Prospective Aerobic Reconditioning Intervention Study (PARIS)

This study has been completed.
Sponsor:
Collaborators:
Information provided by (Responsible Party):
Dalane W. Kitzman, Wake Forest School of Medicine
ClinicalTrials.gov Identifier:
NCT01113840
First received: April 29, 2010
Last updated: January 29, 2014
Last verified: January 2014

April 29, 2010
January 29, 2014
July 1993
December 2004   (final data collection date for primary outcome measure)
Peak exercise capacity [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
Peak exercise capacity [ Designated as safety issue: No ]
Complete list of historical versions of study NCT01113840 on ClinicalTrials.gov Archive Site
Quality of life [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
Quality of life [ Designated as safety issue: No ]
Not Provided
Not Provided
 
Prospective Aerobic Reconditioning Intervention Study
Exercise Conditioning in Elderly Patients With Heart Failure

The purpose of this study is :

  • To determine if aerobic exercise conditioning can improve symptoms, cardiovascular function and quality of life in elderly patients with congestive heart failure.
  • To describe the baseline clinical characteristics, cardiovascular function and neurohumoral function in elderly patients with congestive heart failure.
  • To determine the specific cardiovascular and noncardiovascular mechanisms by which symptoms and quality of life may improve following exercise conditioning in elderly patients with congestive heart failure.

In patients over age 65, cardiovascular disease accounts for the largest percentage of deaths, hospital days, doctor visits, and overall health care expenditures. In addition, heart failure is the most common discharge diagnosis in the elderly. Heart failure can be defined as a state in which cardiac output is insufficient to meet metabolic demands. This is most frequently manifested by symptoms of fatigue and dyspnea. Inherent in this definition is that symptoms may be increased or only occur during times when metabolic demand is increased, such as during exercise. As such, exercise intolerance is a hallmark of the heart failure syndrome. Exercise intolerance correlates not only with disease severity and also with subsequent mortality. Exercise tolerance can be objectively quantified during maximal symptom limited standardized exercise protocols by analysis of exercise time, workload, METS (metabolic equivalents), and oxygen consumption (V02)' These measures have appropriately become accepted as standards for functional assessment in this disorder as well as outcome measures following therapeutic interventions in HF. P.A.R.I.S. is a randomized, attention-controlled, single-blind trial of supervised aerobic exercise training in older patients with heart failure. The primary outcome is exercise capacity and the main secondary outcome is quality of life. Mechanistic outcomes were also examined. In PARIS, which focused on cardiac mechanisms, there were HFPEF and HFREF patients studied in parallel. In PARIS-II, there were only HFPEF patients which focused on vascular mechanisms.

Main outcomes have been reported (see citations below).

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Heart Failure
  • Behavioral: Exercise
    Exercise classes three times per week in a controlled, supervised environment.
  • Behavioral: Control
    Control group continues daily life as prior to randomization.
  • Placebo Comparator: Control
    Control group continues with their daily activity as they were prior to randomization. Receive bi-weekly follow-up phone calls to assess health status and encourage adherence with protocol.
    Intervention: Behavioral: Control
  • Active Comparator: Exercise
    Exercise classes three times per week in a controlled, supervised environment.
    Intervention: Behavioral: Exercise

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
201
December 2009
December 2004   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Age greater than or equal to 60 years of age
  • Symptoms of congestive heart failure
  • Able to understand and give informed consent

Exclusion Criteria:

  • Age <60 years
  • Does not have CHF
  • Significant change in cardiac medication <3 weeks
  • Myocardial infarction <3 weeks
  • CABG surgery <3 months
  • Angina pectoris not controlled during daily activity by pharmacological therapy or at <4 METS activity
  • Sustained hypertension with systolic> 190 and diastolic> 110 on medications
  • Valvular heart disease as the primary etiology of CHF
  • Significant aortic stenosis
  • Stroke of <3 months or with any physical restriction impairment that would prevent participation in exercise programs
  • Chronic obstructive pulmonary disease on therapy that limits exercise duration
  • Uncontrolled diabetes mellitus
  • Active treatment for cancer or other noncardiovascular conditions with life expectancy less than three years
  • Anemia "10 gms Hb)
  • Renal insufficiency (cr >2.5 mg/dl)
  • Psychiatric disease - uncontrolled major psychoses, depressions, dementia, or personality disorder
  • Dementia - MMSE ~24 "22 for ~8th grade education)
  • Lack of an acoustic window sufficient to allow definition of endocardial borders on the screening echocardiogram.
  • Plans to leave area or be admitted to a nursing home within 2 years.
  • Inability to walk at least 420 feet in 6 minutes without a cane or other assistive device.
  • Inability to exercise at or near home.
  • At the discretion of the clinical staff, it is believed that the participant cannot or will not complete the protocol because of frailty, illness, or other reason.
  • Participation in a regular exercise regimen more than one time per week for at least twenty minutes per session; including but not limited to walking, swimming, weight lifting, golfing, or taking an exercise class.
  • Inability to ambulate without cane or other assistive device during biomechanics testing or treadmill.
  • Inability to attend at least fourteen weeks of the facility-based intervention
Both
60 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01113840
P.A.R.I.S. I and II, R01AG012257, R01AG018915
Yes
Dalane W. Kitzman, Wake Forest School of Medicine
Wake Forest School of Medicine
  • National Institutes of Health (NIH)
  • National Institute on Aging (NIA)
Principal Investigator: Dalane W Kitzman, MD Wake Forest School of Medicine
Wake Forest School of Medicine
January 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP