity and limited symptoms, which involve dyspnea and fatigue. The investigators tested the hypothesis that hormonal anabolic deficiency associated with neurovascular alterations may worsen the prognosis of patients with heart failure.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

One hundred and fifty six patients have been enrolled so far. Methods were as described below:

  • Muscle sympathetic nerve activity (MSNA) was directly recorded from the peroneal nerve using the microneurography technique ;
  • All patients underwent symptom-limited cardiopulmonary exercise test performed on a cycle ergometer, using a ramp protocol with workload increments of 5 or 10 Watts per minute;
  • Body composition measurements were performed using dual-energy X-ray absorptiometry (DXA);
  • Muscle strength was assessed by handgrip dynamometer using the mean value of three attempts;
  • Blood samples were drawn in the morning after 12h overnight fasting. The laboratory tests included B-type natriuretic peptide (BNP; pg/mL) plasma level, serum sodium (mEq/L), serum potassium (mEq/L), creatinine (mg/dL), haemoglobin level (g/dL), high-sensitivity C-reactive protein (CRP; mg/L), lipid profile (triglyceride, total cholesterol, high-density lipoprotein, and low-density lipoprotein; mg/dL), and fasting glucose (mg/dL). Blood sample to assess hormone plasma levels were also drawn at the same time: total testosterone (TT), free testosterone (FT), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH) and insulin-like growth factor 1 (IGF1).

Studietype

Observationeel

Inschrijving (Werkelijk)

169

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Brazilië
    • SP
      • Sao Paulo, SP, Brazilië, 05403-900
        • Instituto do Coração do Hospital da Clínicas da Universidade de Sao Paulo

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 65 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Mannelijk

Bemonsteringsmethode

Kanssteekproef

Studie Bevolking

Patients with heart failure recruited at Clinical Unit of Myocardiopathy at General Hospital of the University of São Paulo Medical School (UNCAR/HC-FMUSP).

Beschrijving

Inclusion Criteria:

  • age between 18 and 65 years old;
  • at least1 year of diagnosed HF;
  • left ventricular ejection fraction (LVEF) lower than 40% measured by echocardiography;
  • non-ischaemic and ischaemic aetiologies;
  • compensated HF with optimal medication for at least 3 months prior the study;
  • New York Heart Association (NYHA) class of I to IV.

Exclusion Criteria:

  • patients with autonomic diabetic neuropathy;
  • patients with chronic renal failure with haemodialysis;
  • heart transplantation;
  • presence of pacemaker;
  • patients with muscular dystrophy (i.e. Duchenne muscular dystrophy);
  • patients submitted to any hormonal treatment;
  • history of cancer;
  • ongoing infection;
  • myocardial infarction with percutaneous coronary intervention or revascularization 6 months prior to the study entry.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Observatiemodellen: Cohort
  • Tijdsperspectieven: Prospectief

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
Low testosterone

Patients with HF and testosterone deficiency.

  • Cardiopulmonary exercise test
  • Muscle Sympathetic Nerve Activity
  • Dual-energy X-ray absorptiometry
  • Venous occlusion plethysmography
  • Blood sample collection
  • Dynamometers for Handgrip Strength
Diagnostische toets: Cardiopulmonary exercise test
Oxygen consumption (VO2) and carbon dioxide output (VCO2) were measured by means of gas exchange on a breath-by-breath basis. The patients were initially monitored for 2 minutes at rest when seated on the ergometer, after that they were instructed to pedal at a pace of 60-70 rpm and the completion of the test occurred when, in spite of verbal encouragement, the patient reached maximal volitional fatigue.
Diagnostische toets: Muscle Sympathetic Nerve Activity
Multiunit post-ganglionic muscle sympathetic nerve recordings were made using a tungsten microelectrode placed in the peroneal nerve near the fibular head. Nerve signals were amplified by a factor of 50,000 to 100,000 and band-pass filtered (700 to 2000 Hz). For recording and analysis, nerve activity was rectified and integrated (time constant 0.1 seconds) to obtain a mean voltage display of sympathetic nerve activity.
Diagnostische toets: Dual-energy X-ray absorptiometry
Dual-energy X-ray absorptiometry (DXA) scan was used to measure total lean mass, body fat and bone mineral content.
Diagnostische toets: Venous occlusion plethysmography
Venous occlusion plethysmography was used to assess non-invasively blood flow.
Diagnostische toets: Blood sample collection
Blood samples were drawn in the morning after 12h overnight fasting.
Diagnostische toets: Dynamometers for Handgrip Strength
Muscle strength was assessed by handgrip dynamometer using the mean value of three attempts.
Normal testosterone

Patients with HF and normal plasma levels of testosterone.

  • Cardiopulmonary exercise test
  • Muscle Sympathetic Nerve Activity
  • Dual-energy X-ray absorptiometry
  • Venous occlusion plethysmography
  • Blood sample collection
  • Dynamometers for Handgrip Strength
Diagnostische toets: Cardiopulmonary exercise test
Oxygen consumption (VO2) and carbon dioxide output (VCO2) were measured by means of gas exchange on a breath-by-breath basis. The patients were initially monitored for 2 minutes at rest when seated on the ergometer, after that they were instructed to pedal at a pace of 60-70 rpm and the completion of the test occurred when, in spite of verbal encouragement, the patient reached maximal volitional fatigue.
Diagnostische toets: Muscle Sympathetic Nerve Activity
Multiunit post-ganglionic muscle sympathetic nerve recordings were made using a tungsten microelectrode placed in the peroneal nerve near the fibular head. Nerve signals were amplified by a factor of 50,000 to 100,000 and band-pass filtered (700 to 2000 Hz). For recording and analysis, nerve activity was rectified and integrated (time constant 0.1 seconds) to obtain a mean voltage display of sympathetic nerve activity.
Diagnostische toets: Dual-energy X-ray absorptiometry
Dual-energy X-ray absorptiometry (DXA) scan was used to measure total lean mass, body fat and bone mineral content.
Diagnostische toets: Venous occlusion plethysmography
Venous occlusion plethysmography was used to assess non-invasively blood flow.
Diagnostische toets: Blood sample collection
Blood samples were drawn in the morning after 12h overnight fasting.
Diagnostische toets: Dynamometers for Handgrip Strength
Muscle strength was assessed by handgrip dynamometer using the mean value of three attempts.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Impact of testosterone deficiency on mortality
Tijdsspanne: 2 years
Blood sample was collected in the morning (between 8:00-10:00 a.m.) after 12 hours fasting.
2 years
Impact of muscle sympathetic nerve activity on mortality
Tijdsspanne: 2 years
Microneurography was used to assess the sympathetic nervous system.
2 years
Impact of neurovascular alterations on mortality
Tijdsspanne: 2 years
Venous occlusion pletysmography was used to evaluate vasodilation.
2 years

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Impact of testosterone deficiency on body composition
Tijdsspanne: 2 years
Body composition measurements were performed using dual-energy X-ray absorptiometry.
2 years
Impact of testosterone deficiency on functional capacity
Tijdsspanne: 2 years
All patients underwent symptom-limited cardiopulmonary exercise test to measure functional capacity.
2 years
Impact of testosterone deficiency on strength
Tijdsspanne: 2 years
Muscle strength was assessed by handgrip dynamometer using the mean value of three attempts.
2 years

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

University of Sao Paulo General Hospital

Medewerkers

Fundação de Amparo à Pesquisa do Estado de São Paulo

Onderzoekers

  • Hoofdonderzoeker: Maria Janieire de Nazaré Nunes Alves, PhD, InCor Heart Institute

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

30 juni 2016

Primaire voltooiing (Werkelijk)

23 maart 2020

Studie voltooiing (Werkelijk)

30 december 2020

Studieregistratiedata

Eerst ingediend

1 maart 2018

Eerst ingediend dat voldeed aan de QC-criteria

9 maart 2018

Eerst geplaatst (Werkelijk)

13 maart 2018

Updates van studierecords

Laatste update geplaatst (Werkelijk)

3 mei 2021

Laatste update ingediend die voldeed aan QC-criteria

29 april 2021

Laatst geverifieerd

1 april 2021

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • AnabolicHormonesPrognosis

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

Nee

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Klinische onderzoeken op Hartfalen

Klinische onderzoeken op Cardiopulmonary exercise test

Zoek naar vergelijkbare onderzoeken

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

CROs by country

CROs in Indonesia

Voorwaarden

Zeldzame ziekten

Geneesmiddelinterventies

Voedingssupplementen

Sponsor / medewerkers

Locaties

Abonneren