The Effect of Morning vs Evening Aerobic Exercise Training on Cardiac Remodeling and Function Improvement in Patients After ST Elevation Myocardial Infarction
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 201
- 试验地点
- 1
- 主要终点
- left ventricle ejection fraction
研究概览
简要总结
The aim of the study was to intervene in the Aerobic exercise time of patients with STEMI and to explore the optimal exercise time for STEMI patients
详细描述
Cardiovascular disease (CVD) remains the first cause of mortality worldwide. More than 30% of CVD-connected fatalities are ascribed to ST-segment Elevation myocardial infarction (STEMI). There is strong and consistent evidence that aerobic exercise after a STEMI improves overall and cardiovascular-related mortality. Aerobic exercise (AE) acts in key mechanisms of cardiac remodeling and function improvement after STEMI, thus contributing both to prevent or postpone harmful adaptations, and even to recover from negative alterations caused by cardiac ischemia. However, the time of day to exercise for STEMI patients' optimal cardiac benefits is currently unknown.
The circadian clock endows the host with temporal precision and robust adaptation to the surrounding environment. Almost all physiologic, metabolic and endocrine processes, including glycolysis, lipid and carbohydrate metabolism as well as cardiovascular function (heart rate, blood pressure) are influenced by the circadian clock. Recent investigations in rodents utilizing gain-of-function/loss-of-function models and in humans have identified Adverse cardiovascular events have day/night patterns is related to endogenous circadian clock control of platelet activation events. Several studies have also demonstrated the effect of AE at different times on blood pressure. Indeed, timing is critical in amplifying the beneficial impact of AE. However, these studies did not address cardiac structural remodeling or other CVD-related metabolic markers, it difficult to determine the physiological and structural effects of different time AE on cardiovascular health.
Thus, In this trial our aim is to assess, in patients who have had an STEMI, AE in which time of a day can give the best benefits to cardiac remodeling and function improvement.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
In this study, outcome measurement personnel and intervention personnel were separated during the whole process of the experiment, outcome measurement personnel did not know the grouping status, intervention personnel and rehabilitation therapists did not participate in the outcome measurement work.
入排标准
- 年龄范围
- 17 Years 至 75 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Between 18 and 75-years-old;
- •Typical symptoms of acute myocardial infarction within 24 hours, with ST segment elevation of ≥1mm in two consecutive leads on electrocardiogram
- •After receiving complete revascularization treatment
- •Cardiac function grading I to II without any other serious complications
- •Left ventricular ejection fraction >30%
- •Compliant with the guidelines of the American College of Cardiology/American Heart Association for participating in cardiac rehabilitation standards
- •Signed written informed consent.
排除标准
- •Patients with unstable angina
- •severe symptomatic congestive heart failure detectable myocardial ischemia
- •valvular disease requiring surgery
- •severe ventricular arrhythmias
- •severe concomitant life-threatening diseases such as cancer, and rheumatoid disease
- •osteoarticular diseases that may affect the exercise process
结局指标
主要结局
left ventricle ejection fraction
时间窗: at baseline，at the sixth week, and after the 12th week of training or follow-up
Use cardiac ultrasound system to measure left ventricle ejection fraction
次要结局
- Endothelial Function(at baseline，at the sixth week, and after the 12th week of training or follow-up)
- Skeletal muscle and fat mass(at baseline，at the sixth week, and after the 12th week of training or follow-up)
- Oxygen consumption(at baseline，at the sixth week, and after the 12th week of training or follow-up)
- Cardiac structure(at baseline，at the sixth week, and after the 12th week of training or follow-up)
- glucose(at baseline, at the sixth week, and after the 12th week of training or follow-up)
- One year major Adverse Cardiovascular Events(From baseline to one year after participating in rehabilitation)
- VE/VCO2-SLOPE(at baseline，at the sixth week, and after the 12th week of training or follow-up)
- Flow-mediated dilation(at baseline, at the sixth week, and after the 12th week of training or follow-up)
- N-terminal pro-BNP(at baseline, at the sixth week, and after the 12th week of training or follow-up)
- Blood lipid(at baseline, at the sixth week, and after the 12th week of training or follow-up)