PAC-IC-SAS Pilot Study
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Purpose
The aim of this clinical trial is to evaluate the effect of an early treatment of sleep-disordered breathing by adaptive servo-ventilation in heart failure patient following coronary artery bypass graft surgery.
| Condition | Intervention |
|---|---|
|
Central Obstructive Sleep Apneas Syndrome Heart Failure Coronary Artery Bypass Graft Surgery |
Procedure: Adaptive servo-ventilation post-operative treatment for 6 months |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Central Sleep Apneas Syndrome and Ventricular Function in Patients With Heart Failure, After Coronary Artery Bypass Graft Surgery |
- Percent of ventricular function recovery (left ventricular ejection fraction) improvement conferred by an adaptive servo-ventilation post-operative treatment [ Time Frame: after 6 months of adaptive servo-ventilation post-operative treatment ] [ Designated as safety issue: Yes ]Measurement of the left ventricular ejection fraction by a cardiac ultrasonography
- Assessment of adaptive servo-ventilation effect on the endothelial function, after the surgery in comparison with non treated patient with heart failure and central sleep apneas. [ Time Frame: After 6 months of adaptive servo-sentilation post-operative treatment ] [ Designated as safety issue: Yes ]Measurement of peripheral arterial tone
- Assessment of the impact of nocturnal desaturation level on the vascular atherosclerosis of mammary vessels collected during surgery. [ Time Frame: sleep disordered breathing level, 2 months before surgery ] [ Designated as safety issue: Yes ]By immunological and histological analysis of mammary vessels
- Assessment of the impact of nocturnal desaturation level on the oxidative stress, inflammation and insulin sensitivity of the abdominal and epicardiac adipose tissue collected during surgery. [ Time Frame: sleep disordered breathing level, 2 months before surgery ] [ Designated as safety issue: Yes ]Measuring inflammatory and oxidative adipose markers
- Assessment of adaptive servo-ventilation effect on the systemic inflammation and oxidative stress, the insulin resistance, after the surgery in comparison with non treated patient with heart failure and central sleep apneas. [ Time Frame: After 6 months of adaptive servo-sentilation post-operative treatment ] [ Designated as safety issue: Yes ]Measurement of inflammatory and oxidative serum markers
- Assessment of the impact of nocturnal desaturation level on the vascular reactivity of mammary vessels collected during surgery. [ Time Frame: sleep disordered breathing level, 2 months before surgery ] [ Designated as safety issue: Yes ]By vascular reactivity study of mammary vessels
- Assessment of the impact of nocturnal desaturation level on the abdominal and epicardiac adipose tissue structure collected during surgery. [ Time Frame: sleep disordered breathing level, 2 months before surgery ] [ Designated as safety issue: Yes ]By immunological and histological analysis of abdominal and epicardiac adipose tissue
| Estimated Enrollment: | 12 |
| Study Start Date: | December 2012 |
| Estimated Study Completion Date: | February 2015 |
| Estimated Primary Completion Date: | November 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Patients treated by ventilation
Adaptive servo-ventilation post-operative treatment for 6 months
|
Procedure: Adaptive servo-ventilation post-operative treatment for 6 months
Other Name: Adaptive servo-ventilation for sleep-disorderd breathing for 6 months
|
|
No Intervention: Patients not treated by ventilation
Patients not treated during 6 months by an adaptive servo-ventilation
|
Detailed Description:
This clinical trial is a pilot study, on patients with central sleep apneas syndrome and heart failure, undergoing coronary artery bypass graft surgery, and then randomized for the adaptive servo-ventilation treatment application or not after surgery.
The first objective is to evaluate the effect of an early treatment of sleep-disordered breathing by adaptive servo-ventilation in heart failure patient, in terms of ventricular recovery (ejection fraction improvement). This treatment will be instaurated just after coronary artery bypass graft surgery.
Secondary objectives :
- Assessment of adaptive servo-ventilation effect on the endothelial function, the systemic inflammation and oxidative stress, the insulin resistance, after the surgery in comparison with non treated patient with heart failure and central sleep apneas.
- Assessment of the impact of nocturnal desaturation level on the vascular reactivity and atherosclerosis of mammary vessels collected during surgery.
- Assessment of the impact of nocturnal desaturation level on the oxidative stress, inflammation and insulin sensitivity on abdominal and epicardiac adipose tissue collected during surgery.
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Coronary artery bypass graft surgery
- heart failure patient: with left ventricular ejection fraction ≤ à 45% by ultrasonography
- Patient with central sleep apneas syndrome (SAS)
Exclusion Criteria:
- Aortic or mitral valvular surgery
- Patient already treated for a central SAS
- Patient vith an obstructive SAS
- Patient with malignant evolutive pathology
- Pregnant or lactating women
Contacts and Locations| Contact: Renaud TAMISIER, MD, PhD | 33-476-765-516 | RTamisier@chu-grenoble.fr |
| France | |
| University Hospital of Grenoble | Not yet recruiting |
| Grenoble, France, 38000 | |
| Contact: Renaud TAMISIER, MD, PhD 33-476-765-516 RTamisier@chu-grenoble.fr | |
| Sub-Investigator: Sandrine LAUNOIS-ROLLINAT, MD, PhD | |
| Sub-Investigator: Patrick LEVY, MD, PhD | |
| Sub-Investigator: Jean-Louis PEPIN, MD, PhD | |
| Sub-Investigator: Vincent BACH, MD | |
| Sub-Investigator: Olivier CHAVANON, MD, PhD | |
| Sub-Investigator: Rachid HACINI, MD | |
| Sub-Investigator: Jean-Philippe BAGUET, MD, PhD | |
| Sub-Investigator: Gilles BARON-ROCHETTE, MD | |
| Sub-Investigator: Cécile ROCCA, MD | |
| Sub-Investigator: Patrice FAURE, MD, PhD | |
| Principal Investigator: | Renaud TAMISIER, MD, PhD | University Hospital of Grenoble, France |
More Information
Publications:
| Responsible Party: | University Hospital, Grenoble |
| ClinicalTrials.gov Identifier: | NCT01741337 History of Changes |
| Other Study ID Numbers: | 1225, 2012-A01084-39 |
| Study First Received: | November 23, 2012 |
| Last Updated: | December 4, 2012 |
| Health Authority: | France: L’Agence nationale de sécurité du médicament et des produits de santé |
Keywords provided by University Hospital, Grenoble:
|
central obstructive sleep apneas syndrome heart failure coronary artery bypass graft surgery adaptive servo-ventilation treatment |
Additional relevant MeSH terms:
|
Apnea Heart Failure Sleep Apnea Syndromes Sleep Apnea, Obstructive Sleep Apnea, Central Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory |
Signs and Symptoms Heart Diseases Cardiovascular Diseases Sleep Disorders, Intrinsic Dyssomnias Sleep Disorders Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013