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Effect of Remote Ischemic Conditioning on Vascular Health in Stroke Patients

Not Applicable
Completed
Conditions
Stroke, Lacunar
Registration Number
NCT03635177
Lead Sponsor
University of Copenhagen
Brief Summary

The main aim of the current study is to assess cardiovascular effects of remote ischemic conditioning in patients who have suffered from stroke. A group of stroke patients will be subjected to four weeks of daily remote ischemic conditioning and four weeks of placebo and vascular function is assessed as a primary outcome.

Detailed Description

Remote ischemic preconditioning (RIC) has been shown to reduce myocardial damage in association with a myocardial infarct but less is known about the potential effects on vascular function in patients who have suffered a stroke. RIC is a procedure by which blood flow to a limb is repeatedly occluded during a short period by an inflatable cuff. This project evaluates the effect of a two week period with RIC on vascular function and cerebral blood flow velocity as well as on factors associated with blood clot formation in patients who have suffered a stroke. The study also aims to provide mechanistic insight into the beneficial effects of the RIC procedure.

Subjects are patients who within the past five years have suffered from lacunar infarct. The study is of a cross-over design with two weeks of homebased RIC treatment and two weeks of control period in a randomized order. Before and after the experimental periods the subjects undergo a number of tests assessing general health status, vascular function and cerebral blood flow velocity. Skeletal muscle samples are obtained for the determination of selected proteins related to vascular function and angiogenesis and blood samples are obtained for the determination of platelet function.

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Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Clinical symptoms and corresponding computer tomographytomography/magnetic resonance (CT/MR)-scanning results for lacunar infarct within past five years.
  • Small vessel disease stroke (lacunar infarct) is defined by the TOAST criteria
Exclusion Criteria

Clinical significant carotid stenosis. Cardioembolic stroke

  • Clinically significant chronic diseases other than lacunar infarct and associated factors
  • Current or past smoker within the past ten years
  • Current treatment with beta-blockers, peroral steroids or NSAIDS
  • Alcohol- or drug-addiction.
  • Pregnant or lactating.
  • Inability to understand the content of the study information provided.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Primary Outcome Measures
NameTimeMethod
Flow mediated dilationChange from baseline to 4 weeks

Assessment of brachial artery dilation after 5 min occlusion of upper arm by cuff

Secondary Outcome Measures
NameTimeMethod
Skeletal muscle blood flowChange from baseline to 4 weeks

Femoral arterial blood flow measured at rest and during one leg knee extensor exercise

Blood clot structure-gel pointChange from baseline to 4 weeks

Blood clot structure is assessed by gel point

Blood clot structure-fractal analysisChange from baseline to 4 weeks

Blood clot structure is assessed by fractal analysis

Platelet reactivityChange from baseline to 4 weeks

Platelet reactivity is assessed in platelets isolated from blood samples

Skeletal muscle proteinsChange from baseline to 4 weeks

Proteins associated with angiogenesis and vascular function are assessed in skeletal muscle samples obtained from the thigh muscle

Plasma proteinsChange from baseline to 4 weeks

Protein amount is determined in plasma

Cerebral vascular function-visual taskChange from baseline to 4 weeks

Assessment of change in cerebral blood flow velocity with visual task

Cerebral vascular function- motorparadigm taskChange from baseline to 4 weeks

Assessment of change in cerebral blood flow velocity with motorparadigm task

Oral glucose tolerance test (OGTT)Change from baseline to 4 weeks

An oral glucose tolerance test is conducted by assesment of blood glucose and insulin before and after ingestion of glucose

Body compositionChange from baseline to 4 weeks

Body composition is assessed by dual energy x-ray absorptiometry

Plasma lipidsChange from baseline to 4 weeks

Lipid concentration is determined in plasma

Trial Locations

Locations (2)

University of Copenhagen

🇩🇰

Copenhagen, Denmark

Department of Neurology, Herlev Hospital

🇩🇰

Herlev, Denmark

University of Copenhagen
🇩🇰Copenhagen, Denmark

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