Heart Failure Clinical Trial
CHF COPD Sip Feed Anabolic Response
Summary
Weight loss commonly occurs in patients with chronic heart failure (CHF) and chronic obstructive pulmonary disorder (COPD), negatively influencing their quality of life, treatment response and survival. Loss of muscle protein is generally a central component of weight loss in CHF and COPD patients, but patients also have reductions in fat mass and bone density, independent of the severity of the disease state. The purpose of this study is to provide detailed insight in disease related gut function by obtaining information on gut permeability, digestion and absorption of glucose, fat and protein in CHF and COPD patients compared to matched healthy controls. This will provide required information that is necessary to implement new strategies to develop optimal nutritional regimen in CHF and COPD.
Full Description
General aims:
To study the whole-body protein anabolic effect of several dosages of a high-quality protein sip feeding in COPD and CHF subjects as compared to healthy controls.
To investigate the anabolic threshold in subjects with COPD and CHF as compared to healthy controls.
Purpose and objectives: Although the Researchers' previous study supports the concept of supplementing high-quality milk proteins in chronic wasting diseases i.e., COPD and CHF, the dose-response anabolic effects of proteins with high EAA levels are still unclear. Furthermore, there is no insight in the actual protein requirements in COPD and CHF. The knowledge gained from this study will benefit insight in terms of promotion of protein gain after feeding in COPD and CHF subjects. Based on the obtained data of protein behavior (protein kinetics) the Researchers will be able to further refine and personalize nutritional supplementation in COPD and CHF subjects in order to stop and even restore progressive muscle wasting.
Eligibility Criteria
Inclusion criteria CHF subjects:
Ability to walk, sit down and stand up independently
Age 45 years or older
Ability to lie in supine or elevated position for 8 hours
Diagnosis of CHF; under regular care by cardiologist
Reduced ejection fraction (<45%) assessed in the past 2 years
NYHA class II-IV
Clinically stable condition; no hospitalization 4 weeks preceding first study day
Willingness and ability to comply with the protocol
Inclusion criteria COPD subjects:
Ability to walk, sit down and stand up independently
Age 45 years or older
Ability to lie in supine or elevated position for 8 hours
Diagnosis of moderate to very severe chronic airflow limitation and compliant to the following criteria: FEV1 < 70% of reference FEV1
Clinically stable condition and not suffering from a respiratory tract infection or exacerbation of their disease (defined as a combination of increased cough, sputum purulence, shortness of breath, systemic symptoms such as fever, and a decrease in FEV1 > 10% compared with values when clinically stable in the preceding year) at least 4 weeks prior to the first test day
Shortness of breath on exertion
Willingness and ability to comply with the protocol
Inclusion criteria healthy subjects:
Healthy male or female according to the investigator's or appointed staff's judgment
Ability to walk, sit down and stand up independently
Age 45 years or older (older control group)
Age between 20-30 years old (young group)
Ability to lay in supine or elevated position for 8 hours
No diagnosis of CHF or COPD
Willingness and ability to comply with the protocol
Exclusion Criteria all subjects:
Any condition that may interfere with the definition 'healthy subject' according to the investigator's judgment (healthy subjects only)
Established diagnosis of malignancy
History of untreated metabolic diseases including hepatic or renal disorder
Presence of acute illness or metabolically unstable chronic illness
Presence of fever within the last 3 days
Body mass index >40 kg/m2 (healthy subjects only)
Any other condition according to the PI or nurse that was found during the screening visit, that would interfere with the study or safety of the patient
Use of protein or amino acid containing nutritional supplements within 5 days of first study day
Current Use of long-term oral corticosteroids (CHF only)
Use of short course of oral corticosteroids within 4 weeks preceding first study day
Failure to give informed consent or Investigator's uncertainty about the willingness or ability of the subject to comply with the protocol requirements
(Possible) pregnancy
Already enrolled in another clinical trial and that clinical trial interferes with participating in this study
When during the period from enrollment to the test day any condition causing the subject to not meet inclusion criteria or to meet exclusion criteria, the subject will be excluded from the study.
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