Eccentric (braking) cycling instead of regular pedaling for people with left heart failure

Visa-versa! Breaking Instead of Pushing the Pedals: Eccentric Exercise to Improve Training Performance in Patients With Heart Failure. A Single-center Randomized Controlled Trial

This will try short sessions of eccentric (braking) cycling versus regular cycling in people with left-heart failure to see if it builds leg muscle and fitness while using less oxygen and putting less strain on the heart.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 16 (estimated)
• Ages: 18 Years to 80 Years
• Sex: All
• Sponsor: University of Zurich (Academic / other)
• Locations: 1 site (Zurich, Canton of Zurich)
• Trial ID: NCT05204693 on ClinicalTrials.gov

What this trial studies

This interventional program tests whether eccentric (lengthening or braking) cycling can deliver higher muscle training power with a much lower oxygen and cardiac demand than standard concentric cycling in people with left-heart failure. Enrolled patients who have been on stable disease-specific medication for more than four weeks perform supervised cycling sessions that include 15 minutes of eccentric cycling and 15 minutes of concentric (normal) cycling while physiological responses are monitored. Key outcomes include changes in muscle strength and mass, exercise capacity, and cardiopulmonary load during and after the intervention. The study excludes people with severe daytime hypoxemia, major comorbidities, inability to ride a bicycle, pregnancy, or current enrollment in another interventional trial, and is run at the Respiratory Clinic of the University Hospital of Zurich.

Who should consider this trial

Good fit: Adults with left-heart disease who are clinically stable on the same disease-specific medication for more than four weeks and who can safely ride a bicycle are the intended candidates.

Not a fit: People with severe daytime hypoxemia, significant renal/hepatic or other comorbid conditions, inability to cycle, known pregnancy, or those already in another interventional trial are unlikely to receive benefit from this program.

Why it matters

Potential benefit: If successful, this approach could increase leg muscle and exercise capacity in people with left-heart failure while placing less strain on the heart and lungs.

How similar studies have performed: Eccentric training has shown promising muscle and low-oxygen-cost benefits in other cardiopulmonary populations, but its specific application in left-heart failure is relatively novel and less well studied.

Eligibility criteria

Inclusion Criteria:

* In a stable condition on the same disease specific medication \>4 weeks.
* Signed informed consent.
* Patients with left-heart disease

Exclusion Criteria:

* Severe daytime hypoxemia (pO2 ≤7.3 kPa or \<55 mmHg).
* Other clinically significant concomitant disease states (e.g., renal, hepatic dysfunction, etc.).
* Inability to follow the procedures of the study, e.g. due to language problems, psychological disorder, dementia or confusional state of the subject, neurological or orthopedic problems with inability to ride a bicycle.
* Woman with known pregnancy (Women with known pregnancy will not be allowed into the study. It will however not be searched for early unknown pregnancy in woman of child-bearing potential, as cycling is not contraindicated in early unknown pregnancy stage and we thus do not plan routine pregnancy tests before study entrance in women of childbearing potential).
* Enrolment into another clinical trial with active treatment.

Where this trial is running

Zurich, Canton of Zurich

• Respiratory Clinic, University Hospital of Zurich — Zurich, Canton of Zurich, Switzerland (Recruiting)

Study contacts

• Study coordinator: Silvia Ulrich, Prof. Dr.

Conditions Left Heart Failure