Resistance Training in HFpEF

NCT ID: NCT02435667

Last Updated: 2021-02-03

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

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-06-30

Study Completion Date

2021-01-31

Brief Summary

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The objective of this proposal is to determine the effect of resistance exercise training on locomotor muscle function, exercise capacity, exertional symptoms, and quality of life in HF patients with preserved ejection fraction (HFpEF).

Detailed Description

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In this randomized controlled pilot study of resistance exercise training in patients with HFpEF, the investigators will recruit 24 HFpEF patients who will be randomized to resistance exercise training (RT - n=12) or no resistance exercise training (standard care control group \[CTL\] - n=12). The investigators will have baseline and follow-up measures of clinical characteristics, leg muscle strength, quality of life, lean muscle mass (body composition via DXA including segmental lean mass), maximal cardiopulmonary exercise test (peak VO2, peak work, ventilatory efficiency), constant-load submaximal cardiopulmonary exercise test with speckle tracking echocardiography (exertional dyspnea and fatigue at matched workloads, cardiac output, diastolic function, left ventricular strain, ventilation, gas exchange, and locomotor muscle neural feedback).

Participants will be asked to make 4 separate study visits. Those randomized to undergo Resistance Training will be expected to make those visits as well.

Conditions

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Heart Failure Preserved Ejection Fraction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Resistance Exercise Training

Entails 36 supervised resistance exercise training sessions (3 sessions per week for 12 weeks). Each exercise session will be supervised by a trained, certified Exercise Physiologist specializing in Cardiac Rehabilitation. The specific resistance exercise training will include Aerobic Exercise, Resistance Exercise, and Core Strengthening Exercises. Other baseline and follow-up tests include: DEXA bone scan, Blood Draw, Cardiopulmonary Max Exercise Test, Quality of Life Questionnaire, and a Submaximal Exercise Test.

Group Type EXPERIMENTAL

Resistance Exercise Training

Intervention Type OTHER

1. Aerobic Exercise

a. Each participant will engage in 5 minutes of aerobic based exercise on an arm/leg ergometer (NuStep Cross Trainer) at an intensity of 12-14 on the Borg Rating of Perceived Exertion Scale as a warm-up prior to the exercise session and again as a cool-down at the end of the exercise session.
2. Resistance Exercise - 2 sets of 8-12 repetitions - beginning at 60% of the initial 1 RM.

a) Leg Extension, b) Bicep Curl, c) Leg Press, d) Chest Press, e) Leg Curl, f)Seated Row (horizontal or pulldown), g) Calf Raises
3. Core Strengthening Exercises a. 5-10 minutes of stability ball and balance exercises

DEXA bone scan

Intervention Type RADIATION

A DEXA scan that provides bone density measures.

Cardiopulmonary Max Exercise Test

Intervention Type OTHER

Pedaling on a cycle ergometer to volitional fatigue.

Quality of Life Questionnaire

Intervention Type OTHER

A 10 minute questionnaire that measures quality of life.

Submaximal Exercise Test

Intervention Type OTHER

Two short submaximal constant-load exercise sessions at 20 Watts. Each session will include 6 minutes of cycling (baseline). Following baseline, the sessions will be randomized to continued constant-load cycling for an additional 9 minutes (for echocardiographic measures) or randomized sub-systolic inflation of bilateral thigh pressure tourniquets to 40 and 80 mmHg for 3 minutes with 3 minutes of deflation between inflations to stimulate locomotor muscle neural feedback.

Blood Draw

Intervention Type OTHER

A blood draw amounting to 1 teaspoon of blood drawn.

Standard Care

No resistance exercise training. Patients will stay on their current healthcare regimen as previously assigned by their physician. Patients will still undergo baseline and follow-up tests similar to the Resistance Exercise Training group, including: DEXA bone scan, Blood Draw, Cardiopulmonary Max Exercise Test, Quality of Life Questionnaire, and a Submaximal Exercise Test.

Group Type PLACEBO_COMPARATOR

DEXA bone scan

Intervention Type RADIATION

A DEXA scan that provides bone density measures.

Cardiopulmonary Max Exercise Test

Intervention Type OTHER

Pedaling on a cycle ergometer to volitional fatigue.

Quality of Life Questionnaire

Intervention Type OTHER

A 10 minute questionnaire that measures quality of life.

Submaximal Exercise Test

Intervention Type OTHER

Two short submaximal constant-load exercise sessions at 20 Watts. Each session will include 6 minutes of cycling (baseline). Following baseline, the sessions will be randomized to continued constant-load cycling for an additional 9 minutes (for echocardiographic measures) or randomized sub-systolic inflation of bilateral thigh pressure tourniquets to 40 and 80 mmHg for 3 minutes with 3 minutes of deflation between inflations to stimulate locomotor muscle neural feedback.

Blood Draw

Intervention Type OTHER

A blood draw amounting to 1 teaspoon of blood drawn.

Interventions

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Resistance Exercise Training

1. Aerobic Exercise

a. Each participant will engage in 5 minutes of aerobic based exercise on an arm/leg ergometer (NuStep Cross Trainer) at an intensity of 12-14 on the Borg Rating of Perceived Exertion Scale as a warm-up prior to the exercise session and again as a cool-down at the end of the exercise session.
2. Resistance Exercise - 2 sets of 8-12 repetitions - beginning at 60% of the initial 1 RM.

a) Leg Extension, b) Bicep Curl, c) Leg Press, d) Chest Press, e) Leg Curl, f)Seated Row (horizontal or pulldown), g) Calf Raises
3. Core Strengthening Exercises a. 5-10 minutes of stability ball and balance exercises

Intervention Type OTHER

DEXA bone scan

A DEXA scan that provides bone density measures.

Intervention Type RADIATION

Cardiopulmonary Max Exercise Test

Pedaling on a cycle ergometer to volitional fatigue.

Intervention Type OTHER

Quality of Life Questionnaire

A 10 minute questionnaire that measures quality of life.

Intervention Type OTHER

Submaximal Exercise Test

Two short submaximal constant-load exercise sessions at 20 Watts. Each session will include 6 minutes of cycling (baseline). Following baseline, the sessions will be randomized to continued constant-load cycling for an additional 9 minutes (for echocardiographic measures) or randomized sub-systolic inflation of bilateral thigh pressure tourniquets to 40 and 80 mmHg for 3 minutes with 3 minutes of deflation between inflations to stimulate locomotor muscle neural feedback.

Intervention Type OTHER

Blood Draw

A blood draw amounting to 1 teaspoon of blood drawn.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of HFpEF.
* Patients 18-80 yrs old with a history stable (no medication changes in past 6 weeks (w/duration of diagnosis \>6 months).
* New York Heart Association class I-III.
* Ejection fraction ≥40%.
* Current non-smokers with \<15 pack year history.
* Non-pregnant women, and individuals who are able to exercise (i.e. without orthopedic limitations or neuromuscular disorders).

Exclusion Criteria

* Patient refusal to participate.
* Significant orthopedic or neuromuscular limitations
* Significant cognitive impairment
* Hemoglobin \< 7.0 g/d.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Thomas P. Olson, M.S., Ph.D.

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Thomas Olson, MS, PhD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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15-000320

Identifier Type: -

Identifier Source: org_study_id

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