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Optimized Management After Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension (POpPART)

1. mars 2021 oppdatert av: University Hospital, Grenoble

Optimised Management After Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension

Balloon pulmonary angioplasty (BPA) is a new method of treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent CTEPH after surgery. BPA improves or even normalises hemodynamic parameters measured during a right heart catheterization. Nevertheless, the vast majority of patients retain dyspnea and impaired exercise capacity despite considerable hemodynamic improvements.

Pulmonary rehabilitation (RHB) can improve symptoms, quality of life and exercise capacity in patients with CTEPH. Unfortunately, access to RHB remains a concern in many countries. Tele-rehabilitation (tRHB) has been shown feasible and effective some cardiac or pulmonary diseases.

This randomized controlled study aims at comparing the effects of tRHB with the effects of simple advices regarding exercising in CTEPH patients with normalized or near-normalized pulmonary hemodynamics after BPA treatment.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of pulmonary embolism leading to dyspnea, effort limitation and sometimes right heart failure and death. Balloon pulmonary angioplasty (BPA) is a new method of treatment for inoperable CTEPH or persistent CTEPH after surgery. BPA restores blood flow in the treated areas and improves or even normalises hemodynamic parameters measured during a right heart catheterization. Nevertheless, the vast majority of patients retain dyspnea and impaired exercise capacity after angioplasty procedures.

Exercise training has been demonstrated to alleviate exercise dyspnea and to improve exercise capacity in many chronic cardiopulmonary conditions. Pulmonary rehabilitation (RHB) can improve symptoms, quality of life and exercise capacity in patients with pulmonary vascular disease of different etiologies including CTEPH. Furthermore, RHB does not present any particular risk for CTEPH patients with normalized or near-normalized pulmonary hemodynamics. Unfortunately, access to RHB remains a concern in many countries. Tele-rehabilitation (tRHB) has been shown feasible and effective some cardiac or pulmonary diseases. Our hypothesis is that tRHB may also be effective in CTEPH patients with normalized or near-normalized pulmonary hemodynamics after BPA treatment.

This randomized controlled study aims at comparing the effects of tRHB with the effects of simple advices regarding exercising in CTEPH patients with normalized or near-normalized pulmonary hemodynamics after BPA treatment.

Studietype

Intervensjonell

Registrering (Forventet)

54

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Age > 18 years old
  • Patients who have undergone pulmonary angioplasty for CTEPH (group 4 of the international classification)
  • Patients with a mean pulmonary artery pressure <= 30 mmHg and cardiac output > 2.5 L/min/m2 at the last angioplasty session
  • Patients who had completed an incremental cardiopulmonary exercise test
  • Patients affiliated to the French social security system
  • Patients with signed informed consent

Exclusion Criteria:

  • Patients unable to complete an incremental cardiopulmonary exercise test
  • Patients unable to complete a 6-minutes walking test, 3-minutes chair raising test and a rehabilitation
  • Patient unable, for technical or any other reason, to connect via the Internet for remote monitoring and/or telerehabilitation
  • Patient for whom a refusal to participate in a rehabilitation programme is anticipated
  • Patient who has participated in a rehabilitation programme in the 6 months prior to the date of inclusion
  • Patients referred to in Articles L1121-5 to L1121-8 of the CSP (pregnant women, parturients, nursing mothers, persons deprived of their liberty by a judicial or administrative decision, persons under psychiatric care and adults subject to a legal protection measure or unable to express their consent).

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Ingen inngripen: Control
Simple physical activity advices will be given to the 27 patients of the control arm
Eksperimentell: telerehabilitation
Patients in the tele rehabilitation arm will perform 24 1h-telerehabilition sessions (dance, gym, cardio training, yoga, ...)
Fremgangsmåte: telerehabilitation
24 sessions (less Thant 1h hour each) of tele rehabilitation. Patients can choose among several activities (gym, dance, cardio training, ...)

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Difference of endurance time on cycloergometer
Tidsramme: At inclusion and after 3 months
Expressed in seconds and calculated as follow: endurance time after 3 months - endurance time at inclusion The two tests are performed at 80% of the maximum power reached during a maximum incremental effort test (performed before inclusion)
At inclusion and after 3 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
6-minutes walking test (6MWT)
Tidsramme: At inclusion and at Month 3
Distance walked in 6-min (in meters)
At inclusion and at Month 3
3-minutes chair rise test (3-CRT)
Tidsramme: At inclusion and at Month 3
Number of rises during 3-CRT (n)
At inclusion and at Month 3
SF-36
Tidsramme: At inclusion and at Month 3
Physical dimensions of the SF-36 questionnaire
At inclusion and at Month 3
Dyspnea (NYHA scale)
Tidsramme: At inclusion, at Month 1, Month 2 and Month 3
Either I, II, III or IV
At inclusion, at Month 1, Month 2 and Month 3
Telerehabilitation
Tidsramme: Through study completion, an average of 3 months
Total number of sessions achieved
Through study completion, an average of 3 months
St George Respiratory Questionnaire (SGRQ)
Tidsramme: At inclusion and at Month 3
Total SGRQ score
At inclusion and at Month 3
Dyspnea (mMRC score)
Tidsramme: At inclusion, at Month 1, Month 2 and Month 3
Either 0, 1, 2, 3 or 4
At inclusion, at Month 1, Month 2 and Month 3

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University Hospital, Grenoble

Etterforskere

  • Hovedetterforsker: Bruno Degano, MD, PhD, CHU Grenoble Alpes

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Forventet)

1. april 2021

Primær fullføring (Forventet)

1. april 2023

Studiet fullført (Forventet)

1. juli 2023

Datoer for studieregistrering

Først innsendt

2. februar 2021

Først innsendt som oppfylte QC-kriteriene

1. mars 2021

Først lagt ut (Faktiske)

2. mars 2021

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. mars 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. mars 2021

Sist bekreftet

1. mars 2021

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • EssaiClinique_POPPART

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Studerer et amerikansk FDA-regulert medikamentprodukt

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Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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