Exercise and Cardiac Measures in Dialysis Patients

NCT ID: NCT00944775

Last Updated: 2017-10-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-08-31

Study Completion Date

2008-06-30

Brief Summary

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Background: The impact of the known non-invasive cardiac indices for identification of hemodialysis (HD) patients at high-risk for sudden cardiac death (SCD) has not been evaluated.

Patients: Fifty-nine HD patients were randomized into 2 groups. Thirty of them (group A-aged 54.6±8.9 years) participated in a supervised training program with stationary bicycles during their HD sessions (3/weekly) for 10 months, while the rest (group B-aged 53.2±6.1 years) remained untrained and were used as controls.

Study hypothesis: Exercise training will affect most of the non-invasive cardiac markers of SCD and the total score positively.

Method: At entry, as well as at the end of the study all subjects underwent a cardiopulmonary exercise testing (estimation of aerobic capacity-VO2peak), an echocardiographic study (LV ejection fraction -LVEF evaluation), an ambulatory 24-hour Holter monitoring for cardiac autonomic nervous system activity evaluation by time- and frequency- domain heart rate variability (HRV) calculation (measurement of SDNN, mean RR and low to high frequency ratio-LF/HF), a signal-averaged ECG (late potentials-LP documentation) and a submaximal exercise test for microvolt-T-wave alternans (TWA) detection.

Detailed Description

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The identification of patients on hemodialysis (HD) at increased cardiac risk with powerful screening tests and the reduction of factors, which increase the probability of malignant arrhythmias are important for primary prevention of sudden cardiac death (SCD).

Study Design: randomized and controlled clinical trial. Setting \& Participants: Fifty-nine HD patients were randomized into exercise training group (group A-30 patients) and controls (group B-29 patients).

Intervention: Group A participated in a 10-month supervised exercise training program during the HD sessions (3/weekly).

Outcomes: The effects of exercise on the score of the non-invasive cardiac markers for SCD risk stratification and on the occurrence of each variable separately. Statistical analysis included a two-group comparison of change scores and an analysis of covariance adjusting for baseline.

Measurements: At entry and the end of the study, in all participants aerobic capacity (VO2peak) and left ventricular ejection fraction (LVEF) were estimated, late potentials and T-wave alternans were detected and heart rate variability was calculated. Specifically, from the 24-h Holter monitoring the standard deviation of all the normal R-R intervals (SDNN), the mean R-R intervals (mean RR), the low (LF) and high (HF) frequency components of the autoregressive power spectrum of the NN intervals and their ratio (LF/HF) were recorded.

Conditions

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Sudden Cardiac Death

Keywords

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Exercise Dialysis Non-invasive cardiac measures Exercise trained patients Controls

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

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exercise training

10-month exercise training program

Group Type EXPERIMENTAL

Exercise training

Intervention Type BEHAVIORAL

10-month exercise training program during hemodialysis sessions

controls

usual care sedentary lifestyle

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Exercise training

10-month exercise training program during hemodialysis sessions

Intervention Type BEHAVIORAL

Other Intervention Names

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Group A group B

Eligibility Criteria

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Inclusion Criteria

* on HD for at least 6 months
* in sinus rhythm
* able to reach a sufficient workload during ergometry

Exclusion Criteria

* with bundle branch block
* unstable hypertension
* diabetes mellitus
* severe congestive heart failure
* recent myocardial infarction
* unstable angina
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aristotle University Of Thessaloniki

OTHER

Sponsor Role lead

Responsible Party

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Evangelia Kouidi

Professor of Sports Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Evangelia J Kouidi, Associate Pr

Role: PRINCIPAL_INVESTIGATOR

Aristotle University of Thessaloniki, Greece

Locations

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Laboratory of Sports Medicine

Thessaloniki, , Greece

Site Status

Countries

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Greece

References

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Bernier-Jean A, Beruni NA, Bondonno NP, Williams G, Teixeira-Pinto A, Craig JC, Wong G. Exercise training for adults undergoing maintenance dialysis. Cochrane Database Syst Rev. 2022 Jan 12;1(1):CD014653. doi: 10.1002/14651858.CD014653.

Reference Type DERIVED
PMID: 35018639 (View on PubMed)

Kouidi EJ, Grekas DM, Deligiannis AP. Effects of exercise training on noninvasive cardiac measures in patients undergoing long-term hemodialysis: a randomized controlled trial. Am J Kidney Dis. 2009 Sep;54(3):511-21. doi: 10.1053/j.ajkd.2009.03.009. Epub 2009 Jul 30.

Reference Type DERIVED
PMID: 19646801 (View on PubMed)

Other Identifiers

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RenalRehab

Identifier Type: -

Identifier Source: org_study_id