Effects of Normobaric Hypoxia During Exercise in Patients With Pulmonary Hypertension Receiving Sildenafil (HEXASH)
Primary Purpose
Hypertension, Pulmonary
Status
Completed
Phase
Not Applicable
Locations
Switzerland
Study Type
Interventional
Intervention
Normobaric hypoxia (FiO2 15%) under Sildenafil
Normobaric hypoxia (FiO2 15%)
Sponsored by
About this trial
This is an interventional treatment trial for Hypertension, Pulmonary focused on measuring hypoxia, exercise, blood markers
Eligibility Criteria
Inclusion Criteria:
- Informed consent as documented by signature (Appendix Informed Consent Form)
- PH class I (PAH) or IV (CTEPH) diagnosed according to guidelines: mean pulmonary artery pressure >20 mmHg, pulmonary vascular resistance ≥3 wood units, pulmonary arterial wedge pressure ≤15 mmHg during baseline measures at the diagnostic right-heart catheterization
Exclusion Criteria:
- resting partial pressure of oxygen <8 kilopascal at Zürich altitude on ambient air
- exposure to an altitude >1000 m for ≥3 nights during the last 2 weeks before the study
- inability to follow the procedures of the study
- patients who take nitrates
- other clinically significant concomitant end-stage disease (e.g., renal failure, hepatic dysfunction)
Sites / Locations
- UniversityHospital Zurich, Department of Pulmonology
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Normobaric hypoxia (FiO2 15%) under Sildenafil
Normobaric hypoxia (FiO2 15%)
Arm Description
Inhalation of deoxygenated air through an altitude simulator ("Altitrainer"), for approx. 1/2 hour. given by a facemask, first at rest and then during exercise under Sildenafil.
Inhalation of deoxygenated air through an altitude simulator ("Altitrainer"), for approx. 1/2 hour given by a facemask, first at rest and then during exercise.
Outcomes
Primary Outcome Measures
mean pulmonary artery pressure (mPAP) / cardiac output (CO)
Difference in mPAP/CO during exercise between tests under normoxia with/without Sildenafil
Secondary Outcome Measures
Differences in pulmonary arterial pressure
Differences in pulmonary arterial pressure at rest and during exercise with/without Sildenafil
Differences in cardiac output
Differences in cardiac output at rest and during exercise with/without Sildenafil
Differences in pulmonary vascular resistance
Differences in pulmonary vascular resistance at rest and during exercise with/without Sildenafil
Differences in pulmonary artery wedge pressure
Differences in pulmonary artery wedge pressure at rest and during exercise with/without Sildenafil
Differences in right atrial pressure
Differences in right atrial pressure at rest and during exercise with/without Sildenafil
Differences in mixed venous oxygen saturation
Differences in mixed venous oxygen saturation at rest and during exercise with/without Sildenafil
Differences in heart rate
Differences in heart rate at rest and during exercise with/without Sildenafil
Differences in blood pressure
Differences in blood pressure at rest and during exercise with/without Sildenafil
Differences in oxygen saturation
Differences in oxygen saturation at rest and during exercise with/without Sildenafil
Differences in arterial blood gases
Differences in arterial blood gases at rest and during exercise with/without Sildenafil
Differences in mixed venous blood gases
Differences in mixed venous blood gases at rest and during exercise with/without Sildenafil
Differences in cerebral tissue oxygenation
Differences in cerebral tissue oxygenation at rest and during exercise with/without Sildenafil
Differences in muscle tissue oxygenation
Differences in muscle tissue oxygenation at rest and during exercise with/without Sildenafil
Differences in symptoms (Borg dyspnoea)
Differences in symptoms (Borg dyspnoea) at rest and during exercise with/without Sildenafil
Differences in symptoms (Borg leg effort)
Differences in symptoms (Borg leg effort) at rest and during exercise with/without Sildenafil
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04697862
Brief Title
Effects of Normobaric Hypoxia During Exercise in Patients With Pulmonary Hypertension Receiving Sildenafil
Acronym
HEXASH
Official Title
Hemodynamic Effects of Acute Normobaric Hypoxia During Exercise in Patients With Pulmonary Hypertension: Single-center Randomized Controlled Trial
Study Type
Interventional
2. Study Status
Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
February 1, 2021 (Actual)
Primary Completion Date
May 31, 2023 (Actual)
Study Completion Date
May 31, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Zurich
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
To study the effect of acute normobaric hypoxia during exercise in patients with pulmonary hypertension with/without Sildenafil
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension, Pulmonary
Keywords
hypoxia, exercise, blood markers
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Participant
Allocation
Randomized
Enrollment
24 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Normobaric hypoxia (FiO2 15%) under Sildenafil
Arm Type
Experimental
Arm Description
Inhalation of deoxygenated air through an altitude simulator ("Altitrainer"), for approx. 1/2 hour. given by a facemask, first at rest and then during exercise under Sildenafil.
Arm Title
Normobaric hypoxia (FiO2 15%)
Arm Type
Experimental
Arm Description
Inhalation of deoxygenated air through an altitude simulator ("Altitrainer"), for approx. 1/2 hour given by a facemask, first at rest and then during exercise.
Intervention Type
Other
Intervention Name(s)
Normobaric hypoxia (FiO2 15%) under Sildenafil
Intervention Description
Inhalation of deoxygenated air through an altitude simulator ("Altitrainer"), for approx. 1/2 hour. given by a facemask, first at rest and then during exercise under Sildenafil.
Intervention Type
Other
Intervention Name(s)
Normobaric hypoxia (FiO2 15%)
Intervention Description
Inhalation of deoxygenated air through an altitude simulator ("Altitrainer"), for approx. 1/2 hour given by a facemask, first at rest and then during exercise.
Primary Outcome Measure Information:
Title
mean pulmonary artery pressure (mPAP) / cardiac output (CO)
Description
Difference in mPAP/CO during exercise between tests under normoxia with/without Sildenafil
Time Frame
4 hours
Secondary Outcome Measure Information:
Title
Differences in pulmonary arterial pressure
Description
Differences in pulmonary arterial pressure at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in cardiac output
Description
Differences in cardiac output at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in pulmonary vascular resistance
Description
Differences in pulmonary vascular resistance at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in pulmonary artery wedge pressure
Description
Differences in pulmonary artery wedge pressure at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in right atrial pressure
Description
Differences in right atrial pressure at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in mixed venous oxygen saturation
Description
Differences in mixed venous oxygen saturation at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in heart rate
Description
Differences in heart rate at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in blood pressure
Description
Differences in blood pressure at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in oxygen saturation
Description
Differences in oxygen saturation at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in arterial blood gases
Description
Differences in arterial blood gases at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in mixed venous blood gases
Description
Differences in mixed venous blood gases at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in cerebral tissue oxygenation
Description
Differences in cerebral tissue oxygenation at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in muscle tissue oxygenation
Description
Differences in muscle tissue oxygenation at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in symptoms (Borg dyspnoea)
Description
Differences in symptoms (Borg dyspnoea) at rest and during exercise with/without Sildenafil
Time Frame
4 hours
Title
Differences in symptoms (Borg leg effort)
Description
Differences in symptoms (Borg leg effort) at rest and during exercise with/without Sildenafil
Time Frame
4 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Informed consent as documented by signature (Appendix Informed Consent Form)
PH class I (PAH) or IV (CTEPH) diagnosed according to guidelines: mean pulmonary artery pressure >20 mmHg, pulmonary vascular resistance ≥3 wood units, pulmonary arterial wedge pressure ≤15 mmHg during baseline measures at the diagnostic right-heart catheterization
Exclusion Criteria:
resting partial pressure of oxygen <8 kilopascal at Zürich altitude on ambient air
exposure to an altitude >1000 m for ≥3 nights during the last 2 weeks before the study
inability to follow the procedures of the study
patients who take nitrates
other clinically significant concomitant end-stage disease (e.g., renal failure, hepatic dysfunction)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Silvia Ulrich, Prof. Dr.
Organizational Affiliation
UniversityHospital Zurich, Department of Pulmonology
Official's Role
Principal Investigator
Facility Information:
Facility Name
UniversityHospital Zurich, Department of Pulmonology
City
Zurich
ZIP/Postal Code
8091
Country
Switzerland
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
We will share individual participant data after publication of the manuscript. The decision about the platform is ongoing.
IPD Sharing Time Frame
After publication of the manuscript.
Learn more about this trial
Effects of Normobaric Hypoxia During Exercise in Patients With Pulmonary Hypertension Receiving Sildenafil
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