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Trial registered on ANZCTR
Registration number
ACTRN12618001487202
Ethics application status
Approved
Date submitted
23/08/2018
Date registered
5/09/2018
Date last updated
5/09/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Abnormal heart rate recovery after exercise and excessive accumulation of fat around the heart in obese patients with sleep breathing disorders
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Scientific title
Blunted heart rate recovery and epicardial fat accumulation in obese patients with obstructive sleep apnea
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Secondary ID [1]
295882
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None
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Universal Trial Number (UTN)
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Trial acronym
OSASEAT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
obese
309347
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obstructive sleep apnea
309348
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epicardial fat
309349
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Condition category
Condition code
Cardiovascular
308212
308212
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
1
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Target follow-up type
Days
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Description of intervention(s) / exposure
Obese patients BMI >30 will be enrolled to perform polysomnography test, cardio-pulmonary exercise testing and echocardiography. Relationship between heart rate recovery, epicardial fat thickness and obstructive sleep apnea will be studied.
Cardiopulmonary exercise testing was performed according to standardized procedures using an electromagnetic braked cycle ergometer. by cardiologists experienced in exercise physiology.
Exercise protocol involved an initial 3 minutes of rest, followed by unloaded cycling for 2 minutes of unload cycling with a progressively increment every minute (10 watt/minute) until exhaustion at a pedaling frequency of 60-65 rpm. Subjects were continuously monitored using 12-lead ECG (Case, GE Healthcare, France). Blood pressure assessed were recorded every 2-minutes. Subjects respired through an oro-nasal mask (Hans Rudolf 7450 SeriesV2™ Mask, CareFusion, France). Breath-by-breath cardiopulmonary data (PowerCube-Ergo, Ganshorn Medizin Electronic GmbH, Niederlauer, Germany) were measured at rest, warm up and incremental exercise testing. Before each test, oxygen (O2) and carbon dioxide (CO2) analyzers and flow mass sensor were calibrated using available precision gas mixture and a 3-L syringe, respectively. Minute ventilation (VE), oxygen uptake (VO2), carbon dioxide output (VCO2) were recorded as concurrent 10-s moving averages, as was determined ventilation anaerobic threshold by the V-slope method. Ventilatory reserve was calculated as (MVV – peak VE) / MVV * 100, where MVV is maximal voluntary ventilation estimated as FEV1 multiplied by 35. Peak values were averaged over the last 30 s of exercise. Patient effort was considered to be maximal if two of the following occurred: predicted maximal work is achieved, predicted maximal heart rate (HR) is achieved, VE/VO2 > 45 and RER > 1.10, as recommended by the ATS/ACCP. At peak exercise, subjects assessed Borg-perceived exertion ratings for both respiratory and leg discomfort. During the study period, mean values between qualified replicate tests performed weekly on control subjects were 3.1 ± 4.2 %, 3.4 ± 3.2 %, 2.1 ± 2.2 %, for peak VO2, VCO2 and VE, respectively. Peak oxygen pulse (O2 pulse) was calculated and was expressed in mL per beat and as percentage of predicted value by dividing the predicted peak VO2 by predicted peak HR. VE/VCO2 slope was calculated off-line as a linear regression function using 10-s averaged values and excluding the non-linear part of the relationship after the respiratory compensation point (where non-linear rise in V’E occurred relative to VCO2 in the presence of decrease of end-tidal pressure of CO2). The percentage of HR reserve used at peak exercise referred to [(HRstage-HRrest) / (220-age in years-HRrest)] * 100, where HR is heart rate. Heart rate recovery was defined as the change in heart rate from peak exercise to 1 minute (HRR-1) and 3 minutes (HRR-3) later.
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Intervention code [1]
312213
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Not applicable
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Comparator / control treatment
control group will be obese patients without obstructive sleep apnea syndrome
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
307183
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Epicardial adipose tissue (EAT) is the primary outcome. EAT is evaluated by the mean of thickness measurements obtained during echocardiography examination
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Assessment method [1]
307183
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Timepoint [1]
307183
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At inclusion
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Secondary outcome [1]
351023
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Heart rate is measured during recovery, one and three minutes following maximal exercise.
Subjects were continuously monitored using 12-lead ECG (Case, GE Healthcare, France) during exercise testing and recovery. Heart rate were measured from ECG tracings.
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Assessment method [1]
351023
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Timepoint [1]
351023
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at inclusion
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Secondary outcome [2]
351024
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obstructive sleep apnea is evalaution during polysomnography evaluation and its severity is characterized by apnea hyponea index (AHI) and oxygen desaturatio index (ODI).
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Assessment method [2]
351024
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Timepoint [2]
351024
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at inclusion
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Eligibility
Key inclusion criteria
obese BMI > 30
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
macrovascular sequellea of metabolic syndrome, such as hypertension, heart failure, coronary artery disease, renal failure
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
group comparison and logistic regression
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/08/2016
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Date of last participant enrolment
Anticipated
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Actual
1/08/2018
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Date of last data collection
Anticipated
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Actual
1/08/2018
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Sample size
Target
35
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Accrual to date
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Final
37
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Recruitment outside Australia
Country [1]
20796
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France
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State/province [1]
20796
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Martinique
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Funding & Sponsors
Funding source category [1]
300480
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University
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Name [1]
300480
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University of Antilles
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Address [1]
300480
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Université des Antilles Campus de Schoelcher, Martinique
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Country [1]
300480
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France
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Primary sponsor type
Hospital
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Name
CHU Martinique
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Address
CHU Martinique, CS 90632 Fort de France, F-97200, France
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Country
France
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Secondary sponsor category [1]
299951
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University
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Name [1]
299951
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Université Antilles
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Address [1]
299951
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Campus de Fouillole 97110 Pointe-à-Pitre, Guadeloupe,
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Country [1]
299951
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France
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301281
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CNIL
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Ethics committee address [1]
301281
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Ethics committee country [1]
301281
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France
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Date submitted for ethics approval [1]
301281
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15/05/2016
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Approval date [1]
301281
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15/07/2016
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Ethics approval number [1]
301281
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Summary
Brief summary
Considering that obese patients with obstructive sleep apnea syndrome (OSA) and increases epicardial adipose tissue (EAT) thickness display sympathetic over activation at baseline conditions, we sought to investigate the effect of this autonomic dysfunction on HRR. Whereas several studies have demonstrated attenuated heart rate recovery (HRR) in obese patients with either OSA or EAT accumulation, whether overlap of both conditions may further impair HRR has not been previously reported. The main objective of our study was to test whether post-exercise HRR in obese patients would be independently associated with OSA condition and EAT increase.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
86474
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Prof REMI NEVIERE
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Address
86474
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CHU Martinique Department of Cardiology , F-97200 Fort de France,
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Country
86474
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France
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Phone
86474
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+33596553524
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Fax
86474
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+33596553525
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Email
86474
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[email protected]
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Contact person for public queries
Name
86475
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REMI NEVIERE
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Address
86475
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CHU Martinique Department of Cardiology , F-97200 Fort de France,
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Country
86475
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France
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Phone
86475
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+33596553524
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Fax
86475
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+33596553525
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Email
86475
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[email protected]
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Contact person for scientific queries
Name
86476
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REMI NEVIERE
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Address
86476
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CHU Martinique Department of Cardiology , F-97200 Fort de France,
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Country
86476
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France
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Phone
86476
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+33596553524
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Fax
86476
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+33596553525
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Email
86476
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Epicardial fat accumulation is an independent marker of impaired heart rate recovery in obese patients with obstructive sleep apnea.
2019
https://dx.doi.org/10.1007/s00392-019-01454-6
N.B. These documents automatically identified may not have been verified by the study sponsor.
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