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CompletedNCT02903225REINCAUpdated Sep 16, 2016

Clinical Value of Heart Rate Variability Indexes to Predict Outcomes After Exercise Training in Chronic Heart Failure

A Phase 4 interventional study of Cardiac Rehabilitation in Heart Failure and Systolic Heart Failure, sponsored by Universidad de la Republica. Completed. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2016-09-16.

Primary conditionHeart Failure, SystolicRegistry: Heart FailureReclassifiedWhy we changed it
Registry
Heart Failure — the first condition term the registry derived for this study.
ClinicalTrials.gg
Heart Failure, Systolic
Why
  1. The study's listed conditions name Heart Failure, Systolic, a narrower term within Heart Failure.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Universidad de la Republica · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Controlled exercise training is a valuable therapeutic addition to pharmacological treatment in most patients with chronic heart failure, reducing long-term mortality, preventing cardiac remodeling and improving functional capacity. Despite the mechanism underlying its benefits might be multifactorial, a sustained improvement in autonomic balance is usually attributed as a major effect. Nevertheless, not all eligible subjects show the same response to exercise, probably due to several differences in the subpopulations enrolled. The investigators hypothesize that some Heart Rate Variability indexes could be valid tools to optimize the selection and follow-up of chronic heart failure patients to training

Read the detailed description

Forty subjects followed in a University Heart Failure Management Program were prospectively included. All patients were evaluated before the randomization and after 24 weeks from enrollment. The investigators performed a detailed anamnesis and complete physical examination, Doppler echocardiography, Stress Testing, 6-minute walk test, heart rate variability analysis, and quality of life test. Patients were randomized either to a training group: performing a supervised training program, or a control group receiving usual care. All patients received an optimal pharmacologic treatment including diuretics, angiotensin converting enzyme inhibitors or angiotensin receptor blockers and beta-adrenergic blocking agents. All patients included in the training group attended a supervised program 3-days/week during 24 weeks (68-74 sessions). Physical aerobic training appears to impart beneficial changes in autonomic control of patients with chronic heart failure through both parasympathetic and sympathetic control of hear rate. These effects produce changes in several Heart Rate Variability indices as HF and rMSSD related with parasympathetic tone.

02

Conditions studied

  • Heart Failure
  • Systolic Heart Failure

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Keywords

  • Heart rate variability
  • Systolic heart failure
  • Physical exercise
  • Parasympathetic indexes
03

In context

Heart Failure, Systolic Reclassified

230 studies on the registry are indexed under Heart Failure, Systolic; 51 are open to participants now.

This study's enrollment of 40 is below the median of 60 across 165 interventional studies indexed under Heart Failure, Systolic.

Browse Heart Failure, Systolic studies →

Lead sponsor

Universidad de la Republica is the lead sponsor of 8 studies on the registry; none are open to participants now.

Compared within Heart Failure, Systolic, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Heart Failure. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • subjects followed in a University Heart Failure Management Program
  • maintained sinus rhythm
  • Functional Class (NYHA) I to III and
  • ≤40% documented by echocardiogram
  • optimal pharmacologic treatment

Exclusion criteria

Exclusion Criteria:

  • history of stroke, myocardial infarction or extended anterior myocardial scar
  • revascularization procedures or recurrent angina within previous 3 months
  • orthopedic impairment
  • alcohol or drug abuse;
  • implant of pacemaker or cardioverter-defibrillator (AICD);
  • frequently ventricular dysrhythmias,
  • atrial flutter or fibrillation
  • insulin-dependent diabetes mellitus;
  • severe or renal dysfunction
  • comorbid non-cardiac disease limiting short term survival
  • previous enrollment in an ET program
  • subjects at great propensity for noncompliance
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
40 participants (actual)

Study arms

  • No intervention
    Usual Care

    usual care and no changes in their previous physical activity

  • Active comparator
    Cardiac Rehabilitation

    Exercise Training program on a 3-days/week basis during 24 weeks (68-74 sessions). Each session started with a 10-min warm-up walking period followed by 20-min of breathing exercises and free non-resistance movements of limbs. This stage was followed by pedaling during 20-minutes at a circuit resistance training protocol using a stationary cycle-ergometer. Each session ended with a cool down period (5-minutes) including diverse stretching maneuvers of engaged muscle groups. The initial bicycle-ergometer workload (WL) was defined as 50% of the maximum achieved in the previous stress testing

    Behavioral: Cardiac Rehabilitation

Interventions

  • BehavioralCardiac Rehabilitation

    All patients included in this group attended a supervised exercise training program. A cardiologist supervised the hole training sessions. Blood pressure, pulse rate, oxygen saturation, and body weight were measured in each session. The modified Borg scale was used to measure the perceived exercise intensity

    Also known as: Exercise training, Educational approach

06

What researchers measure

Primary outcomes

  1. Clinical Events

    Change in New York Heart Association Functional Class; Number of hospitalizations 6 months before and after the date of enrollment; temporary or permanent withdrawal from the study protocol (due to persistent atrial or ventricular arrhythmias; worsening of congestive heart failure symptoms; myocardial infarction; unstable angina; need of cardiac interventions: pacemaker, implantable cardioverter defibrillator, coronary revascularization or cardiac transplantation; stroke or transient ischemic attack; severe peripheral intermittent claudication or death observed during training or follow-up sessions

    Time frame: 6 month

  2. Mean heart rate

    the mean value of the12-min Electrocardiogram-recordings was considered the resting heart rate (beats per minute)

    Time frame: 6 month

  3. 6 minute walk test

    walking along a 20-meter long corridor at their own pace, with the aim of covering as much ground as possible in 6 minutes. The distance walked was expressed in meter

    Time frame: 6 month

  4. left ventricular ejection fraction

    The area-length method was measured to obtain biplane left ventricle volumes. Left Ventricle ejection fraction was derived from the standard equation (%)

    Time frame: one year

  5. quality of life

    All the subjects completed the Short-Form 36 Health Survey (SF-36), available in its Spanish version, for measuring physical and mental quality of life

    Time frame: 6 month

  6. Stress Test

    symptom limited exercise testing, measured in metabolic unit (MET)

    Time frame: 6 month

  7. square root of the mean squared successive differences of R-R intervals (rMSSD)

    short-term continuous electrocardiographic recordings were performed for heart rate variability analysis. In the time domain, the square root of the mean squared successive differences of R-R intervals (rMSSD) were calculated. Units: ms

    Time frame: 6 month

  8. Heart rate power high-frequency (HF)

    The high-frequency (HF), from 0.15 to 0.40 Hz of the power spectral analysis were calculated. Units: ms2/Hz

    Time frame: 6 month

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 16, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02903225
Lead sponsor
Universidad de la Republica
Responsible party
Roberto Ricca-Mallada (Medical Doctor, Magister in Science, Universidad de la Republica) — Principal investigator
First posted
Sep 16, 2016
Start date
Apr 2010
Primary completion
Nov 2013
Completion
Nov 2014
Last update
Sep 16, 2016

Study contacts

Roberto Ricca-Mallada, MD MSc
principal investigator · Hospital de Clinicas

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2016. You cannot join it, but the record below documents what was studied.

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