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RecruitingNCT05817305ITERUpdated Apr 10, 2025

Integrating Exercise Into Lifestyle of Cardiac Outpatients

An observational study in Cardiovascular Diseases, Physical Inactivity and Aging, sponsored by Università degli Studi di Ferrara. Recruiting at 1 site in Italy. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-04-10.

Sponsored by Università degli Studi di Ferrara · Observational

From the registry’s dates

  • Started Jan 1997; still recruiting 29 years 9 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
5,000
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of the study is to investigate the long-term effects of a personalized physical activity program on exercise capacity and quality of life in patients with stable cardiovascular disease. The analysis also intends to evaluate the prognostic value of cardiovascular function estimated through a walking test (1km Treadmill Walking Test, 1k-TWT) in relation to survival, hospitalization, and medical costs. The program considers clinical, socio-economic, and behavioural aspects, psychological support, and risk factor control. Patients receive indications for carrying out a home training program based on the performance of moderate-intensity aerobic activity at least 3-4 days a week for at least 30-60 minutes a day. All patients are also encouraged to improve their daily habits by preferring a more active lifestyle both at home and at work.

Read the detailed description

BACKGROUND: Physical activity and cardiorespiratory fitness are considered major markers of cardiovascular risk and core components of secondary prevention programs for cardiovascular diseases (CVD). The benefits of regular physical activity are well-recognized both for men and women and are inversely associated with mortality risk and the incidence of many chronic diseases. Despite the efforts of many health organizations to increase awareness of this evidence, physical inactivity and low cardiorespiratory fitness remain overlooked risk factors. Directly measured peak oxygen consumption (VO2peak) determined during maximal incremental cardiopulmonary exercise testing (CPX) is the gold standard objective measure of cardiorespiratory fitness. However, because of physical, financial, and time limitations, a direct determination is often not routinely assessed in clinical settings. Submaximal exercise testing can be a viable alternative to CPX. These tests are more practical for examining older adults or a large patient cohort. Also, they are helpful in defining functional limitations, setting up appropriate physical activity programs, and assessing the outcomes of pharmacological treatments.

RATIONALE AND OBJECTIVE OF THE STUDY: The benefits of regular physical activity are well-recognized both for men and women and are inversely associated with mortality risk and the incidence of many chronic diseases. The purpose of this observational registry is to evaluate the efficacy of an exercise-based secondary prevention program among male and female outpatients with stable cardiovascular disease.

DESCRIPTION OF THE FUNCTIONAL EVALUATION: During each session, information about weight, height, body mass index (BMI), blood pressure, cardiometabolic risk factors, and drug therapy in progress are registered. Physical activity habits are assessed using the Seven-Day Physical Activity Recall questionnaire. In addition, patients complete a sub-maximal test of 1km treadmill walking (1k-TWT), which is performed at a moderate intensity and adjusted according to the patient's perception of fatigue. Patients unable to complete the test at a walking speed ≥ 3.0 km/h can perform the test over 500m or 200m. Based on the results of the test, patients receive indications for the proper execution of a home training program, (i.e., at the same effort perceived in the test). The activity should be done at least 3-4 times per week, preferably every day, for at least 30-60 minutes. All patients are also encouraged to improve their daily habits by opting for a more active lifestyle at home and at work. Written informed consent is required from all participants at the time of enrollment.

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Conditions studied

  • Cardiovascular Diseases
  • Physical Inactivity
  • Aging
  • Quality of Life
  • Physician-Patient Relations

Keywords

  • Cardiovascular disease
  • Physical activity
  • Epidemiology
  • Cardiorespiratory fitness
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In context

Cardiovascular Diseases

4,904 studies on the registry are indexed under Cardiovascular Diseases; 919 are open to participants now.

This study's planned enrollment of 5,000 is above the median of 573 across 1,485 observational studies indexed under Cardiovascular Diseases.

Browse Cardiovascular Diseases studies →

Lead sponsor

Università degli Studi di Ferrara is the lead sponsor of 64 studies on the registry; 10 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

male and female outpatients with stable cardiovascular disease involved in an exercise-based secondary prevention program.

Inclusion criteria

  • the presence of one or more previous cardiovascular events

Exclusion criteria

Exclusion Criteria:

  • Ejection fraction \< 30%
  • Chronic heart failure NYHA III-IV
  • Severe aortic or mitral valvulopathy
  • Severe physical or cognitive impairment
  • Exercise-induced complex arrhythmias
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
5,000 participants (estimated)
Target follow-up
10 Years
Patient registry
Yes

Groups and cohorts

  • Cardiac outpatients

    Patients with stable cardiovascular disease who have been referred to the service by their general practitioner or cardiologist

    Other: Medical history and functional evaluation · Other: Health education

Interventions

  • OtherMedical history and functional evaluation

    During each session, physical parameters are measured and data on medical history and physical activity are collected. To assess cardiorespiratory fitness, all patients complete a submaximal, moderate, and perceptually regulated treadmill walking test (1k-TWT). Patients unable to complete the test at a walking speed ≥ 3.0 km/h perform the test over 500m or 200m.

  • OtherHealth education

    Patients receive recommendations for risk factor management as well as continuous motivational counselling in order to develop and maintain a stable active lifestyle.

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What researchers measure

Primary outcomes

  1. Mortality

    Association of all-cause mortality and cause-specific death with exercise capacity

    Time frame: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

Secondary outcomes

  1. Hospitalization

    Association of cause-specific hospitalization with exercise capacity

    Time frame: From date of enrollment until the first hospitalization (any hospital admission is considered an event), assessed up to 12 years

  2. Peak Oxygen Uptake (VO2peak)

    Measurement of cardiorespiratory fitness, reported as ml/kg/min and estimated through a moderate and perceptually regulated 1km treadmill walk test (1k-TWT) or through related short-forms (500m or 200m)

    Time frame: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

  3. Leisure time physical activity levels

    Measurement of physical activity levels, reported as MET/h-week and estimated through the 7-day physical activity recall questionnaire

    Time frame: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

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Study locations

1 of 1 sites recruiting
  • Center for Exercise Science and Sport
    Ferrara, 44123, Italy
    • Giovanni Grazzi, Professor · Contact · giovanni.grazzi@unife.it · +39 0535455963
    • Andrea Raisi, MSc · Contact · andrea.raisi@unife.it · +39 0535455963
    • Giovanni Grazzi, Professor · Principal investigator
    • Gianni Mazzoni, Professor · Sub investigator
    • Simona Mandini, PhD · Sub investigator
    • Andrea Raisi, MSc · Sub investigator
    • Tommaso Piva, MSc · Sub investigator
    • Valentina Zerbini, MSc · Sub investigator
    • Sabrina Masotti, PhD · Sub investigator
    Recruiting
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References and documents

Publications

  • Chiaranda G, Myers J, Mazzoni G, Terranova F, Bernardi E, Grossi G, Codeca L, Conconi F, Grazzi G. Peak oxygen uptake prediction from a moderate, perceptually regulated, 1-km treadmill walk in male cardiac patients. J Cardiopulm Rehabil Prev. 2012 Sep-Oct;32(5):262-9. doi: 10.1097/HCR.0b013e3182663507. PubMed 22936157 ↗
  • Chiaranda G, Bernardi E, Codeca L, Conconi F, Myers J, Terranova F, Volpato S, Mazzoni G, Grazzi G. Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study. BMJ Open. 2013 Oct 25;3(10):e003446. doi: 10.1136/bmjopen-2013-003446. PubMed 24163203 ↗
  • Grazzi G, Myers J, Bernardi E, Terranova F, Grossi G, Codeca L, Volpato S, Conconi F, Mazzoni G, Chiaranda G. Association between VO(2) peak estimated by a 1-km treadmill walk and mortality. A 10-year follow-up study in patients with cardiovascular disease. Int J Cardiol. 2014 May 1;173(2):248-52. doi: 10.1016/j.ijcard.2014.02.039. Epub 2014 Feb 28. PubMed 24630380 ↗
  • Grazzi G, Mazzoni G, Myers J, Codeca L, Pasanisi G, Napoli N, Guerzoni F, Volpato S, Conconi F, Chiaranda G. Improved walking speed is associated with lower hospitalisation rates in patients in an exercise-based secondary prevention programme. Heart. 2016 Dec 1;102(23):1902-1908. doi: 10.1136/heartjnl-2015-309126. Epub 2016 Jul 7. PubMed 27390367 ↗
  • Uliari S, Myers J, Bernardi E, Chiaranda G, Conconi F, Terranova F, Mazzoni G, Grazzi G. Oxygen Uptake Attenuation at Ventilatory Threshold in Men With Coronary Artery Disease. J Cardiopulm Rehabil Prev. 2016 Jul-Aug;36(4):258-62. doi: 10.1097/HCR.0000000000000160. PubMed 27120036 ↗
  • Mandini S, Grazzi G, Mazzoni G, Myers J, Pasanisi G, Sassone B, Conconi F, Chiaranda G. A moderate 1-km treadmill walk predicts mortality in men with mid-range left ventricular dysfunction. Eur J Prev Cardiol. 2017 Oct;24(15):1670-1672. doi: 10.1177/2047487317722434. Epub 2017 Jul 21. No abstract available. PubMed 28728484 ↗
  • Grazzi G, Chiaranda G, Myers J, Pasanisi G, Lordi R, Conconi F, Mazzoni G. Outdoor Reproducibility of a 1-km Treadmill Walking Test to Predict Peak Oxygen Uptake in Cardiac Patients. J Cardiopulm Rehabil Prev. 2017 Sep;37(5):347-349. doi: 10.1097/HCR.0000000000000266. PubMed 28671933 ↗
  • Mazzoni G, Sassone B, Pasanisi G, Myers J, Mandini S, Volpato S, Conconi F, Chiaranda G, Grazzi G. A moderate 500-m treadmill walk for estimating peak oxygen uptake in men with NYHA class I-II heart failure and reduced left ventricular ejection fraction. BMC Cardiovasc Disord. 2018 Apr 16;18(1):67. doi: 10.1186/s12872-018-0801-9. PubMed 29661150 ↗
  • Mazzoni G, Chiaranda G, Myers J, Sassone B, Pasanisi G, Mandini S, Volpato S, Conconi F, Grazzi G. 500-meter and 1000-meter moderate walks equally assess cardiorespiratory fitness in male outpatients with cardiovascular diseases. J Sports Med Phys Fitness. 2018 Sep;58(9):1312-1317. doi: 10.23736/S0022-4707.17.07525-9. Epub 2017 Sep 29. PubMed 28967238 ↗
  • Grazzi G, Mazzoni G, Myers J, Codeca L, Pasanisi G, Mandini S, Piepoli M, Volpato S, Conconi F, Chiaranda G. Determining the best percent-predicted equation for estimated VO2 peak by a 1-km moderate perceptually-regulated treadmill walk to predict mortality in outpatients with cardiovascular disease. J Sci Med Sport. 2018 Mar;21(3):307-311. doi: 10.1016/j.jsams.2017.06.003. Epub 2017 Jun 8. PubMed 28645496 ↗
  • Grazzi G, Mazzoni G, Myers J, Caruso L, Sassone B, Pasanisi G, Guerzoni F, Napoli N, Pizzolato M, Zerbini V, Franchi M, Masotti S, Mandini S, Raisi A, Chiaranda G. Impact of Improvement in Walking Speed on Hospitalization and Mortality in Females with Cardiovascular Disease. J Clin Med. 2020 Jun 5;9(6):1755. doi: 10.3390/jcm9061755. PubMed 32517001 ↗
  • Mazzoni G, Myers J, Sassone B, Pasanisi G, Mandini S, Raisi A, Pizzolato M, Franchi M, Caruso L, Missiroli L, Chiaranda G, Grazzi G. A moderate 200-m walk test estimates peak oxygen uptake in elderly outpatients with cardiovascular disease. J Sports Med Phys Fitness. 2020 May;60(5):786-793. doi: 10.23736/S0022-4707.20.10387-6. PubMed 32438791 ↗
  • Bonnini S, Mazzoni G, Borghesi M, Chiaranda G, Myers J, Mandini S, Raisi A, Masotti S, Grazzi G. Improving walking speed reduces hospitalization costs in outpatients with cardiovascular disease. An analysis based on a multistrata non-parametric test. BMC Health Serv Res. 2020 Nov 17;20(1):1048. doi: 10.1186/s12913-020-05874-3. PubMed 33203408 ↗
  • Chiaranda G, Myers J, Arena R, Kaminsky L, Sassone B, Pasanisi G, Mandini S, Mazzoni G, Grazzi G. Prognostic comparison of the FRIEND and Wasserman/Hansen peak VO2 equations applied to a submaximal walking test in outpatients with cardiovascular disease. Eur J Prev Cardiol. 2021 Apr 23;28(3):287-292. doi: 10.1177/2047487319871728. Epub 2019 Aug 26. PubMed 33891689 ↗
  • Zerbini V, Raisi A, Myers J, Piva T, Lordi R, Chiaranda G, Mazzoni G, Grazzi G, Mandini S. Peak Oxygen Uptake Estimation From A Moderate 1-KM Treadmill Walk in Women With Cardiovascular Disease. J Cardiopulm Rehabil Prev. 2021 Nov 1;41(6):432-434. doi: 10.1097/HCR.0000000000000641. No abstract available. PubMed 34727562 ↗
  • Raisi A, Zerbini V, Myers J, Masotti S, Piva T, Lordi R, Chiaranda G, Grazzi G, Mazzoni G, Mandini S. Moderate walking speed and survival association across 23-years follow-up in female patients with cardiovascular disease. Int J Cardiol. 2023 Jan 15;371:371-376. doi: 10.1016/j.ijcard.2022.09.014. Epub 2022 Sep 9. PubMed 36089160 ↗
  • Raisi A, Piva T, Myers J, Lordi R, Zerbini V, Masotti S, Chiaranda G, Grazzi G, Mazzoni G, Mandini S. A Moderate Walking Test Predicts Survival in Women With Cardiovascular Disease. Am J Prev Med. 2023 Sep;65(3):497-504. doi: 10.1016/j.amepre.2023.02.025. Epub 2023 Mar 5. PubMed 36871638 ↗

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 10, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05817305
Lead sponsor
Università degli Studi di Ferrara
Responsible party
Giovanni Grazzi, MD (Professor, Università degli Studi di Ferrara) — Principal investigator
First posted
Apr 18, 2023
Start date
Jan 1, 1997
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2047 (estimated)
Last update
Apr 10, 2025

Study contacts

Giovanni Grazzi, Professor
Contact
giovanni.grazzi@unife.it
+39 0535455963
Gianni Mazzoni, Professor
study director · Università degli Studi di Ferrara
Giovanni Grazzi, Professor
principal investigator · Università degli Studi di Ferrara

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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