Physical Rehabilitation for Older Patients With Acute Heart Failure With Preserved Ejection Fraction (REHAB-HFpEF)
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT05525663 |
Recruitment Status :
Recruiting
First Posted : September 1, 2022
Last Update Posted : August 1, 2023
|
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Heart Failure With Preserved Ejection Fraction | Behavioral: Rehabilitation Intervention | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 880 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Physical Rehabilitation for Older Patients With Acute Heart Failure With Preserved Ejection |
Actual Study Start Date : | February 16, 2023 |
Estimated Primary Completion Date : | November 2027 |
Estimated Study Completion Date : | January 2028 |
Arm | Intervention/treatment |
---|---|
Experimental: Rehabilitation Intervention
The Rehabilitation Intervention is a novel, progressive, multi-domain rehabilitation and exercise training intervention. The intervention will include strength, balance, endurance, and mobility training and the specific training exercises will be tailored based on participant performance in each of these domains. The intervention will begin as soon as possible after randomization during the hospitalization and will continue 3 times per week in an outpatient setting for 12 weeks.
|
Behavioral: Rehabilitation Intervention
progressive, multi-domain rehabilitation and exercise training intervention |
No Intervention: Attention Control
Attention control participants are contacted bi-weekly by study staff to maintain contact, collect information regarding health status, clinical events, and physical activity/exercise, and ensure retention; they do not receive any specific exercise recommendations.
|
- Combined All-cause Rehospitalization and Death [ Time Frame: Month 6 ]Rate of combined all-cause rehospitalizations and death 6 months following discharge from index hospitalization.
- Prevalence of major mobility disability (MMD) [ Time Frame: Month 6 ]Percentage of participants with MMD, defined as the inability to walk 160 meters during a 6 minute walk test.
- All-cause rehospitalization [ Time Frame: Month 6 ]Exploratory outcome. Rate of rehospitalizations 6 months following discharge from index hospitalization.
- All-cause death [ Time Frame: Month 6 ]Exploratory outcome. Rate of death 6 months following discharge from index hospitalization.
- Cardiovascular rehospitalization and death [ Time Frame: Month 6 ]Exploratory outcome. Rate of combined cardiovascular rehospitalizations and death 6 months following discharge from index hospitalization.
- Short Physical Performance Battery (SPPB) [ Time Frame: Month 6 ]Exploratory outcome. The Short Physical Performance Battery is scored on a scale of 0-12, with a higher score indicating better physical function.
- 6-minute Walk Distance (6MWD) [ Time Frame: Month 6 ]Exploratory outcome. Distance walked in 6 minutes.
- Quality of Life Measured by Kansas City Cardiomyopathy Questionnaire (KCCQ) [ Time Frame: Month 6 ]Exploratory outcome. The KCCQ is a heart failure disease-specific quality of life measure encompassing domains of physical limitation, HF symptoms, quality of life, and social limitation scored on a scale of 0-100 with higher scores indicating better health status.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 60 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age >=60 years old
- Ejection Fraction >=45%
-
In the hospital setting >24 hours for the management of acute decompensated heart failure (ADHF), or diagnosed with ADHF after being hospitalized for another reason. ADHF will be confirmed by the site physician, and will be defined according to the Food and Drug Administration (FDA) definition of hospitalized heart failure as a combination of symptoms, signs, and HF-specific medical treatments, and requires that all 4 of the following are met:
- At least 1 symptom of HF which has worsened from baseline: a. dyspnea at rest or with exertion; b. exertional fatigue; c. orthopnea; d. paroxysmal nocturnal dyspnea (PND)
- At least 2 of the following signs of HF: a. Pulmonary congestion or edema on physical exam (rales or crackles) or by chest X-ray; b. Elevated jugular venous pressure or central venous pressure >=10 mm Hg; c. peripheral edema; d. wedge or left ventricular end diastolic pressure >=15 mmHg; e. rapid weight gain (>=5 lbs.); f. Increased b-type natriuretic peptide (BNP) (>=100 pg/ml) or N-terminal prohormone BNP (>=220pg/ml)
- Change in medical treatment specifically targeting HF, defined as change in dose or initiation of or augmentation of at least 1 of the following therapies: a. diuretics; b. vasodilators; c. other neurohormonal modulating agents, including angiotensinconverting enzyme inhibitors, angiotensin II receptor blockers (with or without neprilysin inhibitor), beta-blockers, aldosterone inhibitors, direct renin inhibitors, or sodium-glucose co-transporter-2 inhibitors
- The primary cause of symptoms and signs is judged by the investigator to be due to HF
- Adequate clinical stability to allow participation in study assessments and the intervention Independent with basic activities of daily living, including the ability to ambulate independently (with or without the use of an assistive device) prior to admission
- Able to walk 4 meters (with or without the use of an assistive device) at the time of enrollment
Exclusion Criteria:
- Acute myocardial infarction within the past 3 months, or planned coronary artery intervention (percutaneous or surgical) within the next 6 months (Note: given that cardiac biomarkers such as troponin are frequently elevated in HF patients, the diagnosis of acute myocardial infarction should be based on clinical diagnosis, not biomarkers alone)
- Severe aortic or mitral valve stenosis
- Severe valvular heart disease with planned intervention within next 6 months
- Known pericardial constriction, genetic hypertrophic cardiomyopathy, or infiltrative cardiomyopathy including amyloid heart disease (amyloidosis)
- Planned discharge other than to home or a facility where the participant will live independently
- Terminal illness other than HF with life expectancy <1 year
- Impairment from stroke or other medical disorders that preclude participation in the intervention
- Known dementia by medical record documentation, OR patients with Montreal Cognitive Assessment (MoCA) <=18 AND without social support, OR MoCA <10 regardless of social support
- Advanced chronic kidney disease defined as estimated glomerular filtration rate <20 mL/min/1.73 m2 or on chronic or intermittent dialysis or dialysis anticipated within the next 6 months
- Already engaging in regular moderate to vigorous exercise conditioning defined as >30 minutes per day, >= twice per week consistently during the previous 6 weeks
- Enrollment in a clinical trial not approved for co-enrollment
- High risk for non-adherence as determined by screening evaluation
- Inability or unwillingness to comply with the study requirements or give consent
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): NCT05525663
Contact: Michael B Nelson, MS | 336-716-6789 | mbnelson@wakehealth.edu |
United States, North Carolina | |
Atrium Health Wake Forest Baptist | Recruiting |
Winston-Salem, North Carolina, United States, 27157 | |
Contact: Dalane W Kitzman, MD 336-716-3274 dkitzman@wakehealth.edu | |
Contact: Michael B Nelson, MS 336-716-6789 mbnelson@wakehealth.edu |
Principal Investigator: | Dalane W Kitzman, MD | Wake Forest University Health Sciences |
Responsible Party: | Wake Forest University Health Sciences |
ClinicalTrials.gov Identifier: | NCT05525663 |
Other Study ID Numbers: |
IRB00087718 R01AG078153 ( U.S. NIH Grant/Contract ) |
First Posted: | September 1, 2022 Key Record Dates |
Last Update Posted: | August 1, 2023 |
Last Verified: | July 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Heart Failure Heart Diseases Cardiovascular Diseases |