The Effect of Morning vs Evening Aerobic Exercise Training on Cardiac Remodeling and Function Improvement in Patients After ST Elevation Myocardial Infarction
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Morning aerobic exercise, Evening aerobic exercise.
- Who it may be relevant to
- Registry conditions: ST-segment Elevation Myocardial Infarction (STEMI). Basic parameters: 17 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- China
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The aim of the study was to intervene in the Aerobic exercise time of patients with STEMI and to explore the optimal exercise time for STEMI patients
Detailed description
Cardiovascular disease (CVD) remains the first cause of mortality worldwide. More than 30% of CVD-connected fatalities are ascribed to ST-segment Elevation myocardial infarction (STEMI). There is strong and consistent evidence that aerobic exercise after a STEMI improves overall and cardiovascular-related mortality. Aerobic exercise (AE) acts in key mechanisms of cardiac remodeling and function improvement after STEMI, thus contributing both to prevent or postpone harmful adaptations, and even to recover from negative alterations caused by cardiac ischemia. However, the time of day to exercise for STEMI patients' optimal cardiac benefits is currently unknown.
The circadian clock endows the host with temporal precision and robust adaptation to the surrounding environment. Almost all physiologic, metabolic and endocrine processes, including glycolysis, lipid and carbohydrate metabolism as well as cardiovascular function (heart rate, blood pressure) are influenced by the circadian clock. Recent investigations in rodents utilizing gain-of-function/loss-of-function models and in humans have identified Adverse cardiovascular events have day/night patterns is related to endogenous circadian clock control of platelet activation events. Several studies have also demonstrated the effect of AE at different times on blood pressure. Indeed, timing is critical in amplifying the beneficial impact of AE. However, these studies did not address cardiac structural remodeling or other CVD-related metabolic markers, it difficult to determine the physiological and structural effects of different time AE on cardiovascular health.
Thus, In this trial our aim is to assess, in patients who have had an STEMI, AE in which time of a day can give the best benefits to cardiac remodeling and function improvement.
Interventions
- Other Morning aerobic exercise
Patients were randomly assigned to morning aerobic exercise training for a 12-week outpatient training program that included a combination of warm-up, aerobic, and relaxation exercises three times a week. Each class consists of 10 minutes of warm-up training, 40 minutes of aerobic training and 10 minutes of relaxation training. The intensity of aerobic exercise training will be personalized. According to the guidance of relevant guidelines, the exercise intensity of patients will be determined a - Other Evening aerobic exercise
Patients were randomly assigned to evening aerobic exercise training for a 12-week outpatient training program that included a combination of warm-up, aerobic, and relaxation exercises three times a week. Each class consists of 10 minutes of warm-up training, 40 minutes of aerobic training and 10 minutes of relaxation training. The intensity of aerobic exercise training will be personalized. According to the guidance of relevant guidelines, the exercise intensity of patients will be determined a
Primary outcome measures
- left ventricle ejection fraction [Time frame: at baseline，at the sixth week, and after the 12th week of training or follow-up]
Secondary outcome measures (10)
- Oxygen consumption [Time frame: at baseline，at the sixth week, and after the 12th week of training or follow-up]
- Endothelial Function [Time frame: at baseline，at the sixth week, and after the 12th week of training or follow-up]
- Skeletal muscle and fat mass [Time frame: at baseline，at the sixth week, and after the 12th week of training or follow-up]
- Cardiac structure [Time frame: at baseline，at the sixth week, and after the 12th week of training or follow-up]
- One year major Adverse Cardiovascular Events [Time frame: From baseline to one year after participating in rehabilitation]
- VE/VCO2-SLOPE [Time frame: at baseline，at the sixth week, and after the 12th week of training or follow-up]
- Flow-mediated dilation [Time frame: at baseline, at the sixth week, and after the 12th week of training or follow-up]
- glucose [Time frame: at baseline, at the sixth week, and after the 12th week of training or follow-up]
- Blood lipid [Time frame: at baseline, at the sixth week, and after the 12th week of training or follow-up]
- N-terminal pro-BNP [Time frame: at baseline, at the sixth week, and after the 12th week of training or follow-up]
Eligibility criteria
Inclusion criteria
- Between 18 and 75-years-old;
- Typical symptoms of acute myocardial infarction within 24 hours, with ST segment elevation of ≥1mm in two consecutive leads on electrocardiogram
- After receiving complete revascularization treatment
- Cardiac function grading I to II without any other serious complications
- Left ventricular ejection fraction >30%
- Compliant with the guidelines of the American College of Cardiology/American Heart Association for participating in cardiac rehabilitation standards
- Signed written informed consent.
Exclusion criteria
- Patients with unstable angina
- severe symptomatic congestive heart failure detectable myocardial ischemia
- valvular disease requiring surgery
- severe ventricular arrhythmias
- severe concomitant life-threatening diseases such as cancer, and rheumatoid disease
- osteoarticular diseases that may affect the exercise process
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
China · 1 center
- Renji Hospital — Shanghai
Identifiers
NCT: NCT06385834 · LY2014-041-A