Chemoreflex Control of Sympathetic Activity in Patients With Coronary Artery Disease

University of Sao Paulo General Hospital

Status: Unknown

Conditions: Obstructive Sleep Apnea (OSA); Coronary Artery Disease (CAD)

Treatments: Other: Aerobic exercise training

Study type: Interventional

Funder types: Other

Identifiers

NCT02624297

CAD-2015/01

Details and patient eligibility

About

The investigators hypothesize that chemoreflex response of muscle sympathetic nerve activity (MSNA) during hypoxia and hypercapnia will be increased in coronary artery disease (CAD) patients and that the presence of obstructive sleep apnea (OSA) will potentiate these responses. And, that the exercise training would decrease the chemoreflex response of MSNA in these patients.

Full description

Forty patients with coronary artery disease, with (n=20) and without (n=20) obstructive sleep apnea will be studied. A healthy control, age-paired group (n=10) will be also evaluated. The patients will be submitted to a polysomnography and randomized for clinical follow-up or exercise training for four months. It will evaluated the autonomic function, chemoreflex control of sympathetic activity during hypoxic and hypercapnic maneuvers, endothelial function and inflammatory markers.

Enrollment: 50 estimated patients

Sex: All

Ages: 35 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Diagnosis of stable coronary artery disease; Age between 35-60 years, male and female; BMI <30 kg/m2 Not involved in a regular exercise program at least three months before the survey;

Exclusion criteria

• Patients with angina and / or ischemia,
• Patients with diabetic neuropathy and / or ischemia of the lower limbs;
• Previous diagnosis of chronic pulmonary, neurological and orthopedic diseases, neoplasia, renal failure and insulin-dependent diabetes mellitus;
• Patients with acute myocardial infarction, cardiac surgery or hospitalization of cardiac origin six months before the study and carriers of pacemaker / implantable defibrillator;
• Patients with cardiac dysfunction (ejection fraction of left ventricle <40%);
• Current smoking and pregnant women.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 5 patient groups

Control Group

No Intervention group

Description:

Healthy control group for comparisons with coronary artery disease groups.

CAD without OSA - Control

No Intervention group

Description:

Clinical follow-up.

CAD without OSA - Intervention

Experimental group

Description:

Aerobic exercise training.

Treatment:

Other: Aerobic exercise training

CAD with OSA - Control

No Intervention group

Description:

Clinical follow-up.

CAD with OSA - Intervention

Experimental group

Description:

Aerobic exercise training.

Treatment:

Other: Aerobic exercise training