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Cardiovascular DiseasesITERNCT05817305

Integrating Exercise Into Lifestyle of Cardiac Outpatients

An observational study of Cardiovascular Diseases and Physical Inactivity, run by Università degli Studi di Ferrara at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of the study is to investigate the long-term effects of a personalized physical activity program on exercise capacity and quality of life in patients with stable cardiovascular disease. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Medical history and functional evaluation and Health education
How many people
5,000 participants
Where
1 siteItaly
Study dates
1 Jan 1997to 31 Dec 2047
How long will I take part?
10 Years
Phase
Observational
Are there results?
Not yet: the study is under way

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 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: male and female outpatients with stable cardiovascular disease involved in an exercise-based secondary prevention program.

Who may be able to join

  • the presence of one or more previous cardiovascular events

Who cannot join

  • Ejection fraction < 30%
  • Chronic heart failure NYHA III-IV
  • Severe aortic or mitral valvulopathy
  • Severe physical or cognitive impairment
  • Exercise-induced complex arrhythmias

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Giovanni Grazzi, Professor contact

+39 0535455963

giovanni.grazzi@unife.it

Italy1 site, 1 recruiting
  • Center for Exercise Science and Sport

    Ferrara, Ferrara, 44123

    Giovanni Grazzi, Professor, +39 0535455963, giovanni.grazzi@unife.it

    Andrea Raisi, MSc, +39 0535455963, andrea.raisi@unife.it

    Recruiting

Other trials in Italy

About this study

Official title: Efficacy of an Exercise-based Secondary Prevention Program in Patients With Stable Cardiovascular Disease

The purpose of the study is to investigate the long-term effects of a personalized physical activity program on exercise capacity and quality of life in patients with stable cardiovascular disease. The analysis also intends to evaluate the prognostic value of cardiovascular function estimated through a walking test (1km Treadmill Walking Test, 1k-TWT) in relation to survival, hospitalization, and medical costs. The program considers clinical, socio-economic, and behavioural aspects, psychological support, and risk factor control. Patients receive indications for carrying out a home training program based on the performance of moderate-intensity aerobic activity at least 3-4 days a week for at least 30-60 minutes a day. All patients are also encouraged to improve their daily habits by preferring a more active lifestyle both at home and at work.

Read the detailed description

BACKGROUND: Physical activity and cardiorespiratory fitness are considered major markers of cardiovascular risk and core components of secondary prevention programs for cardiovascular diseases (CVD). The benefits of regular physical activity are well-recognized both for men and women and are inversely associated with mortality risk and the incidence of many chronic diseases. Despite the efforts of many health organizations to increase awareness of this evidence, physical inactivity and low cardiorespiratory fitness remain overlooked risk factors. Directly measured peak oxygen consumption (VO2peak) determined during maximal incremental cardiopulmonary exercise testing (CPX) is the gold standard objective measure of cardiorespiratory fitness. However, because of physical, financial, and time limitations, a direct determination is often not routinely assessed in clinical settings. Submaximal exercise testing can be a viable alternative to CPX. These tests are more practical for examining older adults or a large patient cohort. Also, they are helpful in defining functional limitations, setting up appropriate physical activity programs, and assessing the outcomes of pharmacological treatments.

RATIONALE AND OBJECTIVE OF THE STUDY: The benefits of regular physical activity are well-recognized both for men and women and are inversely associated with mortality risk and the incidence of many chronic diseases. The purpose of this observational registry is to evaluate the efficacy of an exercise-based secondary prevention program among male and female outpatients with stable cardiovascular disease.

DESCRIPTION OF THE FUNCTIONAL EVALUATION: During each session, information about weight, height, body mass index (BMI), blood pressure, cardiometabolic risk factors, and drug therapy in progress are registered. Physical activity habits are assessed using the Seven-Day Physical Activity Recall questionnaire. In addition, patients complete a sub-maximal test of 1km treadmill walking (1k-TWT), which is performed at a moderate intensity and adjusted according to the patient's perception of fatigue. Patients unable to complete the test at a walking speed ≥ 3.0 km/h can perform the test over 500m or 200m. Based on the results of the test, patients receive indications for the proper execution of a home training program, (i.e., at the same effort perceived in the test). The activity should be done at least 3-4 times per week, preferably every day, for at least 30-60 minutes. All patients are also encouraged to improve their daily habits by opting for a more active lifestyle at home and at work. Written informed consent is required from all participants at the time of enrollment.

Being tested
Medical history and functional evaluation, Health education
Keywords
Cardiovascular disease, Physical activity, Epidemiology, Cardiorespiratory fitness
Medical subject headings
Cardiovascular Diseases, Sedentary Behavior, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Medical history and functional evaluationOther

    During each session, physical parameters are measured and data on medical history and physical activity are collected. To assess cardiorespiratory fitness, all patients complete a submaximal, moderate, and perceptually regulated treadmill walking test (1k-TWT). Patients unable to complete the test at a walking speed ≥ 3.0 km/h perform the test over 500m or 200m.

  • Health educationOther

    Patients receive recommendations for risk factor management as well as continuous motivational counselling in order to develop and maintain a stable active lifestyle.

Study groups in NCT05817305
Study groupRoleWhat they receive
Cardiac outpatientsPatients with stable cardiovascular disease who have been referred to the service by their general practitioner or cardiologist
Receives: Other: Medical history and functional evaluation; Other: Health education

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mortality

    Association of all-cause mortality and cause-specific death with exercise capacity

    Measured: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

Secondary outcomes (3)
  1. Hospitalization

    Association of cause-specific hospitalization with exercise capacity

    Measured: From date of enrollment until the first hospitalization (any hospital admission is considered an event), assessed up to 12 years

  2. Peak Oxygen Uptake (VO2peak)

    Measurement of cardiorespiratory fitness, reported as ml/kg/min and estimated through a moderate and perceptually regulated 1km treadmill walk test (1k-TWT) or through related short-forms (500m or 200m)

    Measured: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

  3. Leisure time physical activity levels

    Measurement of physical activity levels, reported as MET/h-week and estimated through the 7-day physical activity recall questionnaire

    Measured: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Apr 2023
  2. Study start1 Jan 1997
  3. Primary completion31 Dec 2030 (estimated)
  4. Study completion31 Dec 2047 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
5,000 participants (estimated)
Target duration
10 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT05817305
Sponsor's protocol ID
CSB-21-01
Acronym
ITER
Status last verified
May 2024
First submitted
21 Mar 2023
Last updated
10 Apr 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Chiaranda G, Myers J, Mazzoni G, Terranova F, Bernardi E, Grossi G, Codeca L, Conconi F, Grazzi G. Peak oxygen uptake prediction from a moderate, perceptually regulated, 1-km treadmill walk in male cardiac patients. J Cardiopulm Rehabil Prev. 2012 Sep-Oct;32(5):262-9. doi: 10.1097/HCR.0b013e3182663507.

    PubMed 22936157
  • Grazzi G, Chiaranda G, Myers J, Pasanisi G, Lordi R, Conconi F, Mazzoni G. Outdoor Reproducibility of a 1-km Treadmill Walking Test to Predict Peak Oxygen Uptake in Cardiac Patients. J Cardiopulm Rehabil Prev. 2017 Sep;37(5):347-349. doi: 10.1097/HCR.0000000000000266.

    PubMed 28671933
  • Mazzoni G, Sassone B, Pasanisi G, Myers J, Mandini S, Volpato S, Conconi F, Chiaranda G, Grazzi G. A moderate 500-m treadmill walk for estimating peak oxygen uptake in men with NYHA class I-II heart failure and reduced left ventricular ejection fraction. BMC Cardiovasc Disord. 2018 Apr 16;18(1):67. doi: 10.1186/s12872-018-0801-9.

    PubMed 29661150
  • Mazzoni G, Chiaranda G, Myers J, Sassone B, Pasanisi G, Mandini S, Volpato S, Conconi F, Grazzi G. 500-meter and 1000-meter moderate walks equally assess cardiorespiratory fitness in male outpatients with cardiovascular diseases. J Sports Med Phys Fitness. 2018 Sep;58(9):1312-1317. doi: 10.23736/S0022-4707.17.07525-9. Epub 2017 Sep 29.

    PubMed 28967238
  • Mazzoni G, Myers J, Sassone B, Pasanisi G, Mandini S, Raisi A, Pizzolato M, Franchi M, Caruso L, Missiroli L, Chiaranda G, Grazzi G. A moderate 200-m walk test estimates peak oxygen uptake in elderly outpatients with cardiovascular disease. J Sports Med Phys Fitness. 2020 May;60(5):786-793. doi: 10.23736/S0022-4707.20.10387-6.

    PubMed 32438791
  • Zerbini V, Raisi A, Myers J, Piva T, Lordi R, Chiaranda G, Mazzoni G, Grazzi G, Mandini S. Peak Oxygen Uptake Estimation From A Moderate 1-KM Treadmill Walk in Women With Cardiovascular Disease. J Cardiopulm Rehabil Prev. 2021 Nov 1;41(6):432-434. doi: 10.1097/HCR.0000000000000641. No abstract available.

    PubMed 34727562
  • Chiaranda G, Bernardi E, Codeca L, Conconi F, Myers J, Terranova F, Volpato S, Mazzoni G, Grazzi G. Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study. BMJ Open. 2013 Oct 25;3(10):e003446. doi: 10.1136/bmjopen-2013-003446.

    PubMed 24163203
  • Grazzi G, Myers J, Bernardi E, Terranova F, Grossi G, Codeca L, Volpato S, Conconi F, Mazzoni G, Chiaranda G. Association between VO(2) peak estimated by a 1-km treadmill walk and mortality. A 10-year follow-up study in patients with cardiovascular disease. Int J Cardiol. 2014 May 1;173(2):248-52. doi: 10.1016/j.ijcard.2014.02.039. Epub 2014 Feb 28.

    PubMed 24630380
  • Grazzi G, Mazzoni G, Myers J, Codeca L, Pasanisi G, Napoli N, Guerzoni F, Volpato S, Conconi F, Chiaranda G. Improved walking speed is associated with lower hospitalisation rates in patients in an exercise-based secondary prevention programme. Heart. 2016 Dec 1;102(23):1902-1908. doi: 10.1136/heartjnl-2015-309126. Epub 2016 Jul 7.

    PubMed 27390367
  • Uliari S, Myers J, Bernardi E, Chiaranda G, Conconi F, Terranova F, Mazzoni G, Grazzi G. Oxygen Uptake Attenuation at Ventilatory Threshold in Men With Coronary Artery Disease. J Cardiopulm Rehabil Prev. 2016 Jul-Aug;36(4):258-62. doi: 10.1097/HCR.0000000000000160.

    PubMed 27120036
  • Mandini S, Grazzi G, Mazzoni G, Myers J, Pasanisi G, Sassone B, Conconi F, Chiaranda G. A moderate 1-km treadmill walk predicts mortality in men with mid-range left ventricular dysfunction. Eur J Prev Cardiol. 2017 Oct;24(15):1670-1672. doi: 10.1177/2047487317722434. Epub 2017 Jul 21. No abstract available.

    PubMed 28728484
  • Grazzi G, Mazzoni G, Myers J, Codeca L, Pasanisi G, Mandini S, Piepoli M, Volpato S, Conconi F, Chiaranda G. Determining the best percent-predicted equation for estimated VO2 peak by a 1-km moderate perceptually-regulated treadmill walk to predict mortality in outpatients with cardiovascular disease. J Sci Med Sport. 2018 Mar;21(3):307-311. doi: 10.1016/j.jsams.2017.06.003. Epub 2017 Jun 8.

    PubMed 28645496
  • Grazzi G, Mazzoni G, Myers J, Caruso L, Sassone B, Pasanisi G, Guerzoni F, Napoli N, Pizzolato M, Zerbini V, Franchi M, Masotti S, Mandini S, Raisi A, Chiaranda G. Impact of Improvement in Walking Speed on Hospitalization and Mortality in Females with Cardiovascular Disease. J Clin Med. 2020 Jun 5;9(6):1755. doi: 10.3390/jcm9061755.

    PubMed 32517001
  • Bonnini S, Mazzoni G, Borghesi M, Chiaranda G, Myers J, Mandini S, Raisi A, Masotti S, Grazzi G. Improving walking speed reduces hospitalization costs in outpatients with cardiovascular disease. An analysis based on a multistrata non-parametric test. BMC Health Serv Res. 2020 Nov 17;20(1):1048. doi: 10.1186/s12913-020-05874-3.

    PubMed 33203408
  • Chiaranda G, Myers J, Arena R, Kaminsky L, Sassone B, Pasanisi G, Mandini S, Mazzoni G, Grazzi G. Prognostic comparison of the FRIEND and Wasserman/Hansen peak VO2 equations applied to a submaximal walking test in outpatients with cardiovascular disease. Eur J Prev Cardiol. 2021 Apr 23;28(3):287-292. doi: 10.1177/2047487319871728. Epub 2019 Aug 26.

    PubMed 33891689

Questions about this trial

What is this clinical trial studying?

An observational study of Cardiovascular Diseases and Physical Inactivity, run by Università degli Studi di Ferrara at 1 site in Italy.

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 1 inclusion and 5 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: looking for participants now, as of the sponsor's last update on 10 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Giovanni Grazzi, Professor (+39 0535455963, giovanni.grazzi@unife.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mortality (time frame: From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05817305, which also lists 18 linked publications.

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 10 Apr 2025.

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