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Trial of the Effects of Remote Preconditioning on the Tissue Metabolism During Exercise and Ischemia

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ClinicalTrials.gov Identifier: NCT00791206
Recruitment Status : Unknown
Verified December 2013 by Andrew Redington, The Hospital for Sick Children.
Recruitment status was:  Active, not recruiting
First Posted : November 14, 2008
Last Update Posted : December 16, 2013
Sponsor:
Information provided by (Responsible Party):

Study Description
Brief Summary:
Previously, the preconditioning signaling pathways have been studied on molecular level or in animal model. By using MR spectroscopy and imaging in a dynamic human model of preconditioning, we will have a better understanding how mitochondrial and endothelial function are affected by preconditioning in-vivo.

Condition or disease Intervention/treatment Phase
Ischemia Procedure: Real preconditioning Procedure: Sham preconditioning Phase 2

Detailed Description:

Ischemic preconditioning is a mechanism that protects tissue against ischemia-reperfusion injury. The protective effect of preconditioning is induced by short periods (1-5 minutes) of non-lethal ischemia to the target tissue, which becomes resistant to a prolonged, otherwise lethal, period of ischemia. Despite its proven potency in experimental models, ischemic preconditioning has not reached widespread clinical application because of the difficulties in applying the stimulus to the target organ (eg Heart, Brain), and even brief ischemia to the target organ can cause dysfunction.

Remote ischemic preconditioning (RIPC) is a more clinically relevant stimulus. It has been shown that preconditioning of one coronary territory induces ischemia protection in other parts of the heart. Subsequently, other studies have shown, in rodent models, that preconditioning of one organ (eg kidney) could induce protection in other organs (eg heart). We recently have confirmed, in a series of animal and human preclinical studies, that this concept can be widened; ultimately showing that four 5-minute episodes of ischemia to the skeletal limb muscles (induced by inflating a standard blood pressure cuff to a level higher than the blood pressure) protects the heart and lungs against ischemia-reperfusion injury in children undergoing cardiac surgery using cardiopulmonary bypass.

The current research is designed to investigate with MRI spectroscopy techonology, the potential physiological mechanisms involved in the protective effects of preconditioning, and the effects of ischemia and exercise.


Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Participant)
Official Title: Single Blind Randomized Controlled Crossover Trial of the Effects of Remote Preconditioning on the Tissue Metabolism During Exercise and Ischemia
Study Start Date : November 2008
Primary Completion Date : June 2013
Estimated Study Completion Date : June 2014

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: 1 Procedure: Real preconditioning
Preconditioning will consist of four 5 minutes cycles of upper limb ischemia interspaced with 5 minutes of reperfusion, using a blood-pressure cuff inflated to a pressure 15 mmHg greater than systolic arterial pressure.
2 Procedure: Sham preconditioning
Preconditioning will consist of four 5 minutes cycles of upper limb ischemia interspaced with 5 minutes of reperfusion, using a blood-pressure cuff inflated to a pressure 10mmHg with the same cycling protocol as the real preconditioning.


Outcome Measures

Primary Outcome Measures :
  1. Improvement in mitochondrial function following the preconditioning as evidenced by a faster rate of recovery of phosphocreatinine after exercise. [ Time Frame: 2 hours ]
  2. Improvement of endothelial and microvascular dysfunction induced by 20 minutes of forearm ischemia. [ Time Frame: 1 hour ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   16 Years to 40 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Healthy male and female volunteers
  • Post-pubescent non-athletes between the ages of >16 and <40 years of age.

Exclusion Criteria:

  • Older than 40 year old.
  • Younger than 16 year old.
  • Major medical condition
  • Illness, surgery or medical intervention in the last 48 hours.
  • Diabetes Mellitus
  • Caffeine intake in the last 48 hours
  • Athlete (more than 5 training sessions per week)
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00791206


Sponsors and Collaborators
The Hospital for Sick Children
Investigators
Principal Investigator: Andrew Redington, MD The Hospital for Sick Children
More Information

Responsible Party: Andrew Redington, Head, Heart Centre-Cardiology Division, The Hospital for Sick Children
ClinicalTrials.gov Identifier: NCT00791206     History of Changes
Other Study ID Numbers: 1000012859
First Posted: November 14, 2008    Key Record Dates
Last Update Posted: December 16, 2013
Last Verified: December 2013

Keywords provided by Andrew Redington, The Hospital for Sick Children:
exercise
ischemia
MRI
MRI spectroscopy
Ischemia preconditioning

Additional relevant MeSH terms:
Ischemia
Pathologic Processes