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Exercise Training in Barth Syndrome

Primary Purpose

Barth Syndrome

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Exercise training
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Barth Syndrome focused on measuring Barth syndrome, cardiomyopathy, mitochondria, cardiolipin

Eligibility Criteria

15 Years - 30 Years (Child, Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 15-30 years
  2. Sedentary (exercises less than 2x/wk)
  3. Motivated to exercise
  4. Stable on medications for ≥ 3 months
  5. Lives in North America.
  6. Planning on attending the Barth Syndrome International Conference in July 2010.

Exclusion Criteria:

  1. Unstable heart disease
  2. Any concurrent disease that may contraindicate exercise testing and training.
  3. Cardiac transplantation

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Exercise training

    Arm Description

    Aerobic exercise training 45-60 min/3x/week/12 weeks

    Outcomes

    Primary Outcome Measures

    Peak oxygen consumption
    peak oxygen consumption measured by indirect calorimetry

    Secondary Outcome Measures

    Cardiac output
    cardiac output measured by echocardiography
    muscle oxygen extraction
    skeletal muscle oxygen extraction measured by near infrared spectroscopy

    Full Information

    First Posted
    August 30, 2010
    Last Updated
    January 6, 2017
    Sponsor
    Washington University School of Medicine
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01194141
    Brief Title
    Exercise Training in Barth Syndrome
    Official Title
    Safety and Efficacy of Aerobic Exercise Training in Barth Syndrome
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2010 (undefined)
    Primary Completion Date
    December 2013 (Actual)
    Study Completion Date
    December 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Washington University School of Medicine

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Barth syndrome (BTHS) is a genetic disease that results in heart failure, muscle weakness and exercise intolerance. Several studies in non-BTHS heart failure suggest that endurance exercise training is beneficial in improving exercise intolerance, heart function and quality of life in young men with BTHS. This study will examine the effects of Endurance (i.e. aerobic) exercise training on exercise tolerance, heart function, and quality of life in adolescents and young adults with BTHS. We hypothesize that 3 months of endurance training will improve exercise tolerance, heart function and quality of life in adolescents and young men with BTHS.
    Detailed Description
    Barth Syndrome (BTHS) is an X-linked disorder characterized by severe mitochondrial dysfunction, skeletal and cardiomyopathy and growth retardation. The investigators have recently found severe exercise intolerance in adolescents with BTHS that was mediated by impaired skeletal muscle oxygen extraction and utilization. Previous evidence from other mitochondrial pathologies demonstrated that chronic aerobic exercise training enhanced mitochondrial biogenesis, improved skeletal muscle oxygen extraction/utilization, exercise tolerance and quality of life in these individuals. Chronic aerobic exercise training also improved left ventricular and cardio-autonomic function and decreased the occurrence of arrhythmias in non-Barth heart failure and arrhythmia human and animal models. Currently it is unknown if chronic aerobic exercise training is effective in improving left ventricular function, skeletal muscle mitochondrial biogenesis and oxygen extraction/utilization, exercise tolerance, cardio-autonomic function and quality of life in those with BTHS; a condition containing characteristics consistent with both mitochondrial myopathy and heart failure. Establishing the safety and efficacy of aerobic exercise training in BTHS could lead to clinical recommendations of regular exercise training for the standard of care treatment of individuals with BTHS. It may also provide novel mechanistic information about the adaptability of muscle mitochondria in BTHS. Therefore, the overall objective of the pilot/feasibility/proof-of-concept proposal is to collect preliminary data on the following hypothesis: Supervised aerobic exercise training (3x/wk, 20-45 min, 12 wks) will improve skeletal muscle oxygen extraction/utilization, left ventricular function, peak exercise tolerance, cardio-autonomic function and quality of life, and will be found safe in adolescents and young adults with BTHS. The investigators aim to address these hypotheses through left ventricular function, skeletal muscle oxygen extraction/utilization, and whole body oxygen consumption measurements during a graded exercise test at baseline and following a 3 month supervised aerobic exercise training program in 5 BTHS patients (ages 15-30 yrs). Cardio-autonomic function will be examined using post-exercise heart rate recovery measurements obtained at baseline and after the 12 wk intervention. Supervised exercise training programs will be uniformly designed, but individualized and performed at a hospital based physical therapy or cardiac rehabilitation facility near the participant's home. Left ventricular function will be examined using 2-D, Doppler and Tissue Doppler echocardiography, skeletal muscle oxygen extraction/utilization will be measured using near infrared spectroscopy, whole body oxygen consumption will be measured using indirect calorimetry, cardio-autonomic function will be measured using electrocardiography and quality of life will be measured by the Minnesota Living with Heart Failure Questionnaire (MLWHFQ). The investigators expect to find that exercise training is safe in BTHS, and effectively improves cardiac and skeletal muscle function and quality of life. Preliminary data from this proposal will be used in larger federal or association grant applications examining the cardiovascular, musculo-skeletal and autonomic effects of chronic aerobic exercise training in BTHS.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Barth Syndrome
    Keywords
    Barth syndrome, cardiomyopathy, mitochondria, cardiolipin

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    4 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Exercise training
    Arm Type
    Experimental
    Arm Description
    Aerobic exercise training 45-60 min/3x/week/12 weeks
    Intervention Type
    Behavioral
    Intervention Name(s)
    Exercise training
    Intervention Description
    aerobic exercise training, 45-60 minutes, 3x/week, 12 weeks (3-months)
    Primary Outcome Measure Information:
    Title
    Peak oxygen consumption
    Description
    peak oxygen consumption measured by indirect calorimetry
    Time Frame
    Enrollment and 3 months
    Secondary Outcome Measure Information:
    Title
    Cardiac output
    Description
    cardiac output measured by echocardiography
    Time Frame
    Enrollment and 3 months
    Title
    muscle oxygen extraction
    Description
    skeletal muscle oxygen extraction measured by near infrared spectroscopy
    Time Frame
    Enrollment and 3 months

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    15 Years
    Maximum Age & Unit of Time
    30 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age 15-30 years Sedentary (exercises less than 2x/wk) Motivated to exercise Stable on medications for ≥ 3 months Lives in North America. Planning on attending the Barth Syndrome International Conference in July 2010. Exclusion Criteria: Unstable heart disease Any concurrent disease that may contraindicate exercise testing and training. Cardiac transplantation
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    William T Cade, PT, PhD
    Organizational Affiliation
    Washington University School of Medicine
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    27295193
    Citation
    Cade WT, Reeds DN, Peterson LR, Bohnert KL, Tinius RA, Benni PB, Byrne BJ, Taylor CL. Endurance Exercise Training in Young Adults with Barth Syndrome: A Pilot Study. JIMD Rep. 2017;32:15-24. doi: 10.1007/8904_2016_553. Epub 2016 Jun 11.
    Results Reference
    result
    Links:
    URL
    http://www.barthsyndrome.org
    Description
    Related Info

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