Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale
Background: Studies have shown significant benefits of exercise therapy in heart failure (HF) with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF). The mechanisms responsible for the beneficial effect of exercise in HFrEF and HFpEF are still unclear. We hypothes...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-08-01
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| Series: | Therapeutic Advances in Chronic Disease |
| Online Access: | https://doi.org/10.1177/2040622319868376 |
| _version_ | 1819227570271420416 |
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| author | Fernando Bianchini Cardoso Lígia M. Antunes-Correa Thiago Quinaglia A. C. Silva Luis Miguel Silva Camilla Toledo Vinicius Citelli Ribeiro Layde R. Paim Tomas G. Neilan Lício Velloso Wilson Nadruz Celso Darío Ramos Sergio S. Dertkigil Roberto Schreiber Andrei Sposito Jose Roberto Matos-Souza Otávio Berwanger Michael Jerosch-Herold Otávio Rizzi Coelho-Filho |
| author_facet | Fernando Bianchini Cardoso Lígia M. Antunes-Correa Thiago Quinaglia A. C. Silva Luis Miguel Silva Camilla Toledo Vinicius Citelli Ribeiro Layde R. Paim Tomas G. Neilan Lício Velloso Wilson Nadruz Celso Darío Ramos Sergio S. Dertkigil Roberto Schreiber Andrei Sposito Jose Roberto Matos-Souza Otávio Berwanger Michael Jerosch-Herold Otávio Rizzi Coelho-Filho |
| author_sort | Fernando Bianchini Cardoso |
| collection | DOAJ |
| description | Background: Studies have shown significant benefits of exercise therapy in heart failure (HF) with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF). The mechanisms responsible for the beneficial effect of exercise in HFrEF and HFpEF are still unclear. We hypothesized that the effect of exercise on myocardial remodeling may explain its beneficial effect. Methods: IMAGING-REHAB-HF is a single-center, randomized, controlled clinical trial using cardiac magnetic resonance imaging, vasomotor endothelial function, cardiac sympathetic activity imaging and serum biomarkers to compare the effect of exercise therapy in HFpEF (LVEF ≥ 45%) and HFrEF (LVEF < 45%). Subjects will be assessed at baseline and after 4 months. The exercise program will consist of three 60-min exercise sessions/week. The primary endpoints are the effect of exercise on myocardial extracellular volume (ECV), left ventricular (LV) systolic function, LV mass, LV mass-to-volume and LV cardiomyocyte volume. Secondary endpoints include the effect of exercise on vasomotor endothelial function, cardiac sympathetic activity and plasmatic biomarkers. Patients will be allocated in a 2:1 fashion to supervised exercise program or usual care. A total sample size of 90 patients, divided into two groups according to LVEF:HFpEF group (45 patients:30 in the intervention arm and 15 in the control arm) and HFrEF group (45 patients:30 in the intervention arm and 15 in the control arm) – will be necessary to achieve adequate power. Conclusion: This will be the first study to evaluate the benefits of a rehabilitation program on cardiac remodeling in HF patients. The unique design of our study may provide unique data to further elucidate the mechanisms involved in reverse cardiac remodeling after exercise in HFpEF and HFrEF patients. |
| first_indexed | 2024-12-23T10:43:29Z |
| format | Article |
| id | doaj.art-8020c66fd7da4f559dbf9df3065cb235 |
| institution | Directory Open Access Journal |
| issn | 2040-6231 |
| language | English |
| last_indexed | 2024-12-23T10:43:29Z |
| publishDate | 2019-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Chronic Disease |
| spelling | doaj.art-8020c66fd7da4f559dbf9df3065cb2352022-12-21T17:50:06ZengSAGE PublishingTherapeutic Advances in Chronic Disease2040-62312019-08-011010.1177/2040622319868376Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationaleFernando Bianchini CardosoLígia M. Antunes-CorreaThiago Quinaglia A. C. SilvaLuis Miguel SilvaCamilla ToledoVinicius Citelli RibeiroLayde R. PaimTomas G. NeilanLício VellosoWilson NadruzCelso Darío RamosSergio S. DertkigilRoberto SchreiberAndrei SpositoJose Roberto Matos-SouzaOtávio BerwangerMichael Jerosch-HeroldOtávio Rizzi Coelho-FilhoBackground: Studies have shown significant benefits of exercise therapy in heart failure (HF) with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF). The mechanisms responsible for the beneficial effect of exercise in HFrEF and HFpEF are still unclear. We hypothesized that the effect of exercise on myocardial remodeling may explain its beneficial effect. Methods: IMAGING-REHAB-HF is a single-center, randomized, controlled clinical trial using cardiac magnetic resonance imaging, vasomotor endothelial function, cardiac sympathetic activity imaging and serum biomarkers to compare the effect of exercise therapy in HFpEF (LVEF ≥ 45%) and HFrEF (LVEF < 45%). Subjects will be assessed at baseline and after 4 months. The exercise program will consist of three 60-min exercise sessions/week. The primary endpoints are the effect of exercise on myocardial extracellular volume (ECV), left ventricular (LV) systolic function, LV mass, LV mass-to-volume and LV cardiomyocyte volume. Secondary endpoints include the effect of exercise on vasomotor endothelial function, cardiac sympathetic activity and plasmatic biomarkers. Patients will be allocated in a 2:1 fashion to supervised exercise program or usual care. A total sample size of 90 patients, divided into two groups according to LVEF:HFpEF group (45 patients:30 in the intervention arm and 15 in the control arm) and HFrEF group (45 patients:30 in the intervention arm and 15 in the control arm) – will be necessary to achieve adequate power. Conclusion: This will be the first study to evaluate the benefits of a rehabilitation program on cardiac remodeling in HF patients. The unique design of our study may provide unique data to further elucidate the mechanisms involved in reverse cardiac remodeling after exercise in HFpEF and HFrEF patients.https://doi.org/10.1177/2040622319868376 |
| spellingShingle | Fernando Bianchini Cardoso Lígia M. Antunes-Correa Thiago Quinaglia A. C. Silva Luis Miguel Silva Camilla Toledo Vinicius Citelli Ribeiro Layde R. Paim Tomas G. Neilan Lício Velloso Wilson Nadruz Celso Darío Ramos Sergio S. Dertkigil Roberto Schreiber Andrei Sposito Jose Roberto Matos-Souza Otávio Berwanger Michael Jerosch-Herold Otávio Rizzi Coelho-Filho Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale Therapeutic Advances in Chronic Disease |
| title | Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale |
| title_full | Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale |
| title_fullStr | Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale |
| title_full_unstemmed | Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale |
| title_short | Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale |
| title_sort | noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction imaging rehab hf design and rationale |
| url | https://doi.org/10.1177/2040622319868376 |
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