[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"heart-failure-and-reduced-ejection-fraction\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:heart-failure-and-reduced-ejection-fraction":26},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,8,0,[8,48,74,106,141,166,196,221],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":27,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":36,"lastUpdatePostDateStruct":37,"startDateStruct":40,"completionDateStruct":42,"leadSponsor":44,"locationsCount":47},"100599411","developing-a-digital-aid-to-improve-icd-decisions-100599411",false,"NCT07084142","Developing a Digital Aid to Improve ICD Decisions","Developing \"A Digital Shared Decision-Making Aid to Improve Patient-Centered Outcomes in Implantable Cardioverter-Defibrillator (ICD) Decisions Among Older Patients\"","Developmental Testing will attempt to abide by eligibility criteria identical to the planned criteria for the subsequent RCT, but may strategically deviate from these criteria to enhance the testing and development process.\n\nInclusion Criteria:\n\n* Meets or approximates minimal criteria for primary prevention ICD placement. ● Left Ventricular Ejection Fraction (LVEF) \\\u003C35%.\n* Clinical diagnosis of Heart Failure:\n* Patients with severe ischemic dilated cardiomyopathy and underlying NYHA\n* Class II or III Heart Failure, OR, Patients with severe nonischemic dilated cardiomyopathy and underlying NYHA Class II or III Heart Failure.\n* Age ≥ 70 years old.\n* Able to consent in English, Mandarin or Spanish and follow study instructions.\n\nExclusion Criteria:\n\nThe exclusion criteria include any of the following:\n\n* Past ICD implantation (not including pacemakers).\n* Any indication for secondary prevention of SCD via ICD implantation.\n* History of mechanical valve replacement.\n* History of recent myocardial infarction within the last 40 days.\n* History of recent revascularization within the past 90 days.\n* History of familial or genetic disorders with a high-risk of ventricular arrhythmias, such as the long QT syndrome (LQTS) or hypertrophic cardiomyopathy (HCM).\n* Any factors contraindicating ICD placement.\n* Less than 6 months life expectancy and other clinical consideration,\n* Unwilling or unable to consider ICD,\n* Any contraindications to ambulati","ALL","60 Years",{"count":19,"type":20},600,"ESTIMATED","INTERVENTIONAL",[23],"NA","Advanced heart failure, affecting 7 million Americans, has multiple causes and results in greatly increased risk of disability and death. A major problem is sudden cardiac death, when the damaged heart develops an abnormal pattern of electrical conduction that can result in cessation of heart activity. While placement of an Implantable Cardioverter-Defibrillator (ICD) in a patient's chest can help prevent sudden cardiac death, these devices have several important downsides. This protocol focuses on development of a digital decision aid that helps heart failure patients make informed decisions that balance the benefits and downsides of ICD placement. This protocol covers the use of participant surveys, focus groups, and interviews to obtain the needed background information to guide the development of this digital tool, which will be subsequently tested against usual care in a randomized clinical trial. The study design is best described as a mixed methods evaluation and refinement of a digital app to improve ICD decision-making. In the future, the present protocol will be modified to create a new protocol that covers the needed human subjects requirements for performance of this clinical trial.",[26],"Heart Failure and Reduced Ejection Fraction",[28,29,30,31,32,33,34],"heart failure","HFrEF","sudden cardiac death","patient education","shared decision-making","arrhythmia","implantable cardioverter-defibrillator","RECRUITING","2026-04-23",{"date":38,"type":39},"2026-04-27","ACTUAL",{"date":41,"type":39},"2025-08-01",{"date":43,"type":20},"2028-02",{"name":45,"class":46},"Stanford University","OTHER",2,{"id":49,"slug":50,"hasResults":11,"nctId":51,"briefTitle":52,"officialTitle":52,"acronym":53,"eligibilityCriteria":54,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":56,"targetDuration":4,"studyType":21,"phases":58,"briefSummary":59,"conditions":60,"keywords":61,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":66,"lastUpdatePostDateStruct":67,"startDateStruct":68,"completionDateStruct":70,"leadSponsor":72,"locationsCount":4},"100635024","evaluation-of-accelerated-bachmann-bundle-area-pacing-in-heart-failure-with-reduced-ejection-fraction-who-have-electrocardiographic-evidence-of-interatrial-block-and-indicated-for-implantable-cardioverter-defibrillator-100635024","NCT07547306","Evaluation of Accelerated Bachmann Bundle Area Pacing in Heart Failure With Reduced ejectIon Fraction Who Have electrocarDioGraphic Evidence of Interatrial Block and Indicated for Implantable Cardioverter Defibrillator","BRIDGE-HF","Inclusion Criteria:\n\n1. Age ≥18 years at the time of screening.\n2. A documented diagnosis of chronic heart failure with New York Heart Association (NYHA) class II-IV.\n3. Left ventricular ejection fraction (LVEF) ≤40%, documented by an imaging study performed within 12 months prior to screening.\n4. Receiving optimized guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF), unless contraindicated or not tolerated:\n\n   * Participants receiving ongoing treatment must be on a stable regimen for at least 1 month prior to screening (except for diuretics).\n   * Most patients with heart failure require diuretics for volume control, and dose adjustments may be made based on clinical status, including symptoms, signs, and body weight. Each participant should receive individualized diuretic therapy to maintain optimal volume status.\n5. Presence of interatrial block (IAB), defined as a P-wave duration ≥120 ms on a 12-lead electrocardiogram or ECG recording device.\n6. An indication for dual-chamber implantable cardioverter-defibrillator (ICD) implantation for primary or secondary prevention.\n7. NT-proBNP measured within 3 months prior to randomization meeting one of the following criteria:\n\n   * NT-proBNP \\>300 pg\u002FmL\n\nExclusion Criteria:\n\n1. Non-paroxysmal AF.\n2. Uncontrolled tachyarrhythmia.\n3. Sinus bradycardia requiring continuous atrial pacing or atrioventricular block requiring ventricular pacing.\n4. Acute decompensated heart failure at the time of screening or hospitalization for worsening heart failure within 4 weeks prior to enrollment.\n5. Moderate to severe primary valvular heart disease (functional mitral regurgitation or tricuspid regurgitation is not an exclusion criterion).\n6. Prior mechanical tricuspid valve replacement.\n7. Coronary revascularization (PCI or CABG) or valve surgery\u002Frepair performed within 12 weeks prior to enrollment, or planned after randomization.\n8. Obstructive hypertrophic cardiomyopathy.\n9. Infiltrative cardiomyopathy, including but not limited to amyloidosis, sarcoidosis, or Fabry disease.\n10. An indication for cardiac resynchronization therapy (CRT).\n11. Chronic kidney disease, defined as an estimated glomerular filtration rate (eGFR) \\\u003C15 mL\u002Fmin\u002F1.73 m² calculated using the CKD-EPI equation.\n12. Chronic liver disease, defined as alanine aminotransferase (ALT), aspartate aminotransferase (AST), or alkaline phosphatase \\>3 times the upper limit of normal at screening.\n13. Severe pulmonary disease, such as cor pulmonale or irreversible lung disease requiring inhaled therapy or long-term oxygen therapy.\n14. Uncontrolled hypertension, defined as a mean blood pressure \\>140\u002F90 mmHg based on outpatient clinic measurements or home blood pressure recordings within the previous 30 days, or ongoing up-titration of antihypertensive medications.\n15. Pregnant or breastfeeding women, or women planning pregnancy or breastfeeding during the study period.\n16. Active malignancy requiring treatment at the time of screening.\n17. Life expectancy \\\u003C12 months.","18 Years",{"count":57,"type":20},120,[23],"To evaluate the effect of accelerated atrial resynchronization achieved through Bachmann bundle pacing at the time of implantable cardioverter-defibrillator implantation in patients with heart failure with reduced ejection fraction and interatrial block",[26],[62,63,64],"heart failure and reduced ejection fraction","Bachmann bundle area pacing","interatrial block","NOT_YET_RECRUITING","2026-04-20",{"date":36,"type":39},{"date":69,"type":20},"2026-05",{"date":71,"type":20},"2030-12-31",{"name":73,"class":46},"Seoul National University Hospital",{"id":75,"slug":76,"hasResults":11,"nctId":77,"briefTitle":78,"officialTitle":78,"acronym":79,"eligibilityCriteria":80,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":81,"targetDuration":4,"studyType":21,"phases":83,"briefSummary":85,"conditions":86,"keywords":93,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":96,"lastUpdatePostDateStruct":97,"startDateStruct":99,"completionDateStruct":101,"leadSponsor":103,"locationsCount":105},"100634736","phase-3-selenium-intervention-registry-randomized-trial-in-heart-failure-100634736","NCT07543562","Selenium Intervention Registry Randomized Trial in Heart Failure","SIRI-HF","Inclusion Criteria:\n\nTo be considered for inclusion in this study, patients must meet all of the following eligibility requirements:\n\n* 18 years of age\n* primary discharge diagnosis of HF coded as ICD-10: I50, as recorded in The SwedeHF registry\n* be able to provide documented informed consent by signing and dating the designated consent form.\n\nExclusion Criteria:\n\n* Not suitable in the opinion of the Investigator (for example due to severe or terminal comorbidity with poor prognosis, or characteristics, pregnancy etc.) that may interfere with adherence to trial protocol",{"count":82,"type":20},4326,[84],"PHASE3","Heart failure is a serious condition in which the heart is unable to pump blood effectively, and it remains a leading cause of hospitalization and death worldwide despite advances in treatment.\n\nSelenium is an essential micronutrient that plays an important role in cellular energy production, antioxidant defense, and overall cardiovascular function. Low selenium levels are common among patients with heart failure in Northern Europe, and observational studies have shown that selenium deficiency is associated with an increased risk of hospitalization and death. In cases of severe deficiency, such as in Keshan disease, heart dysfunction can be reversed with selenium supplementation, suggesting a potential causal relationship.\n\nHowever, it is not yet known whether selenium supplementation can improve clinical outcomes in patients with heart failure when added to standard medical therapy.\n\nThe SIRI-HF trial is a randomized, placebo-controlled study designed to evaluate whether daily supplementation with 200 micrograms of selenium, in addition to guideline-directed medical therapy, improves outcomes in patients with heart failure.\n\nThe primary endpoint is a composite of recurrent heart failure hospitalizations and cardiovascular death. Secondary endpoints include all-cause mortality, changes in symptoms and functional status, and safety outcomes.\n\nThis study will include patients from Sweden and Norway and aims to determine whether correcting selenium deficiency can improve prognosis in heart failure.",[87,26,88,89,90,91,92],"Heart Failure","Heart Failure and Mildly Reduced Ejection Fraction","Heart Failure and Preserved Ejection Fraction","Selenium Supplementation","Selenium","Cognitive Functioning",[28,94,95,79],"selenium","RRCT","2026-04-15",{"date":98,"type":39},"2026-04-22",{"date":100,"type":39},"2026-04-01",{"date":102,"type":20},"2031-03",{"name":104,"class":46},"Skane University Hospital",11,{"id":107,"slug":108,"hasResults":11,"nctId":109,"briefTitle":110,"officialTitle":111,"acronym":112,"eligibilityCriteria":113,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":114,"targetDuration":4,"studyType":116,"phases":4,"briefSummary":117,"conditions":118,"keywords":120,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":130,"lastUpdatePostDateStruct":131,"startDateStruct":133,"completionDateStruct":135,"leadSponsor":137,"locationsCount":140},"100609018","propensity-matched-study-of-cardiac-contractility-modulation-therapy-in-heart-failure-100609018","NCT07209098","Propensity-Matched Study of Cardiac Contractility Modulation Therapy in Heart Failure","Broaden Accessibility of Breakthrough Treatment for Heart Failure: A Prospective, Propensity-Matched CED to Access the Impact of Cardiac Contractility Modulation Therapy (CCM)","BRIGHTEN-HF","Inclusion Criteria\n\n1. Continuous representation in the database in the year prior to index.\n2. Age 18 or older will be enrolled in either the treatment or control arm of the study.\n3. NYHA III heart failure,\n4. Not receiving CRT\n5. EF 25 - 45%, inclusive.\n6. Remain symptomatic despite at least 3 months of optimized guideline-directed medical therapy (GDMT) as determined by the heart team prior to CCM implantation.\n\nExclusion Criteria\n\n1. Subject has had a prior heart transplant\n2. Subject with mechanical tricuspid valve.\n3. Subject has a left ventricular assist device (LVAD).",{"count":115,"type":20},4200,"OBSERVATIONAL","The purpose of this prospective, multi-center, propensity-matched coverage with evidence development (CED) study is to assess the impact of cardiac contractility modulation (CCM) on mortality and heart failure hospitalizations in Medicare-eligible patients with heart failure who meet indications for CCM.",[26,119],"NYHA Class III Heart Failure",[121,122,123,124,125,126,127,128,129],"Heart failure","Reduced ejection fraction","Cardiac Contractility Modulation","CCM","NYHA III","Propensity Score Matching","All-Cause Mortality","Heart Failure Hospitalizations","CED","2026-03-23",{"date":132,"type":39},"2026-03-24",{"date":134,"type":39},"2025-11-18",{"date":136,"type":20},"2031-04",{"name":138,"class":139},"Impulse Dynamics","INDUSTRY",1,{"id":142,"slug":143,"hasResults":11,"nctId":144,"briefTitle":145,"officialTitle":145,"acronym":146,"eligibilityCriteria":147,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":148,"targetDuration":4,"studyType":21,"phases":150,"briefSummary":151,"conditions":152,"keywords":154,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":157,"lastUpdatePostDateStruct":158,"startDateStruct":160,"completionDateStruct":162,"leadSponsor":164,"locationsCount":140},"100628901","infusing-needed-iron-to-target-insufficiency-in-adults-treated-for-evidence-of-heart-failure-100628901","NCT07467668","Infusing Needed Iron to Target Insufficiency in Adults Treated for Evidence of Heart Failure","INITIATE-HF","Inclusion Criteria:\n\nAdults (age \\>18 years); Diagnosed heart failure with most recent left ventricular ejection fraction \\\u003C50%; Hospitalized for any reason for the index admission; Documented iron deficiency defined as TSAT \\\u003C20% during the index hospitalization; At least 6 months of health plan coverage and prescription drug benefit before admission\n\nExclusion Criteria:\n\nA documented allergy to IV iron in the Kaiser Permanente Northern California (KPNC) electronic health record (EHR) system; A history of hemochromatosis (i.e., iron overload) based on KPNC EHR data; End-stage kidney disease (defined as receiving chronic dialysis or a prior kidney transplant) or advanced chronic kidney disease (i.e., estimated glomerular filtration rate \\[eGFR\\] \\\u003C30 mL\u002Fmin\u002F1.73 m2) based on most recent pre-admission outpatient laboratory results or the KPNC regional End-Stage Kidney Disease Treatment Registry; Serum ferritin \\>300 ng\u002FmL based on KPNC EHR data; Diagnosed with metastatic cancer and\u002For receiving systemic chemotherapy based on KPNC EHR data; Institutionalized (e.g., prison) and\u002For receiving palliative care per KPNC EHR data",{"count":149,"type":20},3000,[23],"The INITIATE-HF study is a cluster randomized controlled trial that aims to find out if reminding doctors about treatment guidelines for iron deficiency in adults with heart failure who are hospitalized and have evidence of iron deficiency changes the subsequent use of intravenous (IV) iron.\n\nTwo groups of hospitalized adult patients with known heart failure and iron deficiency will be compared:\n\n* Group 1 will include doctors who receive a notification with their patient's iron storage test results and guideline recommendations related to the use of IV iron.\n* Group 2 will include doctors who do not receive this notification and continue with usual standard of care.\n\nThe study will measure if this provider-facing notification affects physician use of recommended IV iron treatment in eligible patients with heart failure, left ventricular ejection fraction less than 50%, and iron deficiency. Secondarily, if there is an increased use of IV iron observed in the intervention group, this study will evaluate whether there are differential health outcomes (i.e., fewer subsequent hospital visits and lower risk of death) of patients whose providers were assigned to the intervention group.",[153,87,26,88],"Iron Deficiency (ID)",[155,156,28],"IV iron","iron deficiency","2026-03-11",{"date":159,"type":39},"2026-03-12",{"date":161,"type":20},"2026-03-09",{"date":163,"type":20},"2028-12-31",{"name":165,"class":46},"Kaiser Permanente",{"id":167,"slug":168,"hasResults":11,"nctId":169,"briefTitle":170,"officialTitle":171,"acronym":172,"eligibilityCriteria":173,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":174,"targetDuration":4,"studyType":21,"phases":176,"briefSummary":177,"conditions":178,"keywords":180,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":187,"lastUpdatePostDateStruct":188,"startDateStruct":190,"completionDateStruct":192,"leadSponsor":194,"locationsCount":140},"100626047","comparing-three-types-of-specialist-pacemakers-to-improve-heart-function-and-reduce-rhythm-problems-in-heart-failure-100626047","NCT07430553","Comparing Three Types of Specialist Pacemakers to Improve Heart Function and Reduce Rhythm Problems in Heart Failure","Randomised Investigation of Physiological, Conventional and Optimised Resynchronisation Therapy in Heart Failure With Prolonged QRS Duration (RIPCORD-CRT)","RIPCORD-CRT","Inclusion Criteria:\n\nPatients referred\u002Fscheduled for a CRT procedure (new implant or upgrade) who have:\n\n* Symptomatic heart failure (NYHA II-IV)\n* Reduced ejection fraction (LVEF≤40%)\n* Prolonged QRS duration (≥130ms) and left bundle branch block ECG morphology or very prolonged QRS duration (\\>150ms) and non-left bundle branch block ECG\n* Optimal medical therapy for HF\n\nExclusion Criteria:\n\n* Unable to provide informed consent\n* \\\u003C18 years old\n* Pregnant patients (with female patients of childbearing age requiring a negative urine BHCG)",{"count":175,"type":20},60,[23],"The goal of this clinical trial is to find out which type of specialist pacemaker-known as cardiac resynchronisation therapy (CRT)-works best for people with heart failure and a delay in how the lower chambers of the heart beat together (called electrical dyssynchrony).\n\nThe main aims of the study are:\n\nTo compare the effects of conventional biventricular pacing (BVP), conduction system pacing (CSP) and left-bundle optimised CRT (LOT-CRT) on heart failure symptoms and heart rhythm problems over six months.\n\nTo explore how these pacing methods affect heart muscle strength, electrical activity, and overall heart function.\n\nParticipants will:\n\nAttend four hospital visits over a six-month period.\n\nAt Visit 1, meet a member of the research team to discuss the study and have screening tests to check eligibility. Participants will also have a smartphone app installed and receive training on how to record their daily heart failure symptoms.\n\nAt Visit 2, have a CRT pacemaker implanted. The type of pacemaker will be chosen at random, with a 1 in 3 chance of receiving:\n\n* Biventricular pacing (BVP); the current standard treatment\n* Conduction system pacing (CSP)\n* LOT-CRT (Left-bundle optimised CRT); a combination of both\n\nAt Visit 3 (around 12 weeks after implantation) and Visit 4 (6 months after implantation), take part in routine follow-up assessments to check the pacemaker and heart function.\n\nAt Visits 2 and 4, also undergo non-invasive electrical mapping tests, including wearing a specialised vest and having a low-dose CT scan of the chest. These tests help researchers understand how the heart's electrical system responds to different pacing methods.",[26,179],"Dyssynchrony",[181,182,183,184,28,185,186],"Cardiac resynchronisation therapy","Conduction system pacing","optimised CRT","LOT-CRT","dyssynchrony","left bundle branch pacing","2026-02-17",{"date":189,"type":39},"2026-02-24",{"date":191,"type":39},"2025-11-12",{"date":193,"type":20},"2028-10-24",{"name":195,"class":46},"Imperial College London",{"id":197,"slug":198,"hasResults":11,"nctId":199,"briefTitle":200,"officialTitle":200,"acronym":201,"eligibilityCriteria":202,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":203,"targetDuration":4,"studyType":116,"phases":4,"briefSummary":205,"conditions":206,"keywords":208,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":211,"lastUpdatePostDateStruct":212,"startDateStruct":214,"completionDateStruct":216,"leadSponsor":218,"locationsCount":220},"100603062","secondary-mitral-regurgitation-treatment-with-mitraclip-and-assessment-by-cardiac-magnetic-resonance-100603062","NCT07131631","Secondary Mitral Regurgitation Treatment With MitraClip and Assessment by Cardiac Magnetic Resonance","SMARTER-CMR","Inclusion Criteria:\n\n1\\. Adult patients (≥ 18 years old) with heart failure and reduced ejection fraction (LVEF \\\u003C 50% defined by echocardiography), medically and device-optimized according to guidelines, with significant FMR undergoing TEER with FDA-approved MitraClip device (Abbott Structural, USA)\n\nExclusion Criteria:\n\n1. Concomitant PCI and TEER\n2. Congenital heart disease\n3. Stage D heart failure\n4. Uncontrolled atrial fibrillation\n5. Pregnancy\n6. \\> moderate tricuspid regurgitation\n7. \\>moderate aortic regurgitation or stenosis\n8. Contraindications or unable to undergo CMR\n9. Prior mitral valve repair or replacement",{"count":204,"type":20},125,"This is a multi-center, prospective, observational study designed to evaluate the impact of LV myocardial fibrosis extent assessed by CMR on LV reverse remodeling and clinical outcomes post TEER. The target sample will be up to 125 patients enrolled to achieve 100 evaluable at 6 months of follow-up. Enrollment will occur at up to eight centers.",[26,207],"Functional Mitral Regurgitation",[28,209,210],"reduced ejection fraction","functional mitral regurgitation","2025-12-16",{"date":213,"type":39},"2025-12-23",{"date":215,"type":39},"2022-03-03",{"date":217,"type":20},"2027-07",{"name":219,"class":46},"Minneapolis Heart Institute Foundation",6,{"id":222,"slug":223,"hasResults":11,"nctId":224,"briefTitle":225,"officialTitle":226,"acronym":227,"eligibilityCriteria":228,"healthyVolunteers":11,"sex":16,"minAge":55,"maxAge":4,"enrollmentInfo":229,"targetDuration":4,"studyType":21,"phases":231,"briefSummary":232,"conditions":233,"keywords":234,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":237,"lastUpdatePostDateStruct":238,"startDateStruct":240,"completionDateStruct":241,"leadSponsor":243,"locationsCount":47},"100614118","effectiveness-and-safety-of-uptitration-of-guideline-directed-medical-therapy-in-heart-failure-with-reduced-ejection-fraction-with-limited-kidney-function-assessments-100614118","NCT07275437","Effectiveness and Safety of Uptitration of Guideline Directed MEdical Therapy in Heart Failure With Reduced Ejection Fraction With Limited Kidney Function Assessments","A Randomized, Controlled Trial Investigating the Effectiveness and Safety of Uptitration of Guideline Directed MEdical Therapy in Heart Failure With a Reduced Ejection Fraction With Limited Standardized Kidney Function Assessments (RESUME-HF-Kidney)","RESUME-HF","Inclusion Criteria:\n\n1. Able and willing to give written informed consent\n2. Age ≥ 18 years\n3. Diagnosed with HFrEF (LVEF≤ 45%) according to criteria from 2021 European Society of Cardiology guidelines for heart failure\n4. Less than 100% target dose of 2 individual reno-active GDMT classes (ACEi\u002FARB\u002FARNI, MRA or SGLT-2i)\n\nExclusion Criteria:\n\n1. eGFR\\\u003C25 mL\u002Fmin\u002F1.73 m2 measured up to 30 days before the first visit\n2. Potassium \\> 5.5 mmol\u002FL or \\\u003C3.5 mmol\u002FL at screening\n3. Known intolerance or allergy to two individual GDMT\n4. Signs of hemodynamic instability and\u002For cardiogenic shock\n5. Decompensated heart failure requiring treatment with intravenous loop diuretics\n6. Known concomitant structural kidney disease such as polycystic kidney disease or renal artery stenosis",{"count":230,"type":20},344,[23],"Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) constitutes of four medications that substantially reduce morbidity and mortality, and improve quality of life. In routine clinical practice, various physician- and patient-related factors lead to suboptimal initiation and uptitration of GDMT to optimal dosing, which is associated with worse patient outcomes. A perceived major barrier to the optimalization of GDMT are changes in kidney function and electrolytes, which prompts physicians to halt uptitration, reduce doses, or even discontinue GDMT. Changes in kidney function and electrolytes during optimalization of GDMT are common, but not associated with adverse events.\n\nThe hypothesis of this study is that a reduction in the number of kidney function assessments during initiation and uptitration of GDMT in HFrEF patients will lead to higher achieved doses of GDMT without safety concerns.",[87,26,88],[235,236],"Guideline-Directed Medical Therapy","Limited Kidney Function Assessments","2025-12-10",{"date":239,"type":39},"2025-12-18",{"date":100,"type":20},{"date":242,"type":20},"2030-01-01",{"name":244,"class":46},"University Medical Center Groningen"]