Heart FailurePhase 4MSNCT01164592
Substudy on the Mechanistic Plausibility of the Clinical Benefits of Adaptive Servo-ventilation
A Phase 4 study testing adaptive servoventilation (ASV) in people with Heart Failure and Sleep Disorder, run by ResMed at 94 sites in 8 countries.
Trial summary
The purpose of this study is to assess changes in left ventricular performance using echocardiography as well as ventricular remodelling, changes in sleep and changes in mood, anxiety and cognitive functions occurring as a result of treatment of predominant central sleep apnoea by adaptive servoventilation (ASV) in… Read more about this study
- Who is it for?
- Ages 22 years and older
- Conditions the study is for
- Heart Failure, Sleep Disorder, Cheyne Stokes Respiration
- What is being tested?
- adaptive servoventilation (ASV)
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 312 participants
- Where
- 94 sitesin 8 countries
- Study dates
- Aug 2012to Jun 2015
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 22 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Over 22 years of age
- Severe Chronic Heart Failure (CHF) with NYHA class III-IV or NYHA class II with at least one hospitalisation for HF within the last 24 months
- Left ventricular ejection fraction (LVEF) less than or equal to 45% by means of echocardiography, radionucleotide angiography, left ventriculography or cardiac MRI documented less than 12 weeks before randomisation
- Diagnosis of sleep disordered breathing (SDB) with an apnoea-hypopnoea-index (AHI) of >15/hr with at least 50% central events and a central AHI of at least 10/hr
- Clinically stable with no change in medication and no unplanned hospitalisation for heart failure in preceding month
- Optimised medical treatment according to the applicable guidelines
Show all 9Show fewer
- Able to provide informed consent
- ADDITIONAL INCLUSION CRITERIA FOR THE SUBSTUDY
- Predominant central sleep apnoea (apnoea hypopnoea index > 15/hour with ≥ 50% central events and a central AHI ≥10/hour, derived from full polysomnography (based on total sleep time), documented less than 4 weeks before randomization. Flow measurements have to be performed with nasal cannula
Who cannot join
- Significant chronic obstructive pulmonary disease (COPD) with Forced Expiratory Volume within one second (FEV1)<50% predicted
- Oxygen saturation at rest during the day 90% at the time of inclusion
- Current use of Positive Airway Pressure (PAP) therapy
- Life expectancy < 1 year for diseases unrelated to chronic heart failure
- Cardiac surgery, Percutaneous coronary intervention (PCI), Myocardial Infarction (MI) or unstable angina within 6 months prior to randomisation
- Implantation of ICD (implanted cardiodefibrillator) or CRT (cardiac resynchronisation therapy) scheduled or within 6 months prior to randomisation
Show all 14Show fewer
- Transient ischemic attack (TIA) or Stroke within 3 months prior to randomisation
- Primary hemodynamically significant uncorrected valvular heart disease, obstructive or regurgitant, or any valvular disease expected to lead to surgery during the trial
- Acute myocarditis/pericarditis within 6 months prior to randomisation
- Untreated or therapy refractory Restless legs Syndrome (RLS)
- Pregnancy
- ADDITIONAL EXCLUSION CRITERIA FOR THE SUBSTUDY
- Amyloidosis, hypertrophic obstructive cardiomyopathy or arteriovenous fistulas
- Dosage changes of diuretics more than doubled within the last 4 weeks prior to randomisation
Trial locations and contacts
94 sites in 8 countries.
94 sites in 8 countries
Germany77 sites
Universitätsklinikum Aachen
Aachen, 52074
DRK Krankenhaus
Alzey, 55232
Herzzentrum Bad Krozingen
Bad Krozingen, 79189
Herz- und Diabeteszentrum NRW
Bad Oeynhausen, 32545
Charité Campus Mitte CCM
Berlin, 10117
Charité Campus Mitte
Berlin, 10117
POLIKUM Friedenau
Berlin, 12157
Unfallkrankenhaus Berlin
Berlin, 12683
Jüdisches Krankenhaus Berlin
Berlin, 13347
Praxis für Lunge Herz und Schlaf
Bielefeld, 33617
Kardiologische Praxis Marschner
Bonn, 53225
Helios Klinikum Borna
Borna, 04552
Kardiologie Brühl
Brühl, 50321
Gemeinschaftspraxis Kardiologie Dr. Becker
Castrop-Rauxel, 44575
Kardiologische Praxis Dr. Isbruch
Castrop-Rauxel, 44577
Malteser Krankenhaus St. Hildegardis
Cologne, 50931
Klinikum der Universität zu Köln- Herzzentrum
Cologne, 50937
Klinikum der Universität zu Köln-Schlaflabor
Cologne, 50937
Praxis Dr. Anselm Bäumer
Cologne, 51065
Gemeinschaftspraxis Dres. Gysan/Heinzler/May
Cologne, 51105
Praxis Dr. Hecker
Dortmund, 44135
Kardiologische Praxis Dr. Wetzel
Dortmund, 44141
Praxis Dr. Lodde
Dortmund, 44147
Facharztzentrum Dresden-Neustadt GbR
Dresden, 01099
Gemeinschaftpraxis Dres. Schmidt/Gronke
Dresden, 01219
Praxis Dr. Hohensee
Dresden, 01277
Herzzentrum Universität Dresden
Dresden, 01307
Khs Florence-Nightingale
Düsseldorf, 40489
Kardiologie Oberkassel
Düsseldorf, 40545
Gemeinschaftspraxis PD Dr. Lankisch
Düsseldorf, 40597
Universitätsklinikum Essen
Essen, 45122
Kardiologie Praxis Dr. Bonnekamp
Essen, 45136
Praxis Dr. Tekiyeh
Essen, 45136
Ruhrlandklinik Essen
Essen, 45239
Kath. Kliniken Essen/ Philippusstift
Essen, 45359
Gemeinschaftspraxis Dres. Guckenbiehl
Flonheim, 55237
CardioVaskuläres Centrum Frankfurt
Frankfurt, 60389
Praxis Dr. Diedrichs
Frechen, 50226
Universitätsklinikum Freiburg
Freiburg im Breisgau, 79106
Kardiologische Praxis Gütersloh
Gütersloh, 33330
Gemeinschaftspraxis Dres Leischik/Littwitz
Hagen, 58095
Universitätsklinikum Hamburg-Eppendorf
Hamburg, 20246
Asklepios Klinik Barmbek
Hamburg, 22291
Universitätsklinikum Heidelberg
Heidelberg, 69120
Thoraxklinik Heidelberg gGmbH
Heidelberg, 69126
Lungenklinik Hemer
Hemer, 58675
B&B GmbH
Herne, 44623
Cardio-Praxis Herne Dr. Furche
Herne, 44623
Gemeinschaftspraxis Dr. Bruch
Herne, 44629
Kardiologische Praxis Dr. Schlichting
Herne, 44649
Augusta-Kranken-Anstalt gGmbH Thoraxzentrum Ruhrgebiet
Herne, 44651
St. Elisabeth-Hospital Herten gGmbH
Herten, 45699
Lungenfachklinik Immenhausen
Immenhausen, 34376
Cardiopraxis Ingelheim
Ingelheim, 55218
Gemeinschaftspraxis Dres. Dobler/Turin
Karlstadt am Main, 97753
Universität Leipzig -Herzzentrum
Leipzig, 04289
Universitätsklinikum Schleswig-Holstein Campus Lübeck-Kardiologie
Lübeck, 23538
Universitätsklinikum Schleswig-Holstein Campus Lübeck-Schlaflabor
Lübeck, 23538
Praxis für Kardiologie Dr. med. Menz
Menden, 58706
Krankenhaus Bethanien
Moers, 47441
Kardiologische Praxis Dr. Schön
Mühldorf, 84453
Evangelisches Krankenhaus Mülheim
Mülheim, 45468
Lungenärzte am Rotkreuzplatz
München, 80634
Klinikum Augustinum München
München, 81375
Universitätsklinikum Münster
Münster, 48149
Städtisches Khs Lukas
Neuss, 41472
Kardiologische Praxis Nienburg
Nienburg, 31582
Praxis Dr. Fröhlich
Ratingen, 40885
Universitätsklinikum Regensburg
Regensburg, 93053
Khs St. Adolf Stift
Reinbek, 21465
Praxis Dr. Hein
Reinbek, 21465
Katharinen Hospital Unna
Unna, 59423
Praxis Dr. Gerritsen
Waldkraiburg, 84478
Kardiologisch angiologische Gemeinschaftspraxis
Wiesbaden, 65183
Kardiologische Gemeinschaftspraxis Dr. K. Vorbeck
Wiesbaden, 65183
Missionsärztliche Klinik Würzburg
Würzburg, 97074
Comprehensive Heart Failure Center, Universitätsklinikum Würzburg
Würzburg, 97080
Australia6 sites
Royal Adelaide Hospital
Adelaide, South Australia, 5000
Rivercity Private Hospital
Auchenflower, Queensland, 4066
Melbourne Sleep Disorders Centre
East Melbourne, Victoria, 3002
St. Vincents and Mercy Private Hospital
Melbourne, Victoria, 3065
Hollywood Private Hospital (CVS)
Nedlands, Western Australia, 6009
Westmead Hospital
Westmead, New South Wales, 2145
Finland3 sites
Helsinki University Hospital
Helsinki, 00290
Unesta Research Centre
Tampere, 33520
Tampere University Hospital, Pirkanmaa sairaanhoitopiiri
Tampere, 33521
France3 sites
Clinique Mutualiste des Eaux Claires
Grenoble, 38000
CHU Grenoble, Hopital Michallon
Grenoble, 38043
CHU de Poitiers
Poitiers, 86000
Switzerland2 sites
Cardiocentro Ticino
Lugano, 6900
Ospedale Regionale di Lugano
Lugano, 6903
About this study
Official title: SERVE-HF: Substudy on the Mechanistic Plausibility of the Clinical Benefits of Adaptive Servo-ventilation
The purpose of this study is to assess changes in left ventricular performance using echocardiography as well as ventricular remodelling, changes in sleep and changes in mood, anxiety and cognitive functions occurring as a result of treatment of predominant central sleep apnoea by adaptive servoventilation (ASV) in chronic heart failure in addition to optimal medical therapy in chronic heart failure. This will be a substudy of the SERVE-HF study.
Read the detailed description
This substudy is performed within the SERVE-HF Study, a randomised, multi-centre,international trial with parallel group design, with patients randomised to either control (optimal medical management) or active treatment (optimal medical treatment plus use of adaptive servoventilation) in a 1:1 ratio. The randomization will be the same as in the parent study. For this purpose, the randomization of the parent study will be stratified as to whether a patient is included in the substudy or not. 300 patients will be recruited for the substudy overall.
For the purpose of this substudy, patients will be followed up for a period of 12 months.
The following extra tests will be performed at the baseline visit, the 3 months follow up and the 12 months follow up:
- Echocardiogram (for both groups)
- cMRI (for both groups)
- PSG (at the baseline visit only for patients in the treatment group and at 3 months follow up and the 12 months follow up for all patients)
- 4 questionnaires (for both groups)
- Additional blood testing (for both groups)
- Conditions
- Heart Failure, Sleep Disorder, Cheyne Stokes Respiration
- Being tested
- adaptive servoventilation (ASV)
- Keywords
- Heart failure (HF), Sleep disordered breathing (SDB), Cheyne Stokes Respiration (CSR), Adaptive Servoventilation (ASV)
- Medical subject headings
- Heart Failure, Sleep Wake Disorders, Cheyne-Stokes Respiration, Sleep Apnea Syndromes
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
adaptive servoventilation (ASV)Device
Also called Adaptive Servo-Ventilation with AutoSet CS
Patients randomised to therapygroup should use the adaptive servoventilation (ASV) device each night at least 3 hours
| Study group | Role | What they receive |
|---|---|---|
| Therapy with adaptive servo ventilation | Active comparator | optimal medical therapy + adaptive servoventilation Receives: Device: adaptive servoventilation (ASV) |
| Optimal medical therapy according to guidelines | No intervention | optimal medical therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Left Ventricular Ejection Fraction (LVEF) from baseline to 12 months of therapy as measured by echocardiography (Echo).
Measured: Baseline (Randomization), 6- and 12 month-Follow-up-visit
Secondary outcomes (10)
Changes in left and right ventricular function
Measured: Baseline (Randomization), 6-and 12-month-Follow-up visit
Changes in LV systolic and diastolic indexed volumes
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in right ventricular (RV) systolic and diastolic indexed volumes
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in LV and RV mass
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in LV sphericity index and LV end-systolic global wall stress
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in sleep duration and sleep stages as well as arousals
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in sleep-disordered breathing
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in quality of life assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ)
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in mental status assessed by Mini-Mental State Examination (MMSE)
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in Patient Health Questionnaire-9 (PHQ-9) score and Patient Anxiety Questionnaire GAD-7
Measured: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Jul 2010 (estimated)
- Study startAug 2012
- Primary completionApr 2015
- Study completionJun 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Heart FailureStudies of the same condition, open and under way.
- More trials run by ResMedThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 312 participants (actual)
Sponsor and investigators
- Lead sponsor
- ResMed
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Martin Cowie, Prof, Principal investigator, Royal Brompton Hospital, LondonHolger Woehrle, MD, Study director, ResMed
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01164592
- Sponsor's protocol ID
- 01a
- Acronym
- MS
- Status last verified
- Aug 2015
- First submitted
- 15 Jul 2010
- Last updated
- 7 Aug 2015
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- SERVE-HF: Substudy on the Mechanistic Plausibility of the Clinical Benefits of Adaptive Servo-ventilation
- ClinicalTrials.gov ID
- NCT01164592
- Acronym / sponsor ID
- MS / 01a
- Conditions
- Heart Failure, Sleep Disorder, Cheyne Stokes Respiration
- Keywords
- Heart failure (HF), Sleep disordered breathing (SDB), Cheyne Stokes Respiration (CSR), Adaptive Servoventilation (ASV)
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 312 participants (actual)
- Lead sponsor
- ResMedIndustry (pharma, biotech, devices)
- Study start
- Aug 2012
- Primary completion
- Apr 2015 (actual)
- Study completion
- Jun 2015 (actual)
- First posted
- 16 Jul 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to assess changes in left ventricular performance using echocardiography as well as ventricular remodelling, changes in sleep and changes in mood, anxiety and cognitive functions occurring as a result of treatment of predominant central sleep apnoea by adaptive servoventilation (ASV) in chronic heart failure in addition to optimal medical therapy in chronic heart failure. This will be a substudy of the SERVE-HF study.
Detailed description
This substudy is performed within the SERVE-HF Study, a randomised, multi-centre,international trial with parallel group design, with patients randomised to either control (optimal medical management) or active treatment (optimal medical treatment plus use of adaptive servoventilation) in a 1:1 ratio. The randomization will be the same as in the parent study. For this purpose, the randomization of the parent study will be stratified as to whether a patient is included in the substudy or not. 300 patients will be recruited for the substudy overall.
For the purpose of this substudy, patients will be followed up for a period of 12 months.
The following extra tests will be performed at the baseline visit, the 3 months follow up and the 12 months follow up:
- Echocardiogram (for both groups)
- cMRI (for both groups)
- PSG (at the baseline visit only for patients in the treatment group and at 3 months follow up and the 12 months follow up for all patients)
- 4 questionnaires (for both groups)
- Additional blood testing (for both groups)
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Therapy with adaptive servo ventilation | Active comparator | Device: adaptive servoventilation (ASV)optimal medical therapy + adaptive servoventilation |
| Optimal medical therapy according to guidelines | No intervention | –optimal medical therapy |
Who may qualify
- Ages
- 22 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Over 22 years of age
- Severe Chronic Heart Failure (CHF) with NYHA class III-IV or NYHA class II with at least one hospitalisation for HF within the last 24 months
- Left ventricular ejection fraction (LVEF) less than or equal to 45% by means of echocardiography, radionucleotide angiography, left ventriculography or cardiac MRI documented less than 12 weeks before randomisation
- Diagnosis of sleep disordered breathing (SDB) with an apnoea-hypopnoea-index (AHI) of >15/hr with at least 50% central events and a central AHI of at least 10/hr
- Clinically stable with no change in medication and no unplanned hospitalisation for heart failure in preceding month
Key exclusion criteria (14 listed)
- Significant chronic obstructive pulmonary disease (COPD) with Forced Expiratory Volume within one second (FEV1)<50% predicted
- Oxygen saturation at rest during the day 90% at the time of inclusion
- Current use of Positive Airway Pressure (PAP) therapy
- Life expectancy < 1 year for diseases unrelated to chronic heart failure
- Cardiac surgery, Percutaneous coronary intervention (PCI), Myocardial Infarction (MI) or unstable angina within 6 months prior to randomisation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| adaptive servoventilation (ASV)Also: Adaptive Servo-Ventilation with AutoSet CSPatients randomised to therapygroup should use the adaptive servoventilation (ASV) device each night at least 3 hours | Device | Therapy with adaptive servo ventilation |
Primary outcome
Change in Left Ventricular Ejection Fraction (LVEF) from baseline to 12 months of therapy as measured by echocardiography (Echo).
Time frame: Baseline (Randomization), 6- and 12 month-Follow-up-visit
10 secondary outcomes
Changes in left and right ventricular function
Time frame: Baseline (Randomization), 6-and 12-month-Follow-up visit
Changes in LV systolic and diastolic indexed volumes
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in right ventricular (RV) systolic and diastolic indexed volumes
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in LV and RV mass
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in LV sphericity index and LV end-systolic global wall stress
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in sleep duration and sleep stages as well as arousals
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in sleep-disordered breathing
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in quality of life assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ)
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in mental status assessed by Mini-Mental State Examination (MMSE)
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Changes in Patient Health Questionnaire-9 (PHQ-9) score and Patient Anxiety Questionnaire GAD-7
Time frame: Baseline (Randomization), 6- and 12-month-Follow-up-visit
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2015.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Martin Cowie, Prof principal investigator
Royal Brompton Hospital, London
Holger Woehrle, MD study director
ResMed
94 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing adaptive servoventilation (ASV) in people with Heart Failure and Sleep Disorder, run by ResMed at 94 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Aug 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 94 sites in Germany, Australia, Finland, France, Switzerland and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Left Ventricular Ejection Fraction (LVEF) from baseline to 12 months of therapy as measured by echocardiography (Echo). (time frame: Baseline (Randomization), 6- and 12 month-Follow-up-visit). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2015.