Impact of Face Masks on 6MWD in Patients With Pulmonary Hypertension

NCT ID: NCT05256082

Last Updated: 2022-07-21

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

122 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-15

Study Completion Date

2022-03-31

Brief Summary

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Pulmonary hypertension (PH) is classified according to the Nice Classification into different etiologies, including pulmonary arterial hypertension (PAH), a disease of the pulmonary arteriolar vasculature (Class I), and forms of pulmonary hypertension associated with left heart disease (Class II), lung disease (Class III), pulmonary artery obstructions including chronic pulmonary embolism (Class IV) or other less common causes (Class V). Patients with PH are at risk in the current COVID 19 pandemic.

The course of the disease and the prognosis of the patients are assessed on the basis of various parameters and therapy is adapted accordingly. In addition to clinical, echocardiographic and laboratory examinations, cardiopulmonary performance tests such as the 6-minute walking distance (6MWD) are of particular significance. According to the ESC/ERS guidelines for PH and the recommendations of the Cologne Consensus Conference, exercise performance is a central criterion for prognostication and treatment decisions.

During the COVID-19 pandemic, hospitals require the constant use of face masks for patients, in most cases also during the 6 minute walking test. We suspect a performance-reducing effect of face masks, thus impacting the results of the 6MWD. A systematic error in the assessment of cardiopulmonary performance should be revealed by comparing the results of the 6MWD with and without mask (particularly surgical mask and FFP2 mask).

Detailed Description

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Monocentric, prospective, randomized cross-over study in approximately 120 patients with PH (n=60 for surgical face mask versus no mask; n=60 for FFP2 mask vs. no mask) to evaluate the impact of face masks on 6MWD, Borg dyspnea score, and O2 saturation pre- versus post exercise. Patients are randomized to perform the test with vs. without mask first, and then cross over to the respective other condition.

The primary endpoint is the intra-individual difference in 6MWD with and without mask (analyzed for the whole study group, and for surgical mask and FFP2 mask seperately). Secondary endpoints include differences in Borg score, and O2 saturation.

Conditions

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Pulmonary Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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with mask (FFP2 mask or surgical mask)

Patient is Walking with mouth/nose-mask for 6 Minutes.

Group Type ACTIVE_COMPARATOR

six-minutes-walking test

Intervention Type DIAGNOSTIC_TEST

Patients conducting a six-minutes-walking test

without mask

Patient is Walking without mouth/nose-mask for 6 Minutes.

Group Type PLACEBO_COMPARATOR

six-minutes-walking test

Intervention Type DIAGNOSTIC_TEST

Patients conducting a six-minutes-walking test

Interventions

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six-minutes-walking test

Patients conducting a six-minutes-walking test

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Regular 6MWD in the last 24 months, at least 1 test per 24 months
* Pulmonary (arterial) hypertension according to the Nice Classification Type I-V
* NYHA-WHO/FC I - III
* Lung function test performed within 6 months
* Age ≥18 years
* Severity of symptoms and specific therapy stable during the last 4 weeks
* General ability to participate in the study
* Ability to give consent

Exclusion Criteria

* Contact allergy to face mask materials
* Significant peripheral arterial occlusive disease (Fontaine ≥ IIb)
* Muscular or orthopedic diseases of the lower extremities that contribute to reduced resilience
* Relevant coronary heart disease (angina pectoris ≥ CCS II or positive stress test, myocardial infarction or bypass surgery within the last 3 months)
* inability to perform the 6-minute walk test (mental, physical) or lack of ability to provide essential information (questionnaire, Borg level)
* Uncontrolled high blood pressure (≥140/90 mmHg or ≥160/100 mmHg with 3 antihypertensive drugs) or resting heart rate ≥ 100 b.p.m.)
* Fresh fractures / broken bones (within the last 3 months)
* Not able to give consent Insufficient ability to walk (NYHA IV, immobility, other ailments)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital of Cologne

OTHER

Sponsor Role lead

Responsible Party

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Max Wissmueller

Dr. med. Max Wissmueller

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Max VJ Wissmueller, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital of Cologne

Locations

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University Hospital of Cologne

Cologne, , Germany

Site Status

Countries

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Germany

References

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Tschope C, Birner C, Bohm M, Bruder O, Frantz S, Luchner A, Maier L, Stork S, Kherad B, Laufs U. Heart failure with preserved ejection fraction: current management and future strategies : Expert opinion on the behalf of the Nucleus of the "Heart Failure Working Group" of the German Society of Cardiology (DKG). Clin Res Cardiol. 2018 Jan;107(1):1-19. doi: 10.1007/s00392-017-1170-6. Epub 2017 Oct 10.

Reference Type BACKGROUND
PMID: 29018938 (View on PubMed)

Eikenberry SE, Mancuso M, Iboi E, Phan T, Eikenberry K, Kuang Y, Kostelich E, Gumel AB. To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic. Infect Dis Model. 2020 Apr 21;5:293-308. doi: 10.1016/j.idm.2020.04.001. eCollection 2020.

Reference Type BACKGROUND
PMID: 32355904 (View on PubMed)

Greenhalgh T, Schmid MB, Czypionka T, Bassler D, Gruer L. Face masks for the public during the covid-19 crisis. BMJ. 2020 Apr 9;369:m1435. doi: 10.1136/bmj.m1435. No abstract available.

Reference Type BACKGROUND
PMID: 32273267 (View on PubMed)

Liang M, Gao L, Cheng C, Zhou Q, Uy JP, Heiner K, Sun C. Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis. Travel Med Infect Dis. 2020 Jul-Aug;36:101751. doi: 10.1016/j.tmaid.2020.101751. Epub 2020 May 28.

Reference Type BACKGROUND
PMID: 32473312 (View on PubMed)

Lyu W, Wehby GL. Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Aff (Millwood). 2020 Aug;39(8):1419-1425. doi: 10.1377/hlthaff.2020.00818. Epub 2020 Jun 16.

Reference Type BACKGROUND
PMID: 32543923 (View on PubMed)

Worby CJ, Chang HH. Face mask use in the general population and optimal resource allocation during the COVID-19 pandemic. Nat Commun. 2020 Aug 13;11(1):4049. doi: 10.1038/s41467-020-17922-x.

Reference Type BACKGROUND
PMID: 32792562 (View on PubMed)

Roberge RJ, Kim JH, Benson SM. Absence of consequential changes in physiological, thermal and subjective responses from wearing a surgical mask. Respir Physiol Neurobiol. 2012 Apr 15;181(1):29-35. doi: 10.1016/j.resp.2012.01.010. Epub 2012 Feb 2.

Reference Type BACKGROUND
PMID: 22326638 (View on PubMed)

Roberge RJ, Coca A, Williams WJ, Palmiero AJ, Powell JB. Surgical mask placement over N95 filtering facepiece respirators: physiological effects on healthcare workers. Respirology. 2010 Apr;15(3):516-21. doi: 10.1111/j.1440-1843.2010.01713.x. Epub 2010 Mar 11.

Reference Type BACKGROUND
PMID: 20337987 (View on PubMed)

Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, Shaman J. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020 May 1;368(6490):489-493. doi: 10.1126/science.abb3221. Epub 2020 Mar 16.

Reference Type BACKGROUND
PMID: 32179701 (View on PubMed)

Fikenzer S, Laufs U. Response to Letter to the editors referring to Fikenzer, S., Uhe, T., Lavall, D., Rudolph, U., Falz, R., Busse, M., Hepp, P., & Laufs, U. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical research in cardiology: official journal of the German Cardiac Society, 1-9. Advance online publication. https://doi.org/10.1007/s00392-020-01704-y. Clin Res Cardiol. 2020 Dec;109(12):1600. doi: 10.1007/s00392-020-01736-4. Epub 2020 Sep 23. No abstract available.

Reference Type BACKGROUND
PMID: 32989474 (View on PubMed)

Wissmuller M, Wartner V, Hohmann C, Adler J, Kramer T, Hellmich M, Gerhardt F, Baldus S, Rosenkranz S. Impact of face masks on the 6-minute walk distance in pulmonary hypertension patients during the COVID-19 pandemic: a prospective, randomised cross-over study. Eur Respir J. 2023 Oct 26;62(4):2201454. doi: 10.1183/13993003.01454-2022. Print 2023 Oct.

Reference Type DERIVED
PMID: 37827573 (View on PubMed)

Other Identifiers

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UoC Ethics 20-1581-1

Identifier Type: OTHER

Identifier Source: secondary_id

2020_01

Identifier Type: -

Identifier Source: org_study_id

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