EXERT-FH A FEASIBILITY STUDY
Research type
Research Study
Full title
Investigation of temporal changes in high sensitivity troponin I after exercise in patients with Familial Hypercholesterolaemia- A FEASIBILITY STUDY
IRAS ID
297588
Contact name
Soha Zouwail
Contact email
Sponsor organisation
Cardiff and Vale University Health Board, University Hospital of Wales
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Familial Hypercholesterolaemia (FH) is the most common monogenic disorder encountered in clinical practice. Patients with FH have very high levels of low density lipoprotein cholesterol (LDL-C) since birth and thus a greater cumulative LDL-C burden. Hence, they are at an inherently high risk of developing premature coronary heart disease (CHD).
Timely and effective lipid-lowering treatment has resulted in significant reduction of cardiovascular risk and improved life expectancy of patients with FH. Lifestyle modifications including structured aerobic exercise and a healthy diet are an important adjuvant to pharmacological treatment due to associated improvement in coronary risk factor profile.
General screening for myocardial ischaemia in asymptomatic patients with FH is not a current practice. Previous studies showed that troponin blood levels may increase after prolonged and /or intense exercise in general population and that it can predict risk of cardiovascular events. Indeed, newly published guidelines on sports cardiology and exercise suggested consideration of maximal exercise stress test and functional imaging test for risk assessment of individuals with FH before embarking on high intensity exercise or competitive sports.
In this study, we aim to establish the feasibility of a future study comparing the use of two different exercise stress protocols; the routinely available Bruce stress test and a personalised exercise protocol, to induce changes in biological markers (e.g. high sensitivity troponin, high sensitivity C-reactive protein and N-terminal Pro Brain natriuretic peptide) and cardiovascular metrics (e.g. carotid Intima media thickness, Echocardiography, pulse wave velocity and flow mediated dilation) in asymptomatic individuals with familial hypercholesterolaemia.
Outcome of this study will help in devising future pilot study to examine the change in blood troponin level with exercise and if this change can help predict future cardiovascular events in asymptomatic individuals with familial hypercholesterolaemia.REC name
London - Surrey Research Ethics Committee
REC reference
21/LO/0791
Date of REC Opinion
16 Dec 2021
REC opinion
Further Information Favourable Opinion