Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial

Abstract Background Dilated cardiomyopathy (DCM) is a leading cause of heart failure, particularly in younger individuals. Low physical strength is a global risk factor for cardiovascular mortality, and physical activity and a healthy lifestyle have been shown to improve outcomes in patients with he...

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Main Authors: Farbod Sedaghat‐Hamedani, Ali Amr, Theresa Betz, Elham Kayvanpour, Christoph Reich, Reto Wettstein, Oliver Heinze, Isabell Mohr, Regina Krisam, Anja Sander, Christina Klose, Birgit Friedmann‐Bette, Norbert Frey, Benjamin Meder
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.14970
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author Farbod Sedaghat‐Hamedani
Ali Amr
Theresa Betz
Elham Kayvanpour
Christoph Reich
Reto Wettstein
Oliver Heinze
Isabell Mohr
Regina Krisam
Anja Sander
Christina Klose
Birgit Friedmann‐Bette
Norbert Frey
Benjamin Meder
author_facet Farbod Sedaghat‐Hamedani
Ali Amr
Theresa Betz
Elham Kayvanpour
Christoph Reich
Reto Wettstein
Oliver Heinze
Isabell Mohr
Regina Krisam
Anja Sander
Christina Klose
Birgit Friedmann‐Bette
Norbert Frey
Benjamin Meder
author_sort Farbod Sedaghat‐Hamedani
collection DOAJ
description Abstract Background Dilated cardiomyopathy (DCM) is a leading cause of heart failure, particularly in younger individuals. Low physical strength is a global risk factor for cardiovascular mortality, and physical activity and a healthy lifestyle have been shown to improve outcomes in patients with heart failure. However, inappropriate exercise may increase the risk of arrhythmias in certain individuals with DCM. The determinants for predicting individual risks in this setting are poorly understood, and clinicians are hesitant to recommend sports for cardiomyopathy patients. The activeDCM trial aims to assess the safety and efficacy of a personalized exercise and activity programme for individuals with DCM. Study Design The activeDCM trial is a prospective, randomized, interventional trial with a 12 month follow‐up. Three hundred patients, aged 18–75 years with DCM, left ventricular ejection fraction (LVEF) ≤ 50% and New York Heart Association (NYHA) classes I–III, will be enrolled. The intervention includes a personalized exercise and activity programme. The primary outcome is the increase in peak oxygen uptake (VO2max, mL/kg/min) from baseline to 12 months. Secondary endpoints include adherence to personalized activity programmes, freedom from clinically relevant arrhythmia, unplanned hospitalization for heart failure and changes in NYHA class, quality of life scores, 6 min walk distance, muscular strength, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity troponin T (hsTnT) levels and cardiac function. Advanced research questions include high‐density phenome and omics analysis combined with digital biomarkers derived from Apple Watch devices. Discussion The activeDCM trial will provide valuable insights into the safety and efficacy of personalized exercise training in DCM patients, inform clinical practice and contribute to the development of heart failure management programmes. The study will generate data on the impact of exercise on various aspects of cardiovascular disease, including genetic, metabolic, phenotypic and longitudinal aspects, facilitating the development of future digital tools and strategies, including the incorporation of smart wearable devices.
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spelling doaj-art-07a55564d4e64ffcb2c99177855476702025-08-20T02:38:58ZengWileyESC Heart Failure2055-58222024-12-011164400440610.1002/ehf2.14970Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trialFarbod Sedaghat‐Hamedani0Ali Amr1Theresa Betz2Elham Kayvanpour3Christoph Reich4Reto Wettstein5Oliver Heinze6Isabell Mohr7Regina Krisam8Anja Sander9Christina Klose10Birgit Friedmann‐Bette11Norbert Frey12Benjamin Meder13Medical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyInstitute of Medical Informatics Heidelberg University Hospital Heidelberg GermanyInstitute of Medical Informatics Heidelberg University Hospital Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyInstitute of Medical Biometry University of Heidelberg Heidelberg GermanyInstitute of Medical Biometry University of Heidelberg Heidelberg GermanyInstitute of Medical Biometry University of Heidelberg Heidelberg GermanyDepartment of Sports Medicine Medical Clinic, University Hospital Heidelberg Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyMedical Faculty of the University Heidelberg, Institute for Cardiomyopathies Heidelberg (ICH), Department of Internal Medicine III University Hospital Heidelberg Heidelberg GermanyAbstract Background Dilated cardiomyopathy (DCM) is a leading cause of heart failure, particularly in younger individuals. Low physical strength is a global risk factor for cardiovascular mortality, and physical activity and a healthy lifestyle have been shown to improve outcomes in patients with heart failure. However, inappropriate exercise may increase the risk of arrhythmias in certain individuals with DCM. The determinants for predicting individual risks in this setting are poorly understood, and clinicians are hesitant to recommend sports for cardiomyopathy patients. The activeDCM trial aims to assess the safety and efficacy of a personalized exercise and activity programme for individuals with DCM. Study Design The activeDCM trial is a prospective, randomized, interventional trial with a 12 month follow‐up. Three hundred patients, aged 18–75 years with DCM, left ventricular ejection fraction (LVEF) ≤ 50% and New York Heart Association (NYHA) classes I–III, will be enrolled. The intervention includes a personalized exercise and activity programme. The primary outcome is the increase in peak oxygen uptake (VO2max, mL/kg/min) from baseline to 12 months. Secondary endpoints include adherence to personalized activity programmes, freedom from clinically relevant arrhythmia, unplanned hospitalization for heart failure and changes in NYHA class, quality of life scores, 6 min walk distance, muscular strength, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity troponin T (hsTnT) levels and cardiac function. Advanced research questions include high‐density phenome and omics analysis combined with digital biomarkers derived from Apple Watch devices. Discussion The activeDCM trial will provide valuable insights into the safety and efficacy of personalized exercise training in DCM patients, inform clinical practice and contribute to the development of heart failure management programmes. The study will generate data on the impact of exercise on various aspects of cardiovascular disease, including genetic, metabolic, phenotypic and longitudinal aspects, facilitating the development of future digital tools and strategies, including the incorporation of smart wearable devices.https://doi.org/10.1002/ehf2.14970Apple Watchdilated cardiomyopathyexerciseheart failurepersonalized trainingrandomized controlled trial
spellingShingle Farbod Sedaghat‐Hamedani
Ali Amr
Theresa Betz
Elham Kayvanpour
Christoph Reich
Reto Wettstein
Oliver Heinze
Isabell Mohr
Regina Krisam
Anja Sander
Christina Klose
Birgit Friedmann‐Bette
Norbert Frey
Benjamin Meder
Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial
ESC Heart Failure
Apple Watch
dilated cardiomyopathy
exercise
heart failure
personalized training
randomized controlled trial
title Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial
title_full Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial
title_fullStr Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial
title_full_unstemmed Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial
title_short Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial
title_sort personalized care in dilated cardiomyopathy rationale and study design of the activedcm trial
topic Apple Watch
dilated cardiomyopathy
exercise
heart failure
personalized training
randomized controlled trial
url https://doi.org/10.1002/ehf2.14970
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