Long Term Effect of High-intensity Training After Heart Transplantation
High-intensity training (HIT) has repeatedly been documented to have superior positive effects compared to moderate exercise in patients with coronary heart disease and heart failure. Since heart transplant recipients (HTx), have a denervated heart with different respond to exercise, HIT has previously not been introduced among these patients. Rikshospitalet carried out a RCT to investigate this (the TEX study 2009-2012), and found that this form of exercise also was highly effective and safe in long term HTx with clinically significant improvement in VO2peak, muscular exercise capasity, general HRQoL, and even slower progression of CAV (coronary allograft vasculopathy). Based on these findings we ask the following questions in this follow-up study:
- Would the effect on VO2peak, HRQoL,muscle capacity and CAV obtained during the study period continue during long term follow up (5 years)?
- Is the intervention group more physical active after HIT compared to the control group?
Heart Transplant Recipients
|Study Design:||Observational Model: Case-Crossover
Time Perspective: Cross-Sectional
- mean VO2peak in the intervention group and control group [ Time Frame: 5 years after start of inclusion in RCT (TEX). One measurment. ] [ Designated as safety issue: No ]We will use the same test protocol as the TEX- study.
- How many has progression of cardiac allograft vasculopathy in the intervention group and control group. [ Time Frame: 5 years after inclusion in RCT (TEX study). ] [ Designated as safety issue: No ]Progression of vasculopathy will be studied with IVUS technique, and compared with IVUS pictures from TEX.
- Mean muscle capacity in the intervention group and control group. [ Time Frame: 5 years after inclusion in RCT, TEX study. ] [ Designated as safety issue: No ]
- Quality of life [ Time Frame: 5 years after inclusion in TEX- study. ] [ Designated as safety issue: No ]We will use validated questionnaires to estimate quality of life and to evaluate depression.
- Difference in activity level between groups [ Time Frame: 5 years after inclusion i RCT, TEX study. ] [ Designated as safety issue: No ]To estimate activity the study population will fill out a validated questionnaire about physical activity, and they will wear a physical activity monitor at home for one week.
Biospecimen Retention: Samples Without DNA
Blodsamples from the patients will be studied:
Standard samples: RBC, WBC, plates, CRP, kreatinin, urea, liver tests, thyorid gland tests, lipid profile, fasting- glucose og hba1c, Pro BNP, troponin T, uric acid.
Supplement: Inflammation cytokines/chemokines such as TNF alfa, sTNFR2 og IL-6, IL-10, MCP-1 og IL-8. Growth factors and inhibitors for innervation. Markers for endothelial function; endotelin and von- Willebrand faktor and anti- trombotic factors; fibrinogen, plasminogen activator inhibitor-1.
|Study Start Date:||August 2014|
|Study Completion Date:||November 2015|
|Primary Completion Date:||November 2015 (Final data collection date for primary outcome measure)|
Group that followed high- intensity interval training program in TEX study.
Followed up on a regular basis for HTx recipients in Norway.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02213770
|Oslo, Norway, 0424|
|Study Director:||Lars Gullestad, professor||OUS- kardiologisk avdeling|