Effects of ACE Genotype on Muscular and Functional Adaptations Following a Cardiovascular Rehabilitation Program
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 发起方
- 入组人数
- 60
- 试验地点
- 4
- 主要终点
- Molecular muscle characteristics - mRNA
研究概览
简要总结
The study aims to systematically investigate the interaction between training modality, ACE genotype and disease in heart patients whom complete a cardiovascular rehabilitation program. This is carried out with the goal to improve the benefit of cardiovascular rehabilitation for the patient by maximising adjustments in muscle structure and function with the intervention. A population of healthy individuals will be recruited who will carry out the same training program, in order to compare the training effects respective to the general population.
详细描述
Pharmacological inhibition of angiotensin converting enzyme modifies exercise-induced pro-angiogenic and mitochondrial gene transcript expression. Exercise-induced muscle plasticity importantly interacts with the insertion/deletion genotype of ACE and the training modality and intensity. The aim of this study is to systematically investigate the interaction between training modality, ACE genotype and disease in heart patients whom complete a cardiovascular rehabilitation program.
There are two training modalities being used: The first modality involves cardiovascular training by an interval type of protocol that includes a high repetition number of shortening (i.e. concentric) type contractions on a softrobotic device. The second modality includes a high repetition number of lengthening (i.e. eccentric) type contractions on a softrobotic device. In both training modalities the same muscle groups are exercised over the same range of motion, with the same speed of movement, but with widely differing pedal force. Total absolute external mechanical work will be matched.
In order to assess the baseline values and the effect size of the muscle and training adjustments made, healthy male and female volunteers will be included who are matched with respect to age and sex to the patient population and undergo the same training program.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Factorial
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 65 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patient group inclusion criteria:
- •stable coronary heart patients/heart patients without ischemia
- •Left ventricular ejection fraction > 50%
- •Drug therapy with ACE inhibitors
- •V̇O2peak <86% of the medical reference value Voluntary participation
- •Written informed consent of the subject to participate in the study
排除标准
- •relevant valvular heart disease
- •arterial hypertension (blood pressure at rest> 140/90)
- •arrhythmogenic cardiomyopathy
- •ACE inhibitor intolerance
- •contraindication for ethical reasons
- •known or suspected non-compliance with the curriculum
- •drug or alcohol disease
- •inability of the patient to follow the study procedures (e.g. because of language problems, mental illness, dementia)
- •participation in another clinical trial within the last 30 days prior to confinement and during the study
- •other, clinically significant comorbidities (cardiac arrhythmia, renal insufficiency, hepatic dysfunction, connective tissue disease [Marfan syndrome, Ehlers-Danlos syndrome])
- •Healthy subject group inclusion criteria:
- •inconspicuous ECG under exercise (persons in whom the exercise ECG is abnormal will be referred for a cardiological evaluation recessed to the University Hospital Zurich)
- •V̇O2peak <50 ml O2 min-1 kg-1
- •Voluntary participation
- •Written informed consent of the subject to participate in the study
- •exclusion criteria:
- •relevant valvular heart disease
- •arterial hypertension (blood pressure at rest> 140/90)
- •arrhythmogenic cardiomyopathy
- •ACE inhibitor intolerance
- •contraindication for ethical reasons
- •known or suspected non-compliance with the curriculum
- •drug or alcohol disease
- •inability of the patient to follow the study procedures (e.g. because of language problems, mental illness, dementia)
- •participation in another clinical trial within the last 30 days prior to confinement and during the study
- •other, clinically significant comorbidities (cardiac arrhythmia, renal insufficiency, hepatic dysfunction, connective tissue disease [Marfan syndrome, Ehlers-Danlos syndrome])
结局指标
主要结局
Molecular muscle characteristics - mRNA
时间窗: 975 days: May 2016-January 2019
• mRNA expression of VEGF, HIF-1a, HIF-1b, tenascin-C, Angpt1, Angpt1R, neuropilin, midkine, restin, COX4-1, COX4I-2, CPTI, LPL, LIPE, FATP, CD36 \[relative expression per 28S rRNA\]
Molecular muscle characteristics- phosphorylation
时间窗: 975 days: May 2016-January 2019
• Phosphorylation of proteins phospho-Y397- FAK, phospho-T421/S424-P70S6K, phospho -T183/Y185-JNK, phospho-S2448-mTOR \[pixel counts per actin\]
Cellular muscle characteristics - fiber type %
时间窗: 975 days: May 2016-January 2019
• Distribution of type I, IIA and IIX fibers \[%\]
ACE I/D genotype
时间窗: 975 days: May 2016-January 2019
Genotype of the assessed insertion/deletion gene polymorphism of angiotensin converting enzyme ACE, i.e. ACE-II, ACE-ID or ACE-DD.
Molecular muscle characteristics- protein
时间窗: 975 days: May 2016-January 2019
• Protein content of FAK, FRNK, p70S6K, mTOR, JNK, NDUFA9, SDH, UQCRC1, COX4I1, COX4I2, ATP5A1, VEGF, HIF-1a, CD31, MHC-1, MHC-2A, MHC-2X, MyoD, myogenin, CaMKII \[pixel counts per actin\]
Molecular muscle characteristics- ACE
时间窗: 975 days: May 2016-January 2019
• ACE activity \[fmol min-1\]
Cellular muscle characteristics - fiber area %
时间窗: 975 days: May 2016-January 2019
• Area percentage of type I, IIA and IIX fibers \[% area\]
Cardiovascular function - Heart rate ramp
时间窗: 975 days: May 2016-January 2019
• Heart rate in ramp test on ergometer \[beats per minute\]
Cellular muscle characteristics - fiber type CSA
时间窗: 975 days: May 2016-January 2019
• Cross sectional area of type I, IIA and IIX fibers \[micrometer2\]
Cellular muscle characteristics - Capillary density
时间窗: 975 days: May 2016-January 2019
• Capillary density \[capillaries micrometer-2\]
Cellular muscle characteristics - Capillary-to-fiber ratio
时间窗: 975 days: May 2016-January 2019
• Capillary-to-fiber ratio
Functional muscle characteristics - Maximal Power
时间窗: 975 days: May 2016-January 2019
• Maximal power during ramp test on ergometer \[Watt\]
Functional muscle characteristics - Critical Power
时间窗: 975 days: May 2016-January 2019
• Critical power in ramp test on ergometer \[Watt\]
Muscle metabolism - hemoglobin ramp
时间窗: 975 days: May 2016-January 2019
• Total hemoglobin during ramp test on ergometer \[%\]
Functional muscle characteristics - Real Power
时间窗: 975 days: May 2016-January 2019
• Real Power as estimated on the soft robotic device \[Watt\]
Functional muscle characteristics - Negative Power
时间窗: 975 days: May 2016-January 2019
• Negative Power as estimated on the soft robotic device \[Watt\]
Muscle metabolism - hemoglobin robot exercise
时间窗: 975 days: May 2016-January 2019
• Total hemoglobin during exercise on soft robot \[%\]
Muscle metabolism - serum glucose
时间窗: 975 days: May 2016-January 2019
• Concentration of glucose in serum during ramp test on ergometer \[mmol l-1\]
Cardiovascular function - Heart rate rest
时间窗: 975 days: May 2016-January 2019
• Heart rate at rest \[beats per minute\]
Cardiovascular function - ventilation
时间窗: 975 days: May 2016-January 2019
• Ventilation during ramp test on ergometer \[L min-1\]
Functional muscle characteristics - Reactive Power
时间窗: 975 days: May 2016-January 2019
• Reactive Power as estimated on the soft robotic device \[Watt\]
Muscle metabolism - serum lactate
时间窗: 975 days: May 2016-January 2019
• Concentration of lactate in serum during ramp test on ergometer \[mmol l-1\]
Cardiovascular function - ejection fraction
时间窗: 975 days: May 2016-January 2019
• Ejection fraction
Functional muscle characteristics - Maximal force
时间窗: 975 days: May 2016-January 2019
• Maximal force during the reactive power test on the soft robotic device \[Newton\]
Functional muscle characteristics - Maximal velocity
时间窗: 975 days: May 2016-January 2019
• Maximal velocity during the reactive power test on the soft robotic device \[m sec-1\]
Functional muscle characteristics - Rate of force development
时间窗: 975 days: May 2016-January 2019
• Rate of force development as estimated during the Real Power test on the soft robotic device \[meter sec-2\]
Muscle metabolism - muscle oxygenation ramp
时间窗: 975 days: May 2016-January 2019
• Muscle oxygenation (m. vastus lateralis, m. gastrocnemius, m. gluteus maximus) during ramp test on ergometer \[%\]
Muscle metabolism - muscle oxygenation robot exercise
时间窗: 975 days: May 2016-January 2019
• Muscle oxygenation (m. vastus lateralis, m. gastrocnemius, m. gluteus maximus) during exercise on soft robot \[%\]
Muscle metabolism - lipid compounds
时间窗: 975 days: May 2016-January 2019
• Concentration of lipid compounds in m. vastus lateralis muscle during exercise on soft roboter
Muscle metabolism - metabolites
时间窗: 975 days: May 2016-January 2019
• Concentration of metabolites in m. vastus lateralis muscle during exercise on soft roboter
Cardiovascular function - cardiac output
时间窗: 975 days: May 2016-January 2019
• Cardiac output \[L min-1\]
Cardiovascular function - Maximal oxygen uptake
时间窗: 975 days: May 2016-January 2019
• Maximal oxygen uptake (VO2max) during ramp test on ergometer \[ml O2 min-1 kg-1\]
Cardiovascular function - respiration quotient
时间窗: 975 days: May 2016-January 2019
• Respiration quotient during ramp test on ergometer \[ L O2 inspired / L CO2 expired\]
Cardiovascular function - endurance
时间窗: 975 days: May 2016-January 2019
Time-to-exhaustion in constant load on ergometer \[seconds\]
Cardiovascular function - ventilation frequency
时间窗: 975 days: May 2016-January 2019
• Ventilation frequency ramp test on ergometer \[min-1\]
次要结局
未报告次要终点
