Heart Failure, Systolic
Conditions
Keywords
hypoxia, exercise training, heart failure, cardiac remodeling
Brief summary
Heart failure impairs quality of life and exercise capacity, despite an optimal medical therapy. Alternative methods, like hypoxic conditioning coupled to exercise training, must be explored and describe
Detailed description
All heart failure patients will have a session of 45' of bicycle exercise training (in normoxia or hypoxia) AND a one hour rest session (in normoxia or hypoxia). Exercise training sessions will consist in a continue bicycle exercise test at 70 to 80 % of the maximal heart rate, while breathing (single blind) normoxia or hypoxia gaz. Rest conditioning consist in a one hour of rest, while breathing (single blind) normoxia or hypoxia gaz. For hypoxia sessions, the oxygen saturation target will be fo 85-90 % for the 4 first weeks and 80-85 % for the last 4 weeks. Three arms : * exercise training in NORMOXIA and rest conditioning in NORMOXIA * exercise training in HYPOXIA and rest conditioning in NORMOXIA * exercise training in NORMOXIA and rest conditioning in HYPOXIA
Interventions
OTHERhypoxia air
Normobaric hypoxia is generated by adding azote in normal air to decrease the oxygen availability.
Sponsors
University Hospital, Grenoble
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
this is a single blind study patients don't know if they are breathing normal air (normoxia) or hypoxic air (hypoxia).
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* patient available for exercise training * stable heart failure state I-II New York Heart Association (NYHA) with altered ejection fraction (EF ≤ 40 %) * signed informed consent
Exclusion criteria
* unstable ischemic cardiopathy * right ventricle dysfunction * uncontrolled arrythmias * rest elevated in pulmonary artery pressure (≥ 45 mmHg) * migraine * high altitude trip above 2500 m high during study period * impossibility to realise a maximal bicycle exercise test
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| maximal oxygen uptake in ml/min/kg | after 8 weeks of training and conditioning | The maximal exercise capacity will be assessed by an incremental maximal bicycle exercise test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| End diastolic left ventricle diameter in mm | After 8 weeks of training and conditioning | In parasternal long axe, the end diastolic left ventricle diameter |
| systolic left ventricle ejection fraction in % | After 8 weeks of training and conditioning | the systolic left ventricle ejection fraction will be assessed by Simpson's method in 4 and 2 cavity views |
| flow mediated dilatation (FMD) in % | After 8 weeks of training and conditioning | The rest FMD will be assessed by echocardiography by using the % of variation of the brachial artery diameter 10 minutes after occlusion. |
| systolic and diastolic blood pressure control in mmHg | After 8 weeks of training and conditioning | 24 hours ambulatory blood pressure monitoring |
Countries
France
Outcome results
None listed