60 Participants Needed

Lower-body Negative Pressure Exercise for Heart Failure

SP
Overseen ByStephen P Wright, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of British Columbia
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method to help individuals with a type of heart failure, where the heart becomes stiff and struggles to fill properly, exercise more easily. It uses a special bike with a chamber around the lower body to reduce extra blood returning to the heart, potentially easing breathlessness during exercise. The method involves lower-body negative pressure, creating a vacuum effect, and lower-body neutral pressure, which does not alter pressure, to observe their effects. Researchers aim to determine if this helps individuals exercise longer and feel less out of breath. Those with heart failure exhibiting mild to moderate symptoms and who have been stable for the past few months might be suitable for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance exercise capacity for heart failure patients.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, participants in the heart failure group must have been on stable medical therapy for at least 2 months before joining the study.

What prior data suggests that this lower-body negative pressure exercise is safe for heart failure patients?

Research shows that using lower-body negative pressure to aid exercise in people with heart failure is generally well-tolerated. Related studies have shown promise in helping the heart manage blood flow better during physical activity. This technique uses a chamber that gently pulls on the lower body, reducing the amount of blood returning to the heart and lungs. This can ease exercise for those with heart failure by lessening breathlessness.

No significant reports of harmful effects from this treatment method have emerged so far. Participants usually find it comfortable and safe. As researchers continue to study this approach, they remain vigilant for any possible side effects. However, current findings suggest it is a safe option for those who struggle with heart failure and exercise.12345

Why are researchers excited about this trial?

Most treatments for heart failure with preserved ejection fraction focus on managing symptoms with medications like diuretics and beta-blockers. However, the use of lower-body negative pressure (LBNP) is different because it simulates the effects of exercise without actual physical activity. This method works by creating a vacuum around the lower body, which helps improve circulation and mimic the benefits of exercise on the heart. Researchers are excited about LBNP because it offers a non-pharmacological approach that could benefit patients who find traditional exercise challenging or risky. Additionally, it could provide a new avenue for improving heart function and quality of life in this patient group.

What evidence suggests that this lower-body negative pressure exercise is effective for heart failure?

This trial will compare the effects of lower-body negative pressure and lower-body neutral pressure on heart failure with preserved ejection fraction (HFpEF). Research has shown that lower-body suction can help manage HFpEF, where the heart becomes stiff and struggles to fill with blood. Applying suction to the lower body reduces blood flow back to the heart during exercise, preventing the heart and lungs from becoming overwhelmed and making exercise easier. Although data on this method remains limited, the concept suggests it could help people with HFpEF exercise longer and breathe more easily. This approach might offer a new way to improve life for those affected.12356

Who Is on the Research Team?

ND

Neil D Eves, PhD

Principal Investigator

The University of British Columbia

Are You a Good Fit for This Trial?

This trial is for adults with a specific type of heart failure where the heart stiffens and has trouble filling (HFpEF). They should have had symptoms needing treatment in the past year, be somewhat active but not heavily exercising, and their condition should be stable. People can't join if they've had severe heart issues like low ejection fraction or certain diseases, are very overweight, smoke recently, or exercise a lot.

Inclusion Criteria

I have been treated for heart failure symptoms within the last year.
Your heart shows signs of being enlarged or not functioning properly based on specific measurements.
I have heart failure with preserved ejection fraction, mild to moderate symptoms, and have been stable on my current heart medication for at least 2 months.
See 3 more

Exclusion Criteria

The pressure in the vein in your neck is too high.
I use supplemental oxygen when I move around.
I have a significant heart condition.
See 12 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-2.5 hours
1 visit (in-person)

Baseline Testing

Enrolment, phenotyping, and baseline testing including anthropometrics, blood pressure, echocardiogram, pulmonary function tests, and an incremental cardiopulmonary exercise test

2-2.5 hours
1 visit (in-person)

Treatment

Participants undergo submaximal exercise with or without lower-body negative pressure, with assessments of ventilatory and cardiac function

3 visits, 1-1.5 hours each
3 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Lower-body Negative Pressure
  • Lower-body Neutral Pressure
Trial Overview The study tests whether using a special cycling machine that applies suction to the lower body helps people with HFpEF exercise more by preventing blood from pooling in their lungs. Participants will cycle under different pressure conditions to see how it affects breathlessness and exercise duration.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Heart Failure with Preserved Ejection Fraction (40 Participants)Experimental Treatment3 Interventions
Group II: Healthy Controls (20 Participants)Active Control3 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials
1,506
Recruited
2,528,000+

Published Research Related to This Trial

In a study of 27 elderly heart failure patients, both machine-assisted cycling and conventional exercise training improved exercise capacity equally, as measured by the 6-minute walk distance after 2 weeks.
Machine-assisted cycling showed a potential benefit in enhancing endothelial function, particularly in patients aged 80 and younger, suggesting it may be a more effective option for improving vascular health in this population.
Effects of machine-assisted cycling on exercise capacity and endothelial function in elderly patients with heart failure.Ozasa, N., Morimoto, T., Bao, B., et al.[2019]
Lower body positive pressure (LBPP) treadmill activity significantly increases left ventricular ejection duration (LVED) in both heart failure (HF) patients and healthy individuals, indicating potential benefits for heart function during exercise.
However, the increase in LVED is less pronounced in HF patients compared to healthy individuals, suggesting that while LBPP is beneficial, its effects may vary based on the patient's heart condition.
The Effect of Lower Body Positive Pressure on Left Ventricular Ejection Duration in Patients With Heart Failure.Avadhani, S., Ihsan, M., Nunez, A., et al.[2020]
Exercise training in chronic heart failure patients has shown significant improvements in exercise capacity, comparable to the best pharmacological treatments, without deteriorating cardiac function.
Despite the lack of definitive evidence on improved survival rates, exercise training is recommended for selected heart failure patients, as it enhances muscle function, reduces ventilation during exercise, and improves overall quality of life when supervised properly.
[Physical activity and training in heart failure].Weber, T., Kirchgatterer, A., Auer, J., et al.[2019]

Citations

Exercise Lower-body Negative Pressure in Heart Failure ...Half of all adults with heart failure have a preserved ejection fraction (HFpEF), where left ventricular (LV) diastolic dysfunction (impaired filling) is a key ...
Exercise Lower-body Negative Pressure in Heart Failure ...Experimental: Heart Failure with Preserved Ejection Fraction (40 Participants). Lower-body negative pressure (-15 and -25 mmHg) and neutral ...
Heart Failure With Preserved Ejection Fraction (HFpEF) - NCBIPatients with HFpEF demonstrate increased all-cause mortality, reduced quality of life, and a significant economic healthcare burden. This ...
New Insights on HFpEF TreatmentPatients with HFpEF are hospitalised approximately 1.4 times per year and have a mortality rate of approximately 15% per year. 1. HFpEF is ...
Lower-body Negative Pressure Exercise for Heart FailureThis trial is for adults with a specific type of heart failure where the heart stiffens and has trouble filling (HFpEF). They should have had symptoms needing ...
Heart Failure With Preserved Ejection FractionSpecifically, 28-day age-adjusted case fatality was 11.7% (White males), 10.1% (White females), 7.2% (Black females), and 7.6% (Black males). However, within a ...
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