Sleep Disordered Breathing in Patients With Chronic Heart Failure (VISIFA)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified June 2011 by LudwLudwig Boltzmann Institute for COPD and Respiratory Epidemiology.
Recruitment status was  Recruiting
Sponsor:
Information provided by:
LudwLudwig Boltzmann Institute for COPD and Respiratory Epidemiology
ClinicalTrials.gov Identifier:
NCT00863421
First received: March 15, 2009
Last updated: June 15, 2011
Last verified: June 2011
  Purpose

Only few prospective studies systematically investigated the prevalence of sleep disordered breathing in patients with stable chronic heart failure. Furthermore there is no report on the incidence rate of sleep disordered breathing in this population. This is a prospective multi-centre study of sleep-disordered breathing in 200 patients with stable moderate-to-severe chronic heart failure. Eligible patients will undergo overnight full-night polysomnography, lung function testing, laboratory measurements, and hemodynamic recordings. Measurements will be repeated at 6 months interval for a follow-up period of two years irrespective of the presence or absence of sleep disordered breathing. The primary outcome variable for this study is the prevalence of sleep disordered breathing in the study population. Secondary outcome variables include the 2-year incidence rate of sleep disordered breathing, quality of life measurements, exercise capacity, sleep quality, hemodynamic measurements, and laboratory markers of neurohumoral activation, systemic inflammation, and endothelial function in the study population.


Condition
Sleep-disordered Breathing
Chronic Heart Failure

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Prevalence, Incidence and Clinical Characteristics of Sleep Disordered Breathing in Patients With Stable Chronic Heart Failure

Resource links provided by NLM:


Further study details as provided by LudwLudwig Boltzmann Institute for COPD and Respiratory Epidemiology:

Primary Outcome Measures:
  • Prevalence of sleep disordered breathing in patients with stable chronic heart failure [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • 2-year-incidence of sleep disordered breathing in patients with stable chronic heart failure [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Prevalence of lung function abnormalities in patients with stable chronic heart failure [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Quality of Life in patients with and those without sleep disordered breathing using the Minnesota Living With Heart Failure Questionnaire and the SF-36. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Sleep Quality in patients with and those without sleep disordered breathing using the Pittsburgh Sleep Quality Index, the Sleep Disorders Questionnaire, and the Functional Outcome of Sleep Questionnaire [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Exercise capacity in meters in the total study population using the 6-Minute-Walking-Test distance [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Pro brain natriuretic peptide, C-reactive protein, tumor-necrosis-factor alpha, interleukin-6, asymmetric dimethylarginine, vascular endothelial growth factor [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • Measurements of cardiac output, heart rate variability, and baroreceptor sensitivity [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Biospecimen Retention:   Samples Without DNA

Blood samples


Estimated Enrollment: 200
Study Start Date: September 2008
Estimated Study Completion Date: May 2012
Estimated Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Detailed Description:

Chronic heart failure is a complex clinical syndrome that can result from any structural or functional cardiac or non-cardiac disorder that impairs the ability of the heart to respond to physiological demands for increased cardiac output. Chronic heart failure is characterised by symptoms such as exertional breathlessness and fatigue, and signs of fluid retention as well as signs associated with the underlying cardiac disorder. Patients with chronic heart failure suffer from reduced quality of life and a significantly higher risk of morbidity and mortality.

There is cumulating evidence of a high prevalence of sleep breathing disorders in both patients with acute and chronic heart failure. Most of these reports, however, suffer from important limitations including small sample size, retrospective study design, and/or use of pulse-oximetry or cardio-respiratory polygraphy to screen for sleep disordered breathing rather than full-night polysomnography. Hence, previous studies may have underestimated the full scale of concomitant sleep disordered breathing in patients with chronic heart failure. Furthermore, to the best of our knowledge, there is no report on the incidence of sleep disordered breathing in patients with chronic heart failure.

In this context the presence of sleep disordered breathing in patients with chronic heart failure has important prognostic relevance. Pathophysiological effects of sleep apnea include intermittent hypoxia, sympathetic hyperactivity, systemic inflammation, and sleep fragmentation. These factors may contribute to the worsening of cardiac function and explain the reportedly higher risk of cardiac morbidity and mortality in patients with both chronic heart failure and concomitant sleep disordered breathing. Accordingly, the aims of the present study are three-fold. First, to investigate the prevalence of sleep breathing disorders in patients with stable moderate-to-severe chronic heart failure using the diagnostic gold standard of full-night-polysomnography. Second, to assess the two-year incidence of sleep disordered breathing in patients with chronic heart failure. Third, to identify potential risk factors associated with the presence or absence of sleep disordered breathing in patients with chronic heart failure. The latter will be assessed by using lung function measurements, hemodynamic parameters, and laboratory markers of neurohumoral activation, systemic inflammation, and endothelial function in patients with chronic heart failure.

For this purpose 200 patients with stable moderate-to-severe chronic heart failure will be studied during a 2 year-period. Patients with chronic heart failure will be screened for eligibility during their regular visits at 4 independent heart failure outpatients clinic in Vienna. Eligible patients will undergo full-night-polysomnography, lung function testing, non-invasive hemodynamic monitoring, a six minute-walking-test, and laboratory measurements at 6 months intervals for a total of 2 years (4 visits).

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Participants will be recruited from 4 independent heart failure outpatient clinics in Vienna.

Criteria

Inclusion Criteria:

  • Stable chronic heart failure(NYHA II-IV), defined as

    • a condition diagnosed for at least 6 months prior to inclusion under maximally tolerated medical therapy
    • without any relevant changes to symptoms or medication during the 8 weeks prior to inclusion
    • by the absence of any hospitalizations during the previous 3 month
  • Ejection fraction equal or below 35%
  • Age between 18 and 80 years

Exclusion Criteria:

  • Instable angina pectoris
  • Acute coronary syndrome within the last 6 months
  • Cerebrovascular events (TIA, PRIND, stroke) within the last 12 months
  • Primary pulmonary hypertension(systolic PAP > 45 mmHg)
  • Congenital heart failure
  • Primary heart valve disease
  • Regular use of benzodiazepines, other sedatives, or opiate derivatives
  • Severe renal(s-creatinine > 3 mg/dl) and/or liver disease(GPT > 3xULN)
  • Clinically relevant affections of the central nervous system(e.g.epilepsy, multiple sclerosis,...)
  • Known moderate to severe chronic obstructive pulmonary disease(FEV1/(F)VC < 70% und FEV1 < 50% Soll) or restrictive lung disease with total lung capacity < 70%
  • Untreated hormonal disease(e.g.hypothyreosis,....)
  • Daily alcohol consumption with more than 60g alcohol per day for men and more than 30g alcohol per day for women
  • Implantation of a pacemaker or ICD within the previous 6 months
  • St.p. aortocoronary bypass surgery or lung resection within the previous 12 month
  • Women of child-bearing age
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00863421

Contacts
Contact: Arschang Valipour, M.D. +43-1-91060-41008 arschang.valipour@wienkav.at

Locations
Austria
Otto Wagner Hospital Recruiting
Vienna, Austria, 1140
Contact: Arschang Valipour, M.D.    +43-1-91060-41008    arschang.valipour@wienkav.at   
Principal Investigator: Arschang Valipour, M.D.         
Sponsors and Collaborators
LudwLudwig Boltzmann Institute for COPD and Respiratory Epidemiology
Investigators
Principal Investigator: Arschang Valipour, M.D. Ludwig Boltzmann Institute for COPD
  More Information

No publications provided

Responsible Party: Arschang Valipour, M.D., FCCP, Ass. Prof, Ludwig Boltzmann Institute for COPD Research
ClinicalTrials.gov Identifier: NCT00863421     History of Changes
Other Study ID Numbers: VISIFA 08-058-0508
Study First Received: March 15, 2009
Last Updated: June 15, 2011
Health Authority: Austria: Ethikkommission

Keywords provided by LudwLudwig Boltzmann Institute for COPD and Respiratory Epidemiology:
Sleep disordered breathing
Prevalence
Chronic heart failure
Incidence
Sleep apnea
Cheyne-Stokes-Breathing

Additional relevant MeSH terms:
Heart Failure
Respiratory Aspiration
Cardiovascular Diseases
Heart Diseases
Pathologic Processes
Respiration Disorders
Respiratory Tract Diseases

ClinicalTrials.gov processed this record on October 21, 2014