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De Wilde C, Bekhuis Y, Kuznetsova T, Claes J, Claessen G, Coninx K, Decorte E, De Smedt D, Hansen D, Lannoo M, Van Craenenbroeck EM, Verhaeghe N, Cornelissen VA. Personalized remotely guided preventive exercise therapy for a healthy heart (PRIORITY): protocol for an assessor-blinded, multicenter randomized controlled trial. Front Cardiovasc Med 2023; 10:1194693. [PMID: 37456813 PMCID: PMC10339344 DOI: 10.3389/fcvm.2023.1194693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Aims A key treatment for patients with varying stages of heart failure with preserved ejection fraction (HFpEF) is exercise. Yet, despite a Class 1A recommendation, only one-third of patients exercise sufficiently. A huge treatment gap exists between guidelines and clinical practice. PRIORITY aims to establish the feasibility, clinical effectiveness and cost-effectiveness of a hybrid centre and home-based personalized exercise and physical activity intervention for patients along the HFpEF continuum. Methods An assessor-blinded, multicenter randomized controlled trial will be conducted among 312 patients along the HFpEF continuum. Participants will be randomized (1:1) to the PRIORITY intervention or a comparator group receiving only a written exercise prescription. Participants in the PRIORITY group will receive 18 supervised centre-based exercise sessions during one year, supplemented with a remotely guided home-based physical activity program. Outcomes will be assessed at baseline, 4 months, one and two years. The primary outcome is the peak oxygen uptake (pVO2) at 1-year. Secondary outcomes include physical activity, other physical fitness parameters, cardiovascular health, echocardiographic parameters, health-related quality of life and costs at 1-year FU. Machine learning algorithms will analyse big data on physical activity collected during the 1-year intervention to develop models that can predict physical activity uptake and adherence as well as changes in fitness and health. A cost-utility analysis will be performed to evaluate the cost-effectiveness of the PRIORITY intervention compared to the control condition. Discussion We anticipate that participants in the supervised home-based exercise intervention group will have a greater increase in pVO2 compared to those receiving a written exercise prescription. Trial registration number This trial is registered at ClinicalTrials.gov (NCT04745013) and is currently in the recruitment stage.
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Affiliation(s)
- Camille De Wilde
- Research Group of Rehabilitation of Internal Disorders, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Youri Bekhuis
- Department of Cardiovascular Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
- REVAL—Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Department of Cardiovascular Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Jomme Claes
- Research Group of Rehabilitation of Internal Disorders, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Guido Claessen
- Department of Cardiovascular Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Karin Coninx
- HCI And eHealth, Faculty of Sciences, Hasselt University, Diepenbeek, Belgium
| | - Elise Decorte
- Research Group of Rehabilitation of Internal Disorders, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research, Ghent University, Ghent, Belgium
| | - Dominique Hansen
- REVAL—Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Matthias Lannoo
- Nutrition & Obesity Unit, Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Aging, KU Leuven, Leuven, Belgium
| | - Emeline M. Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Department of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Nick Verhaeghe
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research, Ghent University, Ghent, Belgium
- Department of Public Health, Interuniversity Centre for Health Economics Research, Vrije Universiteit Brussel, Brussels, Belgium
| | - Véronique A. Cornelissen
- Research Group of Rehabilitation of Internal Disorders, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Guazzi M, Arena R. Type 2 diabetes and exercise unexplained dyspnoea: a new focus under the lens with a long way to go yet. Eur J Prev Cardiol 2023; 30:123-124. [PMID: 35959738 DOI: 10.1093/eurjpc/zwac177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Marco Guazzi
- Department of Biological Sciences, University of Milano School of Medicine, Milano, Italy
- Cardiology Division, San Paolo University Hospital, Via A di Rudinì, 8, Milano 20142, Italy
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, USA
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
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Halasz G, Parati G, Piepoli MF. Editorial comments: focus on arterial hypertension and co-morbidities. Eur J Prev Cardiol 2023; 30:1-3. [PMID: 36583952 DOI: 10.1093/eurjpc/zwac301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Geza Halasz
- Cardioloy Department, Azienda Ospedaliera San Camillo-Forlanini, 00152 Rome, Italy
| | - Gianfranco Parati
- Chairman Elect, Council on Hypertension, European Society of Cardiology, University of Milano-Bicocca and, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Massimo F Piepoli
- Clinical Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.,Department of Preventive Cardiology, Wroclaw Medical University, Wroclaw, Poland
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