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Набор скоро начнётся NCT06355388

TRAnscutaneous vaGUS Nerve Stimulation in Patients With Chronic Heart Failure

Без фазы С лечением Heart Failure Heart Failure With Reduced Ejection Fraction Heart Failure With Midrange Ejection Fraction

Ориентир для пациента и семьи

Простыми словами

Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.

Что изучают
В протоколе указаны: Active tVNS, Sham tVNS.
Кому может быть актуально
Состояния в реестре: Heart Failure, Heart Failure With Reduced Ejection Fraction, Heart Failure With Midrange Ejection Fraction. Базовые параметры: от 18 лет · Все.
Что важно проверить
Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
Где проводится
Италия
Следующий шаг
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Обзор

To verify the efficacy of transcutaneous vagus nerve stimulation (tVNS) on and autonomic balance in patients with chronic heart failure and reduced (HFrEF) or mildly reduced (HFmrEF) left ventricular ejection fraction. The study hypothesis is that tVNS increases baroreflex gain, with consequent benefits on sympathovagal balance (at short- and mid-term), and on quality of life and bio-humoral parameters (at mid-term).

Подробное описание

Pilot phase: comparing the effects of right- (10-minute) vs. left-sided tVNS (10-minute) on BRS and heart rate variability (HRV) in a subset of patients.

Short-term phase: comparing the effects of active- (10-minute) vs. sham-tVNS (10-minute) on BRS, HRV, and sympathetic nerve activity.

Mid-term phase: comparing the effects of active- (4-week) vs- sham-tVNS (4-week) on BRS, HRV, biomarkers, exercise performance, and cardiac function.

Вмешательства

  • Устройство Active tVNS
    As for the short-term phase, the ear clip of the "Parasym" device (Parasym, London, United Kingdom), containing the stimulation electrode, will be positioned at the level of the patient's tragus, and a 10-minute stimulation will be initiated with a pulse width of 200 μs, a frequency of 30 Hz, and an intensity of one mA lower than the patient's sensitivity threshold. As fort he mid-term phase, a device will be given to the patient, which will be instructed to position the ear clip of the device
  • Устройство Sham tVNS
    As for the short-term phase, the ear clip of the "Parasym" device (Parasym, London, United Kingdom), containing the stimulation electrode, will be positioned at the level of the patient's tragus for 10-minute but no current will be delivered. As fort he mid-term phase, a device (configured to withhold power delivery) will be given to the patient, which will be instructed to position the ear clip of the device at the level of the tragus and to set stimulation parameters as established in the lab

Первичные конечные точки

  • Mean change in baroreflex gain (ms/mmHg) [Срок оценки: 10 minutes (short-term effect)]
  • Mean change in baroreflex gain (ms/mmHg) [Срок оценки: 4 weeks (mid-term effect)]

Критерии участия

Критерии включения

  • Aged ≥18 years;
  • Ability to consent to enrollment;
  • Diagnosis of chronic heart failure (CHF= and left ventricular ejection fraction <50% according to the latest European guidelines.

Критерии исключения

  • History of acute coronary syndrome within 3 months of enrollment;
  • Clinical need to modify CHF therapy during the study;
  • History of recurrent syncope, orthostatic hypotension, severe bradycardia (average heart rate <50 bpm), or second or third-degree atrioventricular block;
  • Neurological conditions characterized by dysautonomia (e.g., Parkinson's disease);
  • Unstable major psychiatric disorders or treatment with psychoactive drugs or drugs that can act on the autonomic nervous system (e.g., antidepressants, antipsychotics, opioids, benzodiazepines);
  • Uncontrolled thyroid disorders;
  • Active neoplasia;
  • Severe renal insufficiency (estimated glomerular filtration rate <15 ml/min/1.73 m2);
  • Moderate or severe chronic obstructive pulmonary disease (FEV1/FVC <70% of predicted and FEV1 <70%);
  • Liver insufficiency (AST/ALT >100 U/L and/or gamma-GT >150 U/L);
  • Participation in other clinical studies in the 3 months preceding;
  • Women in pregnancy, breastfeeding, or of childbearing age not following adequate contraception (the woman must agree to abstain from heterosexual intercourse or use at least two effective contraceptive measures such as bilateral tubal ligation, male sterilization, use of hormonal contraceptives that inhibit ovulation, intrauterine devices releasing hormones, copper intrauterine devices; all barrier devices must be used in combination with a spermicidal cream).

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение
Рандомизированное
Модель
Перекрёстный дизайн
Маскирование
Двойное слепое
Основная цель
Лечение

Центры проведения

Италия · 1 центр
  • Michele Emdin — Pisa

Идентификаторы

NCT: NCT06355388 · TRAGUSHF

Первоисточники (государственные реестры)

Открыть это исследование на ClinicalTrials.gov ↗