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Type: Artigo
Title: Noninvasive imaging assessment of rehabilitation therapy in heart failure with preserved and reduced left ventricular ejection fraction (IMAGING-REHAB-HF): design and rationale
Author: Cardoso, Fernando Bianchini
Antunes-Correa, Ligia M.
Silva, Thiago Quinaglia A. C.
Silva, Luis Miguel
Toledo, Camilla
Ribeiro, Vinicius Citelli
Paim, Layde R.
Neilan, Tomas G.
Velloso, Licio
Nadruz, Wilson
Ramos, Celso Dario
Dertkigil, Sergio S.
Schreiber, Roberto
Sposito, Andrei
Matos-Souza, Jose Roberto
Berwanger, Otavio
Jerosch-Herold, Michael
Coelho-Filho, Otavio Rizzi
Abstract: Studies have shown significant benefits of exercise therapy in heart failure (HF) with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF). The mechanisms responsible for the beneficial effect of exercise in HFrEF and HFpEF are still unclear. We hypothesized that the effect of exercise on myocardial remodeling may explain its beneficial effect. Methods: IMAGING-REHAB-HF is a single-center, randomized, controlled clinical trial using cardiac magnetic resonance imaging, vasomotor endothelial function, cardiac sympathetic activity imaging and serum biomarkers to compare the effect of exercise therapy in HFpEF (LVEF >= 45%) and HFrEF (LVEF < 45%). Subjects will be assessed at baseline and after 4 months. The exercise program will consist of three 60-min exercise sessions/week. The primary endpoints are the effect of exercise on myocardial extracellular volume (ECV), left ventricular (LV) systolic function, LV mass, LV mass-to-volume and LV cardiomyocyte volume. Secondary endpoints include the effect of exercise on vasomotor endothelial function, cardiac sympathetic activity and plasmatic biomarkers. Patients will be allocated in a 2:1 fashion to supervised exercise program or usual care. A total sample size of 90 patients, divided into two groups according to LVEF:HFpEF group (45 patients:30 in the intervention arm and 15 in the control arm) and HFrEF group (45 patients:30 in the intervention arm and 15 in the control arm) - will be necessary to achieve adequate power. Conclusion: This will be the first study to evaluate the benefits of a rehabilitation program on cardiac remodeling in HF patients. The unique design of our study may provide unique data to further elucidate the mechanisms involved in reverse cardiac remodeling after exercise in HFpEF and HFrEF patients.
Subject: Remodelação ventricular
Country: Reino Unido
Editor: Sage Publications
Rights: Fechado
Identifier DOI: 10.1177/2040622319868376
Date Issue: 2019
Appears in Collections:FCM - Artigos e Outros Documentos

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