A Pilot Case Control Study of Vascular Function in Cyclists

NCT ID: NCT02745665

Last Updated: 2018-01-11

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

UNKNOWN

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-01-10

Study Completion Date

2018-09-30

Brief Summary

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This is a pilot study with the purpose of measuring vascular function, assessed by evaluating arterial stiffness (pulse wave velocity and augmentation index) and endothelial function (flow mediated dilatation), in elite/amateur symptomatic male cyclists with unilateral Endofibrosis (EF), compared to asymptomatic males cyclists and to a group of age matched healthy males (non-athletes).

Detailed Description

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Endofibrosis (EF) of the iliac arteries is a non-atheromatous flow-limiting condition specific to highly trained athletes. Although the pathophysiology is not well understood, haemodynamic injury and mechanical stress are considered to play a key role in developing EF. Recurrent exposure to these factors could trigger an arterial remodelling process that results in an intravascular lesion such as EF that more resembles an "adaptive intimal thickening". Although the natural history of this condition is not known, it is believed to be progressive with increasing numbers of reports of limb threatening ischaemia due to dissection and/or thrombosis of the arterial lumen. Therefore, it is imperative to understand the pathophysiological mechanism behind this condition in order to develop accurate diagnostic and screening criteria/tools for an early identification and characterization of EF. As there are no data in the literature supporting this hypothesis, the investigators have designed this pilot study to evaluate this hypothesis as to whether athletes with EF have evidence of vascular dysfunction in their arteries. There are currently no data on whether athletes who develop EF have underlying arterial disease or abnormalities. It is quite possible that people who develop EF have an underlying systemic endothelial dysfunction and that this may represent a risk factor for the development of the disease. Therefore the investigators will study non-invasively endothelial function (measured as flow mediated dilatation) as well as arterial stiffness (measured as pulse wave velocity and augmentation index) to improve the understanding about the structural and mechanical characteristics of the vascular tree in this cohort of patients.

Conditions

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Endothelial Function and Arterial Stiffness

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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1-Elite Cyclist

10 symptomatic cyclists with unilateral diagnosis of iliac EF,

FLOW MEDIATED DILATION Ankle brachial pressure index (ABPI) PULSE WAVE VELOCITY AND AUGMENTATION INDEX Blood pressure RAMP Test

flow mediated dilation (endothelial function)

Intervention Type OTHER

ABPI

Intervention Type OTHER

Pulse wave velocity and augmentation index

Intervention Type OTHER

blood pressure

Intervention Type OTHER

ramp test

Intervention Type OTHER

2-Amateur Cyclist

10 asymptomatic cyclists with no evidence of EF

FLOW MEDIATED DILATION ABPI PULSE WAVE VELOCITY AND AUGMENTATION Blood pressure RAMP Test

flow mediated dilation (endothelial function)

Intervention Type OTHER

ABPI

Intervention Type OTHER

Pulse wave velocity and augmentation index

Intervention Type OTHER

blood pressure

Intervention Type OTHER

ramp test

Intervention Type OTHER

3-Control

10 age-matched healthy male group

FLOW MEDIATED DILATION ABPI PULSE WAVE VELOCITY AND AUGMENTATION Blood pressure RAMP Test

flow mediated dilation (endothelial function)

Intervention Type OTHER

ABPI

Intervention Type OTHER

Pulse wave velocity and augmentation index

Intervention Type OTHER

blood pressure

Intervention Type OTHER

ramp test

Intervention Type OTHER

Interventions

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flow mediated dilation (endothelial function)

Intervention Type OTHER

ABPI

Intervention Type OTHER

Pulse wave velocity and augmentation index

Intervention Type OTHER

blood pressure

Intervention Type OTHER

ramp test

Intervention Type OTHER

Other Intervention Names

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vascular function assessment Duplex ultrasound and ankle brachial pressure index Arterial stiffness 20 minute static cycle ride to exhaustion

Eligibility Criteria

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Inclusion Criteria

* Males + 18 years elite or amateur racing cyclists with more than 3 years of training

Exclusion Criteria

* \- Subjects with a previous history of acute coronary syndrome (including myocardial infarction), stroke, transient ischaemic attack, cardiac surgery, other major cardiovascular (CV) surgery, or percutaneous coronary intervention (PCI), carotid surgery or carotid angioplasty, valvular heart, dysrhythmia
* subjects treated with cardiovascular medication for blood pressure, or cholesterol
* subjects with any clinical condition (diabetes, dyslipidaemia, obesity) that in the opinion of the investigator, may have a possible unfavourable effect on patient risk if included in the study, or is likely to interfere with the requirements of the study
* subject with characteristics that may interfere with adherence to the study protocol, such as dementia, substance abuse, history of non-compliance with prescribed medications, or medical appointment
* subject participating in another trial of an investigational drug or device within 30 days prior to screening will be excluded.
* subject that previously underwent surgery for iliac EF
* female subjects
* smokers
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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St George's, University of London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rob Hinchliffe

Role: PRINCIPAL_INVESTIGATOR

St George's, University of London

Locations

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St George's University Hospitals NHS Foundation Trust

Tooting, London, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Cristiana Vitale, Md, PhD

Role: CONTACT

07702288177

Fabrizio D'Abate, MSc

Role: CONTACT

Facility Contacts

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Rob Hinchliffe

Role: primary

References

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Peach G, Schep G, Palfreeman R, Beard JD, Thompson MM, Hinchliffe RJ. Endofibrosis and kinking of the iliac arteries in athletes: a systematic review. Eur J Vasc Endovasc Surg. 2012 Feb;43(2):208-17. doi: 10.1016/j.ejvs.2011.11.019. Epub 2011 Dec 19.

Reference Type BACKGROUND
PMID: 22186674 (View on PubMed)

Other Identifiers

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16.0065

Identifier Type: -

Identifier Source: org_study_id

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