Microvascular Dysfunction in Adults with Congenital Heart Disease and the Effect of Exercise Training

NCT ID: NCT06715137

Last Updated: 2024-12-04

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

55 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-18

Study Completion Date

2024-05-31

Brief Summary

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The goal of this prospective cohort study is to deepen the understanding of the pathophysiology in adults with congenital heart disease (CHD). Through this research, the investigators aim to identify potential strategies to improve the prevention and treatment of these patients. In this context, the effects of exercise training will also be assessed. The main questions it aims to answer are:

* Is coronary microvascular dysfunction (MVD) present in adults with diverse types of CHD?
* Is peripheral MVD present in adults with diverse types of CHD?
* Are coronary and peripheral MVD correlated in adults with diverse types of CHD?
* Is microvascular function correlated with inflammation and oxidative stress in adults with diverse types of CHD?
* Are inflammation and oxidative stress correlated with ventricular function in adults with diverse types of CHD?
* Are MVD and diminished ventricular function interrelated and associated with reduced exercise capacity in adults with diverse types of CHD?
* Does exercise training in adults with CHD result in improvements in coronary and peripheral microvascular function, inflammation and oxidative stress, biventricular function, muscle strength, exercise capacity and quality of life?

For the last research question, patients were randomized to receive either conventional care or home-based aerobic and strength exercise training.

Detailed Description

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Conditions

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Congenital Heart Defect Congenital Heart Disease Microvascular Dysfunction Exercise Training Oxidative Stress Coronary Microvascular Dysfunction Peripheral Microvascular Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers

Study Groups

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Exercise arm

Each participant received a personalized rehabilitation schedule combining aerobic interval cycle training and a dynamic strength exercise program, developed to ensure that the participants met the physical activity guidelines.

Group Type EXPERIMENTAL

Exercise training

Intervention Type BEHAVIORAL

Each participant received a personalized rehabilitation schedule combining aerobic interval cycle training and a dynamic strength exercise program, developed to ensure that the participants met the physical activity guidelines. For the aerobic training, the patients cycled for 30-45 minutes on an exercise bike at home 3 times a week. During each training session, the heart rate (HR) was continuously recorded using a chest strap and displayed in a smartphone application. The target HR zones were predefined with alternating intervals of intensive and extensive aerobic training. The program followed a progressive structure with the objective of completing 40 minutes of intensive aerobic training after 16 weeks. In the strength training program, 4 dynamic exercises targeting major muscle groups were performed 3 times a week. Every 2 weeks, these exercises were intensified by altering the starting position or adding extra weight.

Conventional care arm

In the conventional care arm, patients did not receive explicit exercise advice but were provided with general information regarding a healthy lifestyle, in accordance with current physical activity guidelines during the first study visit.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Exercise training

Each participant received a personalized rehabilitation schedule combining aerobic interval cycle training and a dynamic strength exercise program, developed to ensure that the participants met the physical activity guidelines. For the aerobic training, the patients cycled for 30-45 minutes on an exercise bike at home 3 times a week. During each training session, the heart rate (HR) was continuously recorded using a chest strap and displayed in a smartphone application. The target HR zones were predefined with alternating intervals of intensive and extensive aerobic training. The program followed a progressive structure with the objective of completing 40 minutes of intensive aerobic training after 16 weeks. In the strength training program, 4 dynamic exercises targeting major muscle groups were performed 3 times a week. Every 2 weeks, these exercises were intensified by altering the starting position or adding extra weight.

Intervention Type BEHAVIORAL

Other Intervention Names

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Exercise program Home-based aerobic and strength exercise program Training program Exercise training progam

Eligibility Criteria

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Inclusion Criteria

* adults with congenital heart disease: as many different types of CHD as possible were incorporated
* New York Heart Association (NYHA) class I-II
* who visited the out-patient clinic at the Antwerp University Hospital

Exclusion Criteria

* smoking
* body mass index \>35 kg/m²
* professional endurance athlete
* the presence of macrovascular coronary artery disease
* diabetes mellitus
* a systemic disease (e.g., malignancies, acute and chronic inflammatory diseases in the preceding 3 months)
* a contraindication for adenosine administration.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital, Antwerp

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Antwerp University Hospital

Edegem, Antwerp, Belgium

Site Status

Countries

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Belgium

References

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Vanreusel I, Vermeulen D, Goovaerts I, Stoop T, Ectors B, Cornelis J, Hens W, de Bliek E, Heuten H, Van Craenenbroeck EM, Van Berendoncks A, Segers VFM, Briede JJ. Circulating Reactive Oxygen Species in Adults with Congenital Heart Disease. Antioxidants (Basel). 2022 Nov 30;11(12):2369. doi: 10.3390/antiox11122369.

Reference Type BACKGROUND
PMID: 36552576 (View on PubMed)

Vanreusel I, Taeymans J, Van Craenenbroeck E, Segers VFM, Van Berendoncks A, Briedé JJ, et al. Oxidative Stress in Patients with Congenital Heart Disease: A Systematic Review. Advances in Redox Research. 2024:100109

Reference Type BACKGROUND

Vanreusel I, Taeymans J, Van Craenenbroeck E, Segers VFM, Van Berendoncks A, Briede JJ, Hens W. Elevated oxidative stress in patients with congenital heart disease and the effect of cyanosis: a meta-analysis. Free Radic Res. 2023 May-Jun;57(6-12):470-486. doi: 10.1080/10715762.2023.2284639. Epub 2023 Dec 26.

Reference Type BACKGROUND
PMID: 38000042 (View on PubMed)

Vanreusel I, Hens W, Van Craenenbroeck E, Van Berendoncks A, Segers VFM. Peripheral Microvascular Dysfunction in Children and Adults with Congenital Heart Disease: A Literature Review. Curr Cardiol Rev. 2024;20(4):e210224227260. doi: 10.2174/011573403X278440240209064408.

Reference Type BACKGROUND
PMID: 38409710 (View on PubMed)

Vanreusel I, Segers VFM, Craenenbroeck EV, Berendoncks AV. Coronary Microvascular Dysfunction in Patients with Congenital Heart Disease. Curr Cardiol Rev. 2023;19(4):e190123212886. doi: 10.2174/1573403X19666230119112634.

Reference Type BACKGROUND
PMID: 36658708 (View on PubMed)

Other Identifiers

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Edge 001475

Identifier Type: -

Identifier Source: org_study_id