Loughborough University
Browse
CYCLE paper KI final 29012021 Clean.pdf (348.49 kB)

A randomized controlled trial to investigate the effects of intra-dialytic cycling on left ventricular mass

Download (348.49 kB)
journal contribution
posted on 2021-06-04, 08:18 authored by Matthew Graham-Brown, Daniel S. March, Robin Young, Patrick Highton, Hannah M.L. Young, Darren R. Churchward, Maurice Dungey, David StenselDavid Stensel, Nicolette BishopNicolette Bishop, Nigel J. Brunskill, Alice C. Smith, Gerry P. McCann, Alex McConnachie, James Burton
Cardiovascular disease is the leading cause of death for patients receiving hemodialysis. Since exercise mitigates many risk factors which drive cardiovascular disease for these patients, we assessed effects of a program of intra-dialytic cycling on left ventricular mass and other prognostically relevant measures of cardiovascular disease as evaluated by cardiac MRI (the CYCLE-HD trial). This was a prospective, open-label, single-blinded cluster-randomized controlled trial powered to detect a 15g difference in left ventricular mass measured between patients undergoing a six-month program of intra-dialytic cycling (exercise group) and patients continuing usual care (control group). Pre-specified secondary outcomes included measures of myocardial fibrosis, aortic stiffness, physical functioning, quality of life and ventricular arrhythmias. Outcomes were analyzed as intention-to-treat according to a pre-specified statistical analysis plan. Initially, 130 individuals were recruited and completed baseline assessments (65 each group). Ultimately, 101 patients completed the trial protocol (50 control group and 51 exercise group). The six-month program of intra-dialytic cycling resulted in a significant reduction in left ventricular mass between groups (-11.1g; 95% confidence interval -15.79, -6.43), which remained significant on sensitivity analysis (missing data imputed) (-9.92g; 14.68, -5.16). There were significant reductions in both native T1 mapping and aortic pulse wave velocity between groups favoring the intervention. There was no increase in either ventricular ectopic beats or complex ventricular arrhythmias as a result of exercise with no significant effect on physical function or quality of life. Thus, a six-month program of intradialytic cycling reduces left ventricular mass and is safe, deliverable and well tolerated.

Funding

National Institute of Health Research (NIHR) in the United Kingdom (Grant Reference Number CS-2013-13-014; JOB)

History

School

  • Sport, Exercise and Health Sciences

Published in

Kidney International

Volume

99

Issue

6

Pages

1478 - 1486

Publisher

Elsevier

Version

  • AM (Accepted Manuscript)

Rights holder

© International Society of Nephrology

Publisher statement

This paper was accepted for publication in the journal Kidney International and the definitive published version is available at https://doi.org/10.1016/j.kint.2021.02.027.

Acceptance date

2021-02-10

Publication date

2021-04-08

Copyright date

2021

ISSN

0085-2538

eISSN

1523-1755

Language

  • en

Depositor

Prof Lettie Bishop. Deposit date: 2 June 2021

Usage metrics

    Loughborough Publications

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC