Muscle Afferent Feedback Effects in Patients With Heart Failure
Muscle Afferent Feedback Effects in Patients With Heart Failure: The Development of Central Fatigue
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
A substantial part in limiting exercise and/or physical activity in humans results from the development of peripheral and central fatigue during physical activity. Peripheral fatigue comprises biochemical changes within the metabolic milieu of the working muscle leading to an attenuated response to neural excitation, while central fatigue comprises a failure of the central nervous system to drive motoneurons.
Patients with HF have overactive group III/IV muscle afferents and an exaggerated development of central fatigue during physical activity that is not explained by their reduced physical conditioning or cardiac insufficiency caused by their failing heart. The exact mechanisms accounting for the exaggerated central fatigue in HF remains elusive, however, the development of central fatigue during exercise has recently been linked to signaling by group III/IV muscle afferents. This makes the heightened neural feedback in HF a likely candidate for these patients' increased susceptibility to central fatigue.
Lower pH, increased lactate and increased adenosine triphosphate has been shown to activate group III/IV afferents in a physiological manner and thus induce, in a rested and unfatigued muscle, the intramuscular milieu associated with moderate to heavy exercise. The objective of this study is to quantitate and compare the sensitivity of group III/IV afferents and associated effects on central fatigue in HF patients and healthy controls when skeletal muscle is subject to controlled lower pH, increased lactate and increased adenosine triphosphate.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 1
Contactos e Locais
Locais de estudo
-
-
Utah
-
Salt Lake City, Utah, Estados Unidos, 84148
- Veterans Affairs Salt Lake City Heath Care System
-
Salt Lake City, Utah, Estados Unidos, 84148
- George E Wahlen Vetern Affairs Medical Center
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Heart Failure Inclusion Criteria:
- Subjects with a history of stable cardiomyopathy (ischemic and non-ischemic, greater than 1 year duration, ages 20-79 years)
- New York Heart Association class I through IV symptoms
- Left ventricular ejection fraction less than 35 percent (heart failure patients with reduced left ventricular ejection fraction) or greater than 50 percent (heart failure patients with preserved left ventricular ejection fraction)
- Sedentary, no regular physical activity for at least 6 months prior
- Post-menopausal for at least 2 years and follicle stimulating hormone greater than 40
Heart Failure Exclusion Criteria:
- Patients with atrial fibrillation or heart failure believed to be secondary to atrial fibrillation
- Morbidly obese patients with a body mass index greater than 35
- Patients with uncontrolled hypertension, greater than 160/100
- Anemia with a hemoglobin less than 9
- Severe renal insufficiency (creatinine clearance less than 30 by the Cockcroft-Gault formula)
- Patients with significant non-cardiac comorbidities
- Orthopedic limitations that would prohibit them from performing the elbow-flexor exercise
- Current smoker or smoking history of 15 packs or more per year
- Women currently taking hormone replacement therapy
Healthy Control Inclusion Criteria:
- Ages 20-75 years
- Sedentary, no regular physical activity for at least 6 months prior
- Post-menopausal for at least 2 years and follicle stimulating hormone greater than 40
Healthy Control Exclusion Criteria:
- History of cardiovascular related abnormalities or pulmonary abnormalities
- Morbidly obese patients with a body mass index greater than 35
- Patients with uncontrolled hypertension, greater than 160/100
- Anemia with a hemoglobin less than 9
- Orthopedic limitations that would prohibit them from performing the elbow-flexor exercise
- Current smoker or smoking history of 15 packs or more per year
- Women currently taking hormone replacement therapy
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Ciência básica
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Outro: Heart Failure Patients
Patients with heart failure will undergo intervention of muscle contraction with metabolite solution administration.
Maximal voluntary muscle contraction exercise with varying metabolite solution administration of adenosine triphosphate, lactate, and protons with phosphate buffer.
|
Participants will perform maximal elbow flexor or knee extensor contractions before and after administration of metabolite solutions of pH 7.2, pH 7.0 and pH 6.6
Outros nomes:
|
|
Outro: Control Participants
Healthy control participants will undergo intervention of muscle contraction with metabolite solution administration.
Maximal voluntary muscle contraction exercise with varying metabolite solution administration of adenosine triphosphate, lactate, and protons with phosphate buffer.
|
Participants will perform maximal elbow flexor or knee extensor contractions before and after administration of metabolite solutions of pH 7.2, pH 7.0 and pH 6.6
Outros nomes:
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Prazo |
|---|---|
|
Elbow Flexor Maximal Voluntary Contraction in newton-meters
Prazo: 2 minutes
|
2 minutes
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Markus Amann, PhD, University of Utah
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Doenças cardíacas
- Doenças cardiovasculares
- Insuficiência cardíaca
- Efeitos Fisiológicos das Drogas
- Agentes Neurotransmissores
- Mecanismos Moleculares de Ação Farmacológica
- Agentes Antiarrítmicos
- Agentes Vasodilatadores
- Agentes do Sistema Nervoso Periférico
- Analgésicos
- Agentes do Sistema Sensorial
- Agentes Purinérgicos
- Agonistas Purinérgicos do Receptor P1
- Agonistas Purinérgicos
- Adenosina
Outros números de identificação do estudo
- 62914
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
Ensaios clínicos em Falha crônica do coração
-
Region SkaneInscrevendo-se por conviteInsuficiência Cardíaca Classe II da New York Heart Association (NYHA) | Insuficiência Cardíaca Classe III da New York Heart Association (NYHA)Suécia
-
Medical University of BialystokInstitute of Cardiology, Warsaw, Poland; Medical University of Lodz; Poznan University... e outros colaboradoresAinda não está recrutandoInsuficiência Cardíaca Sistólica | Insuficiência Cardíaca com Fração de Ejeção Reduzida | Insuficiência Cardíaca Classe IV da New York Heart Association | Insuficiência Cardíaca Classe III da New York Heart AssociationPolônia
-
University of WashingtonAmerican Heart AssociationConcluídoInsuficiência Cardíaca, Congestiva | Alteração Mitocondrial | Insuficiência Cardíaca Classe IV da New York Heart AssociationEstados Unidos