Trial Outcomes & Findings for Training-induced Increased Left Ventricular Trabeculation (NCT NCT02568072)

NCT ID: NCT02568072

Last Updated: 2021-08-05

Results Overview

Measured on echocardiography and cardiac magnetic resonance: 1. Echocardiographic measure of compacted myocardial tissue (systole) - Jenni Compacted layer measurement (cm) 2. Cardiac magnetic resonance measure of compacted myocardial tissue (diastole) - Petersen Compacted layer measurement (cm)

Recruitment status

COMPLETED

Target enrollment

120 participants

Primary outcome timeframe

Baseline and 7 months

Results posted on

2021-08-05

Participant Flow

Participant milestones

Participant milestones
Measure
Study Group
120 subjects recruited into study. 18-35 years old and had never run a marathon distance previously. Individuals were excluded if they had pre-existing cardiovascular disease during preliminary investigations or contraindication to cardiac magnetic resonance (CMR).
Overall Study
STARTED
120
Overall Study
COMPLETED
68
Overall Study
NOT COMPLETED
52

Reasons for withdrawal

Reasons for withdrawal
Measure
Study Group
120 subjects recruited into study. 18-35 years old and had never run a marathon distance previously. Individuals were excluded if they had pre-existing cardiovascular disease during preliminary investigations or contraindication to cardiac magnetic resonance (CMR).
Overall Study
Unavailable for appointment
23
Overall Study
Unable to contact
3
Overall Study
Diagnosis of Long QT Syndrome
1
Overall Study
Withdrawal by Subject
1
Overall Study
Sustained injury, marathon not run
24

Baseline Characteristics

Training-induced Increased Left Ventricular Trabeculation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Study Group
n=68 Participants
120 subjects recruited into study. 18-35 years old and had never run a marathon distance previously. Individuals were excluded if they had pre-existing cardiovascular disease during preliminary investigations or contraindication to cardiac magnetic resonance (CMR).
Age, Categorical
<=18 years
0 Participants
n=99 Participants
Age, Categorical
Between 18 and 65 years
68 Participants
n=99 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
Age, Continuous
29.5 years
STANDARD_DEVIATION 3.2 • n=99 Participants
Sex: Female, Male
Female
32 Participants
n=99 Participants
Sex: Female, Male
Male
36 Participants
n=99 Participants
Region of Enrollment
United Kingdom
68 participants
n=99 Participants

PRIMARY outcome

Timeframe: Baseline and 7 months

Population: One subject did not undergo cardiac magnetic resonance imaging post marathon due to first trimester pregnancy 68 Participants underwent the "Jenni Compacted layer measurement (cm)" and 67 Participants underwent the "Petersen Compacted layer measurement (cm)"

Measured on echocardiography and cardiac magnetic resonance: 1. Echocardiographic measure of compacted myocardial tissue (systole) - Jenni Compacted layer measurement (cm) 2. Cardiac magnetic resonance measure of compacted myocardial tissue (diastole) - Petersen Compacted layer measurement (cm)

Outcome measures

Outcome measures
Measure
Baseline
n=68 Participants
Study participants with places in the 2016 London Marathon assessed prior to training
7 Months
n=67 Participants
Study participants evaluated after completing the 2016 London Marathon
Thickness of Compacted Myocardial Tissue (cm)
Jenni Compacted layer measurement (cm)
0.8 cm
Interval 0.7 to 1.0
0.85 cm
Interval 0.7 to 1.0
Thickness of Compacted Myocardial Tissue (cm)
Petersen Compacted layer measurement (cm)
0.53 cm
Interval 0.45 to 0.63
0.56 cm
Interval 0.48 to 0.64

PRIMARY outcome

Timeframe: Baseline and 7 months

Population: One subject did not undergo cardiac magnetic resonance imaging post marathon due to first trimester pregnancy 68 Participants underwent the "Jenni Compacted layer measurement (cm)" and 67 Participants underwent the "Petersen Compacted layer measurement (cm)"

Measured on echocardiography and cardiac magnetic resonance: 1. Echocardiographic measure of non-compacted myocardial tissue (systole) - Jenni Non-Compacted layer measurement (cm) 2. Cardiac magnetic resonance measure of non-compacted myocardial tissue (diastole) - Petersen Non-Compacted layer measurement (cm)

Outcome measures

Outcome measures
Measure
Baseline
n=68 Participants
Study participants with places in the 2016 London Marathon assessed prior to training
7 Months
n=67 Participants
Study participants evaluated after completing the 2016 London Marathon
Thickness of Non-compacted Myocardial Tissue (cm)
Petersen Non-Compacted layer measurement (cm)
0.65 cm
Interval 0.44 to 0.84
0.58 cm
Interval 0.43 to 0.73
Thickness of Non-compacted Myocardial Tissue (cm)
Jenni Non-Compacted layer measurement (cm)
0.8 cm
Interval 0.5 to 1.0
0.8 cm
Interval 0.6 to 1.0

PRIMARY outcome

Timeframe: Baseline and 7 months

Population: One subject did not undergo cardiac magnetic resonance imaging post marathon due to first trimester pregnancy 67 Participants underwent the "Fractal Dimension analysis" with paired results at baseline and at 7 months.

Measured on cardiac magnetic resonance, dimensionless unit and measure of endomyocardial boarder complexity. The higher the value the greater the endocardial boarder complexity and therefore the more trabeculation. Two measurements were made: 1. Captur et al. Global mean left ventricular fractal dimension 2. Captur et al. Maximum apical fractal dimension These values are between 1 and 2. Binarisation eliminates pixel detail originating from the blood pool. The edge image is covered by a series of grids. The minimum size is set to 2 pixels. The maximum size of the grid series is dictated by the dimensions of the bounding box, referring to the smallest rectangle that encloses the foreground pixels. Through the implementation of this 2D box-counting approach, a fractal output of between 1 and 2 is expected. The log-lot plot (e) produces a good fit using linear regression and yields a gradient equivalent to - FD (1.363).

Outcome measures

Outcome measures
Measure
Baseline
n=68 Participants
Study participants with places in the 2016 London Marathon assessed prior to training
7 Months
n=67 Participants
Study participants evaluated after completing the 2016 London Marathon
Myocardial Fractal Dimension
Captur et al. Global mean left ventricular fractal dimension
1.20 unitless
Standard Deviation 0.06
1.19 unitless
Standard Deviation 0.05
Myocardial Fractal Dimension
Captur et al. Maximum apical fractal dimension
1.36 unitless
Standard Deviation 0.09
1.36 unitless
Standard Deviation 0.07

SECONDARY outcome

Timeframe: Baseline and 7 months

Population: Three subjects did not have complete cardiopulmonary exercise testing results post marathon, two due to injuries sustained and one due to equipment failure. 68 Participants underwent the cardiopulmonary exercise test at baseline but 65 Participants underwent the cardiopulmonary exercise test at 7 months.

peak oxygen consumption measured by cardiopulmonary exercise testing on a semi-recumbent cycle ergometer. Reported standardised to age, gender, height and weight in ml/kg/min

Outcome measures

Outcome measures
Measure
Baseline
n=68 Participants
Study participants with places in the 2016 London Marathon assessed prior to training
7 Months
n=65 Participants
Study participants evaluated after completing the 2016 London Marathon
Increase in Peak Oxygen Consumption on Cardiopulmonary Exercise Testing After Training
37.9 ml/kg/min
Standard Deviation 6.3
38.4 ml/kg/min
Standard Deviation 6.9

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 7 months

Population: As no changes in remodelling data were demonstrated in the primary analysis, it was felt by the primary supervisor that NTproBNP levels would not be expected to change and further investigation and expense would not be of value. The initial hypothesis that NTproBNP levels would change was predicated on the assumption that remodelling changes would be found and correlation with biomarker elevation would have yielded some insights had remodelling occurred.

Serum biomarker level. No outcome data reported as during the conduct of the study remodelling was not seen from baseline to post-marathon study time-points and therefore NTproBNP levels were expected to remain unchanged and would not provide any additional value in the study and so was not undertaken.

Outcome measures

Outcome data not reported

Adverse Events

Study Group

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr Andrew D'Silva

St George's, University of London

Phone: 020 7188 7188

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place