Muscle, Essential Amino Acids, and eXercise in Heart Failure
| Status: | Recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 60 - Any |
| Updated: | 10/27/2017 |
| Start Date: | September 19, 2017 |
| End Date: | December 31, 2019 |
| Contact: | Charlene Robinson |
| Email: | Robinson.Charlene1@mayo.edu |
| Phone: | 480-301-4992 |
Cost-effective Strategies to Improve Rehabilitative Outcomes for Heart Failure Patients With Preserved Ejection Fraction
Half of heart failure patients have preserved ejection fraction (HFpEF). Like patients with
reduced ejection fraction (HFrEF), HFpEF patients suffer from exercise intolerance (low
VO2max), which reduces physical function, quality of life, and survival. Strikingly, there is
no medication proven to increase survival for HFpEF patients. Whereas exercise intolerance in
HFrEF patients is the result of cardiovascular limitations, physical dysfunction in HFpEF
patients is largely the result of peripheral abnormalities in skeletal muscle. Indeed,
research in HFpEF patients identified that physical function and VO2peak are directly related
to leg lean mass, and drugs focused on improving cardiovascular function have failed to
improve VO2peak. Unfortunately, no therapy has been identified for this population that can
concurrently improve cardiovascular and muscle health. The need for improved muscle therapies
is reinforced by the fact that HFpEF patients are commonly older adults who are predisposed
to muscle wasting. Strategic essential amino acid (EAA) ingestion has been shown to improve
the adaptive response of muscle to exercise. Therefore, the investigators will determine, in
HFpEF patients, the extent to which ingesting a strategic mixture of EAAs during an acute
aerobic exercise training program enhances the response to this exercise strategy.
reduced ejection fraction (HFrEF), HFpEF patients suffer from exercise intolerance (low
VO2max), which reduces physical function, quality of life, and survival. Strikingly, there is
no medication proven to increase survival for HFpEF patients. Whereas exercise intolerance in
HFrEF patients is the result of cardiovascular limitations, physical dysfunction in HFpEF
patients is largely the result of peripheral abnormalities in skeletal muscle. Indeed,
research in HFpEF patients identified that physical function and VO2peak are directly related
to leg lean mass, and drugs focused on improving cardiovascular function have failed to
improve VO2peak. Unfortunately, no therapy has been identified for this population that can
concurrently improve cardiovascular and muscle health. The need for improved muscle therapies
is reinforced by the fact that HFpEF patients are commonly older adults who are predisposed
to muscle wasting. Strategic essential amino acid (EAA) ingestion has been shown to improve
the adaptive response of muscle to exercise. Therefore, the investigators will determine, in
HFpEF patients, the extent to which ingesting a strategic mixture of EAAs during an acute
aerobic exercise training program enhances the response to this exercise strategy.
Inclusion Criteria:
- Age 60+ years of age
- Able to communicate meaningfully with the investigator and must be legally competent
to provide written informed consent.
- Diagnosed with HFpEF as per established echocardiographic criteria (New York Heart
Association Class II-III).
Exclusion Criteria:
- Unstable angina, myocardial infarction in the past 4 weeks
- Uncompensated heart failure
- New York Heart Association class IV symptoms, complex ventricular arrhythmias,
symptomatic severe aortic stenosis, acute pulmonary embolus, acute myocarditis,
untreated high-risk proliferative retinopathy, recent retinal hemorrhage, uncontrolled
hypertension, baseline blood screening abnormalities
- Medication non-compliance
- Medical / orthopedic conditions precluding exercise
- Exercise training (>2 weekly sessions of moderate to high intensity aerobic or
resistance exercise)
- Subjects on anti-coagulation medication will not be eligible for the muscle biopsy
procedure, but are deemed eligible for study participation if INR < 3.
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