Effectiveness of a Walking Program Modulating Cardioreparative Factors in Heart Failure (EPCCHFWalk)

Study Description

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

The incidence of heart failure grows as the population continues to age. Heart failure incidence approaches 10 per 1,000 persons after the age of 65. Although pharmacotherapy improves the treatment of heart failure it remains insufficient in preventing the progression of this debilitating disease. Cell based therapy has gained great strides over the last decade, launching cellular therapy into the mix of artillery for the treatment of chronic heart failure and coronary disease. While early pre-clinical work demonstrates that stem cell based therapy improves heart failure the exact mechanism in which these endothelial progenitor cells (EPC's) are recruited from the bone marrow, proliferate under the mediation of growth factors, and migrate to the injured tissues endogenously still remains obscured. Therefore in order for clinicians and scientist to impact heart failure treatment, a greater understanding of the physiological changes in EPC's and other modulators of cardioreparative process need further investigation.

Condition or disease	Intervention/treatment
Heart Failure	Other: Physical Fitness; Biological: Walking Exercise Group

Detailed Description:

Heart failure remains a devastating progressive chronic disease in which pharmacotherapy is not often sufficient. Although cell based therapy is gaining publicity in the treatment of coronary artery disease and heart failure. Determining how endothelial progenitor cells are recruited, proliferate, and home to injured tissue is an important area of investigation. Equally important is determining factors which improve EPC stimulation and efficiency such as realistic levels of exercise and the modulation of various cardioreparative factors (VEGF, NRG-1, and SDF-1) within heart failure patients. Since the endogenous repair mechanism is down regulated in heart failure patients such efforts may uncover ways to tip the balance in heart failure back to normal reparative maintenance.

Study Design

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Study Type :	Observational
Actual Enrollment :	9 participants
Observational Model:	Cohort
Time Perspective:	Prospective
Official Title:	Effectiveness of a Walking Program Modulating Cardioreparative Factors in Heart Failure
Actual Study Start Date :	July 2009
Actual Primary Completion Date :	January 2014
Actual Study Completion Date :	January 2014

Groups and Cohorts

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Group/Cohort	Intervention/treatment
Walking Exercise Group; Walking Exercise Group versus Control Group	Other: Physical Fitness; Does intensity of aerobic walking exercise modify cardiac reparative factors; Other Name: Quality of Life Questionnaires Biological: Walking Exercise Group; Walking Group will increase intensity, duration, and steps of walking per week.; Other Name: Quality of Life Questionnaires

Outcome Measures

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. endothelial progenitor cells [ Time Frame: 12 Weeks ]

Secondary Outcome Measures :

1. exercise [ Time Frame: 12 Months ]

Biospecimen Retention:   Samples With DNA

60 ml of blood will be used to measure baseline levels of EPC's, NRG-1, VEGF, and SDF-1. Repeat venipuncture will be done at Week 12. Approximately 60 ml of blood for the measurement of EPC's, NRG1, VEGF, and SDF-1.

Eligibility Criteria

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	30 Years to 65 Years (Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

Cardiac Heart Failure Patients

Criteria

Inclusion criteria:

1. Subjects 30-65 years old.
2. Subjects able to give Informed Consent.
3. Subjects who will give permission for collection of clinical and demographic data from the electronic medical records.

4. Subjects with symptomatic ischemic or non-ischemic heart failure in a stable condition with New York Heart Association class II-III for at least the last 3 months before study enrollment.

   • Left ventricular ejection fraction (LVEF) < 40%.
   • Peak volume of oxygen utilization (peak VO2) of < 25 ml/kg/min.
5. Patient on a stable dose of statin or who can be initiated on statin therapy.
6. Subjects with ischemic cardiomyopathy must have had either a negative stress test within the last 6 months or a cardiac catheterization within the last year confirming stable disease.

Exclusion criteria:

1. Subjects with myocardial infarction or unstable angina within the last six months.
2. Subjects with symptomatic or severe aortic stenosis.
3. Subjects with severe HTN (SBP > 180) or hypotension (SBP < 100).
4. Subjects who are pregnant.
5. Subjects who have bone marrow suppression.
6. Subjects with exercise limiting peripheral arterial disease.
7. Subjects with history of ventricular tachycardia without an implantable defibrillator
8. Subjects with decompensated diabetes (HgA1c >10).
9. Subjects with orthopedic limitations.
10. Subjects with any other clinical condition precluding regular participation in walking exercise regimen.
11. Subjects who already participate in regular physical exercise regimen for greater than 30 minutes a day 5 days per week.

Contacts and Locations

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Tennessee
Vanderbilt Heart and Vascular Institute
Nashville, Tennessee, United States, 37232-8802

Sponsors and Collaborators

Vanderbilt University Medical Center

Investigators

Study Director:	Douglas B Saywer, MD, PhD	Vanderbilt Heart and Vascular Institute

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Responsible Party:	Vanderbilt University Medical Center
ClinicalTrials.gov Identifier:	NCT00937443 History of Changes
Other Study ID Numbers:	Vanderbilt_University
First Posted:	July 13, 2009
Last Update Posted:	April 4, 2017
Last Verified:	March 2017

Keywords provided by Vanderbilt University Medical Center:

Physical Activity; Cardiac Heart Failure; Exercise Regimen; Cardioreparative Factors

Additional relevant MeSH terms:

Heart Failure; Heart Diseases; Cardiovascular Diseases