Acupuncture on Cardiac and Autonomic Function in Human Heart Failure - Full Text View

Purpose

Acupuncture treatment may improve the cardiac function and the quality of life in heart failure patients. These effects may be related to the inhibition of sympathetic activity and/or increased vagal function. The suppression of inflammatory reaction with acupuncture treatment may also be associated with these outcomes. Specific aims include:

To evaluate the effect of acupuncture treatment on human cardiac sympathetic/vagal activity
To evaluate the effect of acupuncture treatment on cardiac function and functional capacity
To evaluate the general health score of the quality-of-life with acupuncture treatment
To explore the mechanism of acupuncture treatment on inflammation and nitrative stress in heart failure patients.

Condition	Intervention	Phase
Chronic Heart Failure	Procedure: Acupuncture	Phase 2

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Acupuncture on Cardiac and Autonomic Function in Human Heart Failure

Resource links provided by NLM:

MedlinePlus related topics: Acupuncture Acute Bronchitis Heart Failure

U.S. FDA Resources

Further study details as provided by The Cleveland Clinic:

Primary Outcome Measures:

Change in Cardiac Function [ Time Frame: Baseline ] [ Designated as safety issue: No ]
Change in Cardiac Function [ Time Frame: 7 weeks ] [ Designated as safety issue: No ]
After no acupuncture treatment
Change in Cardiac Function [ Time Frame: 13 weeks ] [ Designated as safety issue: No ]
After acupuncture treatment

Secondary Outcome Measures:

Change in Heart Rate Variability [ Time Frame: Baseline ] [ Designated as safety issue: No ]
Change in Heart Rate Variability [ Time Frame: 7 weeks ] [ Designated as safety issue: No ]
After no acupuncture treatment
Change in Heart Rate Variability [ Time Frame: 13 weeks ] [ Designated as safety issue: No ]
After acupuncture treatment

Estimated Enrollment:	20
Study Start Date:	February 2013
Estimated Study Completion Date:	October 2013
Estimated Primary Completion Date:	October 2013 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Acupuncture Acupuncture needles	Procedure: Acupuncture
Placebo Comparator: No Acupuncture "no acupuncture treatment"

Detailed Description:

The primary aim of this study is to evaluate the effect of acupuncture treatment on cardiac sympathetic/vagal activity in chronic heart failure patients. The investigators would like to investigate the effect of acupuncture treatment on cardiac function and the general health score of the quality-of-life. The investigators would like to further explore the mechanism of acupuncture treatment on autonomic imbalance and chronic inflammatory reaction in heart failure patients by comparing the treatment and sham groups, the baseline before the treatment and the changes after treatment.

Chronic heart failure affects millions people and is a leading cause of death in US. Despite of advance in diagnoses and treatments, the long-term prognosis and quality of life of chronic heart failure patients remain poor. The mortality of chronic heart failure is estimated 50% within 4 years, and is more than 50% in patients with severe chronic heart failure.

Chronic heart failure results from the left ventricular (LV) systolic and/or diastolic dysfunction. Autonomic imbalance with sustained sympathetic overdrive and vagal withdrawal plays an important role in the development of chronic heart failure. This autonomic dysregulation is related to increased heart rate, excess inflammatory response, progressive LV dysfunction, increased mortality and morbidity in chronic heart failure patients. Sympathetic active inhibition with beta-adrenergic receptor blockers has shown significant reduction in mortality and morbidity in chronic heart failure patients. Also modulation of parasympathetic activation with electrical vagus nerve stimulation (VNS) has demonstrated as a potential therapy for chronic heart failure.

Acupuncture has been widely used in China for thousands of years to treat a variety of diseases and their symptoms. Except pain disorders, increasing evidences have shown that acupuncture may be useful for cardiovascular diseases, such as coronary artery disease, hypertension and chronic heart failure. It has been demonstrated that certain acupuncture points have shown to inhibit cardiac sympathetic activation or increase cardiac vagal component in both experimental animals and clinical studies. Recently a small clinical trial by Dr. Kristen, et al has found that acupuncture could improve exercise tolerance in chronic heart failure patients.

The investigators hypothesize that acupuncture treatment may improve the cardiac function and the quality of life in heart failure patients. These effects may be related to the inhibition of sympathetic activity and/or increased vagal function. The suppression of inflammatory reaction with acupuncture treatment may also be associated with these outcomes. In addition to optimized standard heart failure medications, acupuncture may be a safe therapeutic strategy in chronic heart failure treatment. Studies of acupuncture on cardiac autonomic activity in heart failure may show more evidence of acupuncture treatment in chronic heart failure patients.

Eligibility

Ages Eligible for Study:	21 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Age ≥ 21 years
CHF (New York Heart Association (NYHA) class II-III), LVEF ≤40%
All patients will have sinus rhythm and compensate with individually optimized standard heart failure medications. Routine medications will be continued during the study period
Able and willing to give informed consent or comply with study procedures.

Exclusion Criteria:

Acupuncture treatment within 3 months before the beginning of the study
Presents with cutaneous eczema at potential acupoints
Have a history of major bleeding or increased propensity of excessive bleeding due to platelet dysfunction
Currently taking anti-coagulants (e.g. warfarin)

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01804816

Contacts

Contact: Jamie Viterna, BS

216-636-6153

viternj@ccf.org

Locations

United States, Ohio
Cleveland Clinic	Recruiting
Cleveland, Ohio, United States, 44195
Contact: Jamie Viterna, BS 216-636-6153 viternj@ccf.org

Sponsors and Collaborators

The Cleveland Clinic

Investigators

Principal Investigator:

W.H. Wilson Tang, MD

The Cleveland Clinic

More Information

Publications:

Middlekauff HR, Hui K, Yu JL, Hamilton MA, Fonarow GC, Moriguchi J, Maclellan WR, Hage A. Acupuncture inhibits sympathetic activation during mental stress in advanced heart failure patients. J Card Fail. 2002 Dec;8(6):399-406.

Kurono Y, Minagawa M, Ishigami T, Yamada A, Kakamu T, Hayano J. Acupuncture to Danzhong but not to Zhongting increases the cardiac vagal component of heart rate variability. Auton Neurosci. 2011 Apr 26;161(1-2):116-20. doi: 10.1016/j.autneu.2010.12.003. Epub 2011 Jan 7.

Deng YJ, Liang WX, Cheng SY. [Influence of acupoint-catgut-implantation on blood pressure and cardiac function in chronic congestive heart failure rats]. Zhen Ci Yan Jiu. 2011 Feb;36(1):40-5. Chinese.

Kristen AV, Schuhmacher B, Strych K, Lossnitzer D, Friederich HC, Hilbel T, Haass M, Katus HA, Schneider A, Streitberger KM, Backs J. Acupuncture improves exercise tolerance of patients with heart failure: a placebo-controlled pilot study. Heart. 2010 Sep;96(17):1396-400. doi: 10.1136/hrt.2009.187930. Epub 2010 Jun 15.

Responsible Party:	Wilson Tang, Staff Cellular and Molecular Medicine and Cardiovascular Medicine, The Cleveland Clinic
ClinicalTrials.gov Identifier:	NCT01804816 History of Changes
Other Study ID Numbers:	12-580
Study First Received:	March 4, 2013
Last Updated:	April 24, 2013
Health Authority:	United States: Institutional Review Board

Keywords provided by The Cleveland Clinic:

Chronic Heart Failure
Heart Failure

Additional relevant MeSH terms:

Heart Failure
Heart Diseases
Cardiovascular Diseases

ClinicalTrials.gov processed this record on May 19, 2013