By InvitationNot Applicable

Exercise Prescription in Cardiac Rehabilitation Mediated by Autonomic Function

Portugal90 participantsStarted 2024-01-02

Plain-language summary

Cardiac rehabilitation (CR) is an essential secondary prevention component in the treatment of cardiovascular diseases and one of the most cost- effective clinical interventions. Exercise training (ET) in CR programs (CRP) has unequivocal benefits in the reduction of cardiovascular adverse events, by decreasing the overactivated sympathetic tone. This ET added value can be measured by variables that express autonomic control using indirect (standard) or direct (experimental) methodologies. Direct autonomic assessment (ex. Microneurography) is accurate but unusable in daily practice, whereas standard indirect autonomic assessment using clinical parameters is imprecise, resulting in underprescription to safeguard patient safety, with less benefit to the patients. In this project, we aim to apply Machine Learning models to a set of indirect and direct variables, to make a multivariate correlation analysis and so define a normalization factor for exercise prescription.

Who can participate

Age range18 Years

SexALL

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Inclusion Criteria: * Patients with Coronary artery disease and no heart failure criteria * Patients with non ischaemic heart failure and reduced left ventricle ejection fraction Exclusion Criteria: * patients with ongoing acute coronary syndrome * patients with ongoing acute decompensated heart failure * Severe valvular heart disease that might confound the relationship between exercise and autonomic function. * Severe arrhythmias (e.g., sustained ventricular tachycardia, atrial fibrillation with a rapid ventricular rate) that are symptomatic or untreated * Severe uncontrolled hypertension (e.g., systolic BP \> 180 mmHg or diastolic BP \> 110 mmHg) * Active infectious diseases or other significant acute medical illnesses (e.g., sepsis, active malignancy, acute kidney injury) * Pregnancy or lactation (to ensure safety during exercise interventions) * Significant cognitive impairment or mental illness (e.g., dementia, schizophrenia) that would impair the ability to follow exercise protocols or understand study instructions * nability to comply with study procedures due to any reason (e.g., language barriers, lack of informed consent) * Chronically immunocompromised states (e.g., HIV with CD4 count \< 200 cells/µL or on immunosuppressive therapy) * Presence of significant comorbidities such as advanced chronic obstructive pulmonary disease (COPD), kidney disease (e.g., stage 4-5 chronic kidney disease), or uncontrolled diabetes that would make exercise unsafe or confound the…

What they're measuring

Normalization Factor for Sympathetic Activation Derived from Multimodal Autonomic Assessment

Timeframe: Baseline (before initiation of cardiac rehabilitation program)

Trial details

NCT IDNCT07288840

SponsorInstituto Politécnico de Leiria

Sponsor typeOTHER

Study typeOBSERVATIONAL

Primary completion2025-12