[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"heart-failure-systolic\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:heart-failure-systolic":28},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,18,0,[8,53,84,110,142,171,193,214,234,261,307,330,353,374,402,441,466,524],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":29,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":41,"lastUpdatePostDateStruct":42,"startDateStruct":45,"completionDateStruct":47,"leadSponsor":49,"locationsCount":52},"100541632","paced-heart-rate-acceleration-for-cardiac-conditioning-100541632",false,"NCT06332391","Paced Heart Rate Acceleration for Cardiac Conditioning","A New Pacing Approach for Cardiac Conditioning and Enhanced Cardioprotection","HeartExcel","Inclusion Criteria:\n\n* Provision of signed and dated informed consent form\n* Stated willingness to comply with all study procedures and availability for the duration of the study\n* Male or female sex\n* Age 18 years or greater\n* Available transportation for study visits\n* Left ventricular ejection fraction \\\u003C or = 40% despite at least 3 months guideline-directed medial therapy\n* NYHA class II-III heart failure symptoms\n* Atrial-lead inclusive implantable cardioverter defibrillator or biventricular defibrillator in place \\> 3 months\n* Intrinsic or biventricular paced QRS duration of \\\u003C= 120 milliseconds\n\nExclusion Criteria:\n\n* Age \\\u003C 18 years\n* Inability to ambulate safely\n* Congenital or primary valve disease\n* Ongoing (not suppressed) atrial arrhythmias\n* Left ventricular thrombus\n* Severe peripheral arterial disease that limits mobility\n* Hospital admission for life-threatening condition (e.g. heart failure, stroke) in the past 3 months\n* Major surgery in the past 3 months or anticipated during the period of study\n* Ventricular pacing indication in the absence of biventricular pacing\n* Life expectancy \\\u003C 1 year\n* Hemodialysis\n* Hematocrit \\\u003C 30%\n* Severe chronic lung disease that limits activity or requires oxygen\n* Pregnancy\n* Implantable cardioverter defibrillator battery longevity \\\u003C 1 year\n* Vulnerable populations such as prisoners and institutionalized individuals","ALL","18 Years","120 Years",{"count":21,"type":22},52,"ESTIMATED","INTERVENTIONAL",[25],"NA","A clinical trial of exercise-similar heart rate acceleration delivered via cardiac pacing vs. sham intervention in subjects at rest will be performed. The study population comprises subjects with guideline-directed medically managed left ventricular dysfunction due to ischemic or non-ischemic cardiomyopathy and an existing implantable cardioverter defibrillator or biventricular implantable cardioverter defibrillator. The purpose of the study is to understand how the heart rate pattern of exercise contributes to the considerable cardiac conditioning effects of exercise and estimate whether the pacing approach may have translational clinical applicability. Fifty-two subjects will be randomized, single-blinded, to either the pacing intervention or a sham intervention which they will receive once daily, 3 days\u002Fweek for 6 weeks. Baseline symptoms and clinical test results will be compared to the same measures at 2 weeks, 4 weeks and 6 weeks of intervention\u002Fsham and at 3 months and one-year post-intervention. The primary endpoint will be the change in left ventricular ejection fraction from baseline in intervention vs. sham groups (mixed effects linear regression with time and treatment arm as fixed effects and pre-specified covariates of sex and cardiomyopathy type as random effects). Secondary endpoints will include changes in quality of life, 6-minute walk distance, cardiopulmonary exercise test (CPET) measures, daily activity and major adverse cardiac events (MACE) at 3 and 12 months between pacing and sham groups. A \"dose-response\" analysis of outcomes at 2, 4, and 6 weeks of the intervention vs. sham compared with baseline will be performed.",[28],"Heart Failure, Systolic",[30,31,32,33,34,35,36,37,38,39],"heart failure","exercise","heart rate","implantable defibrillator","cardiac conditioning","exercise tolerance","pacing","cardiac output","quality of life","walking distance","RECRUITING","2026-06-22",{"date":43,"type":44},"2026-06-25","ACTUAL",{"date":46,"type":44},"2024-06-26",{"date":48,"type":22},"2028-11-30",{"name":50,"class":51},"Denice Hodgson-Zingman, MD","OTHER",1,{"id":54,"slug":55,"hasResults":11,"nctId":56,"briefTitle":57,"officialTitle":58,"acronym":59,"eligibilityCriteria":60,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":61,"enrollmentInfo":62,"targetDuration":4,"studyType":64,"phases":4,"briefSummary":65,"conditions":66,"keywords":70,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":74,"lastUpdatePostDateStruct":75,"startDateStruct":76,"completionDateStruct":78,"leadSponsor":80,"locationsCount":83},"100568003","non-interventional-study-on-guideline-directed-medical-therapy-for-patients-with-heart-failure-hf-in-germany-100568003","NCT06675552","Non-interventional Study on Guideline Directed Medical Therapy for Patients With Heart Failure (HF) in Germany","PHenotype-based RApid SEquencing of Guideline-directed Medical Therapy for Heart Failure With Reduced Ejection Fraction (PHRASE-HF): A Multicentre, Prospective, Non-interventional Study to Examine Outcomes of Rapid In-hospital Implementation of GDMT and Its Translation From Discharge Into Routine Care","PHRASE-HF","Inclusion Criteria:\n\n* Age ≥18 years at the time of signing the informed consent\n* Hospitalised in a participating site and receiving full inpatient treatment (at least 24h hospital stay)\n* Diagnosis of HFrEF according to the current guidelines of the European Society of Cardiology (ESC) with a left ventricular EF of ≤40% (as measured per echocardiography during the index hospital stay or within 3 months prior to index hospitalisation with available reports from imaging (ejection fraction) at the time of study inclusion)\n* Treated with a maximum of 2 of the indicated drug classes (ACE-I\u002FARNI\u002FARB, BB, MRA, SGLT2i) according to guideline recommendation (GDMT) at admission.\n* Signed and dated written informed consent prior to enrolment in the study\n* Willing and capable to fulfil requirements listed in the ICF\n\nExclusion Criteria:\n\n* Initial presentation (index hospitalisation) in cardiogenic shock or other kinds of shock\n* Status post heart transplantation\n* History of intolerance to one or more GDMT drug classes (ACE-I\u002FARNI\u002FARB, BB, MRA, SGLT2i) or significant side effects that led to the discontinuation of two or more substances within one drug class (except from ACE-I\u002FARB, e.g., if 2 different ACE inhibitors triggered cough, but sartans are tolerated, then the patient is not excluded)\n* Current or planned participation in a clinical trial\n* Decision by the investigator that the participant should not participate in the study if the participant is unlikely to comply with study procedures\n* Pregnancy or breast-feeding","130 Years",{"count":63,"type":22},438,"OBSERVATIONAL","Heart failure (HF) is a global public health issue that affects more than 63 million people worldwide. The clinical and economic burden of HF on health care systems is substantial. Heart failure with reduced ejection fraction (HFrEF) represents approximately 50% of the HF patient population.The burden of HF is expected to increase substantially as the population ages, and despite improvements in treatment, hospitalisation and mortality rates remain especially high in HFrEF patients. The current guideline recommendation of directed medical therapy for HFrEF combines four drug classes with proven prognostic benefit: Angiotensin receptor-neprilysin inhibitor (ARNI)\u002Fangiotensin converting enzyme inhibitors (ACE I)\u002Fangiotensin receptor blockers (ARB), betablockers (BB), mineralocorticoid receptor antagonists (MRA), and sodium-glucose co-transporter 2 inhibitors (SGLT2i). The 2023 ESC (European Society of Cardiology) HF guideline update additionally recommends a rapid in-hospital sequencing approach of guideline-directed medical therapy (GDMT) with frequent physician visits during the first 6 weeks post discharge. Studies investigating the implementation of GDMT in a real-world setting have shown that a significant proportion of patients did not receive the recommended drug combination therapy. Delayed initiation of GDMT contributes to the low number of patients receiving guideline concordant HFrEF therapy, which ultimately may affect patient outcomes. One approach to implement the 2023 ESC guideline updates for heart failure treatment regarding early in-hospital initiation and rapid up-titration of GDMT could be to provide specific training on GDMT recommendations. Such a standardised training is offered to the physicians treating HF patients within selected hospitals of the German Helios hospital network (Helios-GDMT-program). Evidence is needed in order to assess whether in-hospital initiation and up-titration of all phenotype concordant classes of GDMT at hospital discharge can be observed after standardised physician training and whether the GDMT-program implementation also translates into real-world routine outpatient care with respect to use of GDMT and clinical outcomes.",[67,68,69,28],"Heart Disease","Heart Failure","Cardiovascular Disease",[71,72,73],"Heart Failure with Reduced Ejection Fraction (HFrEF)","Guideline Directed Medical Therapy","Real-World Evidence","2026-06-18",{"date":41,"type":44},{"date":77,"type":44},"2024-11-15",{"date":79,"type":22},"2027-06-30",{"name":81,"class":82},"AstraZeneca","INDUSTRY",6,{"id":85,"slug":86,"hasResults":11,"nctId":87,"briefTitle":88,"officialTitle":89,"acronym":4,"eligibilityCriteria":90,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":91,"enrollmentInfo":92,"targetDuration":4,"studyType":23,"phases":94,"briefSummary":96,"conditions":97,"keywords":4,"overallStatus":99,"whyStopped":4,"lastUpdateSubmitDate":100,"lastUpdatePostDateStruct":101,"startDateStruct":103,"completionDateStruct":105,"leadSponsor":107,"locationsCount":109},"100635042","phase-1-a-study-of-ly3971297-in-participants-with-heart-failure-100635042","NCT07547540","A Study of LY3971297 in Participants With Heart Failure","A Phase 1, Single-Blinded, Single-Ascending Dose Study to Evaluate the Safety and Tolerability of a Single Dose of LY3971297 in Participants With HFpEF and Participants With HFrEF","Inclusion Criteria:\n\n* Are diagnosed with chronic heart failure with New York Heart Association Class II-III (Heart Failure) HF symptomatology at screening and on guideline-directed HF therapy for at least 6 months prior to screening.\n* Have not changed optimal guideline-directed HF therapy, either medication or medication dose, in the last 4 weeks prior to screening and during screening period, and do not plan to change HF therapy for the next 90 days.\n* Must be on a stable dose of vasodilator therapy for at least 4 weeks prior to screening, with no dose adjustments planned during the study.\n* Have an estimated glomerular filtration rate of greater than or equal to (≥) 30 milliliter per minute per 1.73 square meters (mL\u002FMinute\u002F1.73m²) at screening.\n* Are between 30 days and within 12 months from recent heart failure hospitalization to screening.\n* Have systolic blood pressure (SBP) greater than (\\>) 110 millimeters of mercury (mmHg) at screening and at enrollment.\n* Have a body mass index within the range of 18.5 to 40 kilograms per square meter (kg\u002Fm²) (inclusive).\n* Are individuals assigned male or female at birth, who are not of childbearing potential.\n* Have venous access sufficient to allow blood sampling.\n* Applicable to heart failure with preserved ejection fraction (HFpEF) participants only\n\n  * Have left ventricular ejection fraction (LVEF) \\>45 percent (%).\n  * Left atrial volume index \\>34 milliliters per square meter (mL\u002Fm²) in participants in sinus rhythm, or \\>40 mL\u002Fm² in participants with atrial fibrillation (AF).\n  * N-terminal pro-B-type natriuretic peptide (NT-proBNP) \\>300 picograms per milliliter (pg\u002FmL) for participants without AF or \\>850 pg\u002FmL for participants with AF.\n  * Have a documented history of signs, symptoms, or both, consistent with HFpEF.\n* Applicable to heart failure with reduced ejection fraction (HFrEF) participants only:\n\n  * Have LVEF \\\u003C40% .\n  * NT-proBNP \\>600 pg\u002FmL for participants without AF or \\>900 pg\u002FmL for participants with AF.\n  * Have a documented history of signs, symptoms, or both, consistent with HFrEF.\n\nExclusion Criteria:\n\n* Have known allergies to related compounds of LY3971297 or any components of the formulation, or a history of significant atopy.\n* Had a myocardial infarction, unstable angina pectoris, coronary artery bypass graft surgery, revascularization or other major cardiovascular surgery, stroke, or transient ischemic attack in the last 90 days prior to screening.\n* Have New York Heart Association (NYHA) Class 4, acute decompensated HF (exacerbation of HF) requiring IV diuretics, IV inotropes, or IV vasodilators, within 30 days prior to screening, and\u002For during screening period until randomization.\n* Have SBP ≥180 mmHg at screening.\n* Have symptomatic hypotension.\n* Have resting heart rate \\>90 beats per minute (bpm) at screening.\n* Have known cardiac amyloidosis, infiltrative myocardial diseases, muscular dystrophies, cardiomyopathy with reversible causes, hypertrophic cardiomyopathy, pericardial constriction, or complex congenital heart disease.\n* Have any history of moderate-to-severe stenosis of the mitral and\u002For aortic valve or severe mitral and\u002For aortic regurgitation.\n* Have any history of moderate-to-severe tricuspid or pulmonic valve stenosis or severe tricuspid or pulmonic regurgitation.\n* Have a history of syncope that, in the opinion of the investigator, may affect the participant's safety.\n* Bioprosthetic valve replacement within 12 months prior to screening or any history of mechanical valve replacement, or planned valve replacement or repair during the study period.\n* Have any history of greater than moderate pulmonary hypertension.\n* Have a pacemaker or implantable cardioverter-defibrillator placement within 90 days prior to screening.\n* Have severe chronic obstructive pulmonary disease (COPD).\n* Have clinically significant or uncontrolled cardiac arrhythmia.\n* Have a significant history of, or presence of, hepatic disease, including any abnormal liver function tests.\n* Have, within 3 years prior to screening, a history of an active or untreated malignancy or are in remission from a clinically significant malignancy (Exceptions: basal or squamous cell skin cancer).\n* For US sites: have donated blood of more than 500 mL within the previous 90 days of screening or intend to donate blood during the course of the study.\n* For Japan sites: have donated any blood within the last 4 weeks, any apheresis (blood components) within the last 2 weeks, at least 400 mL of blood within the last 16 weeks for female participants or 12 weeks for male participants, or at least 800 mL of blood for female participants or 1200 mL of blood for male participants within 12 months.\n* Other sites: Participants who have recently donated blood or blood components, or who intend to donate during the course of the study.\n* Have not been on a stable dose of medications for at least 4 weeks prior to screening, or have planned dose adjustments during the study.\n* Participants must abstain from taking new prescription or nonprescription drugs.\n* Have concurrent use or intend to use phosphodiesterase 5 inhibitor or soluble guanylyl cyclase activators.\n* Have any history of intolerance to vasodilator medications that, in the opinion of the investigator, would put them at risk of not tolerating study drug.\n* Have BP and\u002For pulse rate constituting a risk when taking the Investigational Medicinal Product (IMP).\n* Are diagnosed with orthostatic hypotension.\n* Show evidence of an acute infection with fever or infectious disease at screening.\n* Applicable to HFrEF participants only\n\n  * Have been listed for cardiac transplantation and\u002For anticipated or implanted ventricular assist device.\n  * Have received cardiac resynchronization therapy for less than 6 months.","65 Years",{"count":93,"type":22},90,[95],"PHASE1","The main purpose of this study is to assess how well LY3971297 is tolerated and what side effects may occur in participants with heart failure with preserved ejection fraction (HFpEF) and participants with heart failure with reduced ejection fraction (HFrEF). Blood tests will be performed to investigate how the body processes the study drug and how the study drug affects the body. For each participant, the study will last about 2 months and will include 1 inpatient visit lasting approximately 4 days and 5 outpatient visits.",[68,98,28],"Heart Failure, Diastolic","NOT_YET_RECRUITING","2026-06-15",{"date":102,"type":44},"2026-06-16",{"date":104,"type":22},"2026-07",{"date":106,"type":22},"2027-11",{"name":108,"class":82},"Eli Lilly and Company",10,{"id":111,"slug":112,"hasResults":11,"nctId":113,"briefTitle":114,"officialTitle":115,"acronym":116,"eligibilityCriteria":117,"healthyVolunteers":11,"sex":17,"minAge":118,"maxAge":4,"enrollmentInfo":119,"targetDuration":4,"studyType":23,"phases":121,"briefSummary":122,"conditions":123,"keywords":129,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":132,"lastUpdatePostDateStruct":133,"startDateStruct":135,"completionDateStruct":137,"leadSponsor":139,"locationsCount":141},"100491282","diuretics-alone-vs-aortix-endovascular-device-for-acute-heart-failure-100491282","NCT05677100","Diuretics Alone vs. Aortix Endovascular Device for Acute Heart Failure","DRAIN-HF: Diuretics Alone vs. Aortix Endovascular Device for Acute Heart Failure","DRAIN-HF","Inclusion Criteria (Randomized Study):\n\n* Currently admitted to the hospital with a primary diagnosis of decompensated heart failure, irrespective of ejection fraction (EF);\n* Patients should be on maximally tolerated diuretic therapy and not diuresing sufficiently before being enrolled in DRAIN-HF. After being up-titrated on diuretics, patients should be followed for at least 24 hours on the higher of: i) furosemide 80 mg IV bid or equivalent or ii) IV furosemide or equivalent IV loop diuretic at a dose 2.5 x total daily home dose of furosemide equivalents in 2 divided doses, as tolerated, patient must have: Urine Output \\\u003C1,500mL in a 12-hour period OR a Net Fluid Loss ≤375mL in a 12-hour period.\n* Persistent signs and\u002For symptoms of congestion as evidenced by at least 2+ pitting edema, elevated jugular venous pressure \\>12 cm water or ascites after treatment with IV diuretics per inclusion criterion 2.;\n* Age \\>21 years and able to provide written informed consent;\n* Negative pregnancy test if patient is of child-bearing potential.\n\nExclusion Criteria (Randomized Study):\n\n* Treatment with high dose IV inotropes within the last 48 hours prior to enrollment. High dose is defined as \\>5 µg\u002Fkg\u002Fmin dopamine OR \\>5 µg\u002Fkg\u002Fmin dobutamine OR \\>0.375 µg\u002Fkg\u002Fmin milrinone;\n* Active and ongoing hypotension with a systolic blood pressure \\\u003C90 mmHg lasting more than 30 minutes or a mean arterial pressure (MAP) \\\u003C60 mmHg lasting more than 30 minutes at enrollment;\n* Treatment with vasopressors (defined as phenylephrine, norepinephrine, epinephrine or, vasopressin) within 48 hours prior to enrollment;\n* An estimated PASP of \\>80 mmHg as measured on echocardiogram or echocardiographic evidence of primarily right heart failure;\n* Acute kidney failure defined as an increase in serum creatinine to ≥4.0mg\u002FdL (≥353.6 µmol\u002FL) at enrollment;\n* Evidence of contrast induced nephropathy, nephritis or nephrotic syndrome;\n* Prior kidney transplant, single kidney, partial nephrectomy OR use of dialysis, continuous renal replacement therapy (CRRT) or ultrafiltration in the last 90 days prior to enrollment;\n* Confirmed decompensated cirrhosis (defined as Child Pugh class B or C) or concern for shock liver (AST \\> 1000U\u002FL or total Bilirubin \\> 5.0mg\u002Fdl) at enrollment;\n* Presence of an active, uncontrolled infection that would preclude safe placement or removal of the device;\n* Prior heart transplant or likely heart transplantation before the 30- day follow-up visit;\n* Current or previous support with a durable LVAD at any time or planned LVAD insertion before the 30-day follow-up visit;\n* Use of an intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), or percutaneous ventricular assist devices (e.g. Impella or TandemHeart) within the last 30 days;\n* Confirmed diagnosis of AL amyloidosis;\n* Acute myocardial infarction Type 1 within 30 days of enrollment, or planned coronary revascularization in the next 30 days;\n* Stroke within 30 days of enrollment;\n* Severe Bleeding Risk (any of the following):\n\n  1. Previous intracranial bleed unless there is documentation in the medical record (from a physician that is not part of the study) that the patient can safely use anticoagulation for 7 days,\n  2. GI bleeding within 6 months requiring hospitalization and\u002For transfusion,\n  3. Recent major surgery within 30 days if the surgical wound is judged to be associated with an increased risk of bleeding,\n  4. Procedure with arterial ilio-femoral access \\> 6 FR within 30 days,\n  5. Platelet count \\\u003C75,000 cells\u002Fmm3,\n  6. Uncorrectable bleeding diathesis or coagulopathy (e.g. INR ≥2 not due to anticoagulation therapy) or hypercoaguable state including HIT;\n  7. Inability to tolerate anticoagulation therapy for up to 7 days.\n* Contraindicated Anatomy :\n\n  1. Descending aortic anatomy that would prevent safe placement of the device \\[\\\u003C18 mm or \\>31 mm aorta diameter at deployment location (measured between the superior aspect of the T10 vertebra and superior aspect of the L1 vertebra)\\],\n  2. Ilio-femoral diameter or peripheral vascular anatomy that would preclude safe placement of a 21F (outer diameter) introducer sheath,\n  3. Femoral artery depth inconsistent with use of closure device,\n  4. Abnormalities or severe vascular disease that would preclude safe access and device delivery (e.g. aneurysm with thrombus, marked tortuosity, significant narrowing or inadequate size of the abdominal aorta, iliac or femoral arteries, or severe calcification),\n  5. Known connective tissue disorder (e.g. Marfan Syndrome) or other aortopathy at risk of vascular injury,\n  6. Any endovascular stent graft in the descending aorta. Any endovascular stent graft in the femoro-iliac vessels that is not well endothelialized and would preclude safe introduction\u002Fremoval of the Aortix pump as demonstrated by imaging.\n* Known hypersensitivity or contraindication to study or procedure medications (e.g. anticoagulation therapy) or device materials (e.g. history of severe reaction to nickel or nitinol);\n* Participation in any other clinical investigation that is likely to confound study results or affect the study;\n* Poor health such that the patient is unable to undergo the Aortix device placement\u002Fretrieval and\u002For unlikely to be able to survive to the 30-day visit;\n* Unable or unwilling to undergo screening (imaging, PA Catheter placement), device implant and retrieval procedures or return for 30-day visit.\n\nInclusion Criteria (Advanced Heart Failure Registry):\n\n* Currently admitted to the hospital with a primary diagnosis of decompensated HF, irrespective of ejection fraction (EF).\n* Patient has already been evaluated and indicated to receive an LVAD or heart transplant and will receive the LVAD or be listed for heart transplantation in the next 30 days if their congestion status and renal function improves.\n* Patient must have been treated with ≥ 80 mg IV furosemide bid or equivalent and have evidence of increasing diuretic dosing requirements over the past 12 months, as tolerated.\n* Must have evidence of refractoriness to medical management as documented by persistent signs and\u002For symptoms of congestion as evidenced by at least 2+ pitting edema, elevated jugular venous pressure \\>12 cm water, or ascites after treatment with IV diuretics for a minimum of 24 hours.\n* Serum creatinine ≥ 2.0 mg\u002FdL AND eGFR ≤ 45 ml\u002Fmin\u002F1.73m2 at time of enrollment\n* Age ≥ 21 years and able to provide written informed consent.\n* Negative pregnancy test if patient is of childbearing potential.\n\nExclusion Criteria (Advanced Heart Failure Registry):\n\n* Treatment with high dose IV inotropes within 48 hours prior to enrollment. High dose is defined as any one of the following: \\>5 µg\u002Fkg\u002Fmin dopamine OR \\>5 µg\u002Fkg\u002Fmin dobutamine OR \\>0.375 µg\u002Fkg\u002Fmin milrinone.\n* Active and ongoing hypotension with a systolic blood pressure \\\u003C80 mmHg lasting more than 30 minutes or a mean arterial pressure (MAP) \\\u003C55 mmHg lasting more than 30 minutes at enrollment.\n* Treatment with vasopressors (defined as phenylephrine, norepinephrine, epinephrine or, vasopressin) within 48 hours prior to enrollment.\n* An estimated PASP of \\>80 mmHg as measured on echocardiogram or echocardiographic evidence of primarily right heart failure.\n* Acute kidney failure defined as an increase in serum creatinine to ≥ 4.0mg\u002FdL at enrollment.\n* Evidence of contrast-induced nephropathy, nephritis, or nephrotic syndrome.\n* Prior kidney transplant, single kidney, partial nephrectomy OR use of dialysis, continuous renal replacement therapy (CRRT), or ultrafiltration in the last 90 days prior to enrollment.\n* Confirmed decompensated cirrhosis (defined as Child Pugh class B or C) or concern for shock liver (AST \\> 1000U\u002FL or total Bilirubin \\> 5.0mg\u002Fdl) at enrollment.\n* Presence of an active, uncontrolled infection that would preclude safe placement or removal of the device.\n* Current or previous support with a durable LVAD.\n* INTERMACS Profile 1 at enrollment.\n* Currently on mechanical ventilatory support.\n* Use of an intra-aortic balloon pump (IABP) within the last 14 days or use of an extracorporeal membrane oxygenation (ECMO) or percutaneous ventricular assist device (e.g., Impella or TandemHeart) within the last 30 days.\n* Confirmed diagnosis of AL amyloidosis.\n* Acute myocardial infarction Type 1 within 30 days of enrollment or planned coronary revascularization in the next 30 days.\n* Stroke within 30 days of enrollment.\n* Severe Bleeding Risk (any of the following):\n\n  * Previous intracranial bleed unless there is documentation in the medical record (from a physician that is not part of the study) that the patient can safely use anticoagulation for 7 days.\n  * GI bleeding within 6 months requiring hospitalization and\u002For transfusion.\n  * Recent major surgery within 30 days if the surgical wound is judged to be associated with an increased risk of bleeding.\n  * Procedure with arterial ilio-femoral access \\> 6 Fr within 30 days.\n  * Platelet count \\\u003C75,000 cells\u002Fmm3 .\n  * Uncorrectable bleeding diathesis or coagulopathy (e.g., INR≥ 2 not due to anticoagulation therapy) or hypercoagulable state including HIT.\n  * Inability to tolerate anticoagulation therapy for up to 7 days.\n* Contraindicated Anatomy :\n\n  * Descending aortic anatomy that would prevent safe placement of the device \\[\\\u003C18 mm or \\>31 mm aorta diameter at deployment location (measured between the superior aspect of the T10 vertebra and superior aspect of the L1 vertebra)\\].\n  * Ilio-femoral diameter or peripheral vascular anatomy that would preclude safe placement of a 21 Fr (outer diameter) introducer sheath.\n  * Femoral artery depth inconsistent with use of closure device.\n  * Abnormalities or severe vascular disease that would preclude safe access and device delivery (e.g., aneurysm with thrombus; marked tortuosity; significant narrowing or inadequate size of the abdominal aorta, iliac, or femoral arteries; or severe calcification).\n  * Known connective tissue disorder (e.g., Marfan Syndrome) or other aortopathy at risk of vascular injury.\n  * Any endovascular stent graft in the descending aorta. Any endovascular stent graft in the femoro-iliac vessels that is not well endothelialized and would preclude safe introduction\u002Fremoval of the Aortix pump as demonstrated by imaging.\n* Known hypersensitivity or contraindication to study or procedure medications (e.g., anticoagulation therapy) or device materials (e.g., history of severe reaction to nickel or nitinol).\n* Participation in any other clinical investigation that is likely to confound study results or affect the study.\n* Poor health such that the patient is unable to undergo the Aortix device placement\u002Fretrieval and\u002For unlikely to be able to survive to the 30-day visit.\n* Unable or unwilling to undergo screening, device implant and retrieval procedures, or return for 30-day visit.","21 Years",{"count":120,"type":22},320,[25],"Aortix is a circulatory support device for chronic heart failure patients on medical management who have been hospitalized for acute decompensated heart failure (ADHF) and have persistent congestion despite usual medical therapy.\n\nEligible ADHF patients with diuretic resistance (irrespective of ejection fraction) will be enrolled and randomized 1:1 to either the Aortix system or standard of care medical management.",[68,124,125,126,28,98,127,128],"Cardiorenal Syndrome","Cardio-Renal Syndrome","ADHF","Heart Failure; With Decompensation","Heart Failure, Congestive",[130,131],"mechanical circulatory support","percutaneous","2026-06-05",{"date":134,"type":44},"2026-06-09",{"date":136,"type":44},"2023-08-23",{"date":138,"type":22},"2027-08",{"name":140,"class":82},"Procyrion",48,{"id":143,"slug":144,"hasResults":11,"nctId":145,"briefTitle":146,"officialTitle":147,"acronym":4,"eligibilityCriteria":148,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":149,"targetDuration":4,"studyType":23,"phases":151,"briefSummary":152,"conditions":153,"keywords":156,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":161,"lastUpdatePostDateStruct":162,"startDateStruct":164,"completionDateStruct":166,"leadSponsor":168,"locationsCount":170},"100472091","the-canadian-cabg-or-pci-in-patients-with-ischemic-cardiomyopathy-trial-stich3c-100472091","NCT05427370","The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy Trial (STICH3C)","The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy Trial","Inclusion Criteria:\n\n1. Age \\>18 years;\n2. LVEF ≤40% quantified by either echocardiography, SPECT ventriculography, or magnetic resonance within 2 months of randomization;\n3. Prognostically important multivessel CAD (triple vessel CAD or double vessel disease including the left anterior descending (LAD) or LM). Significant coronary stenosis is defined as ≥ 70% based on coronary angiography, and\u002For fractional flow reserve (FFR) ≤0.80 or instantaneous wave-free ratio (iFR) ≤0.89. For LM disease, significant coronary stenosis is defined as \\>50% based on coronary angiography, intravascular ultrasound (IVUS) minimal luminal area (MLA) ≤6.0 mm2 (\\\u003C4.5 mm2 Asian descent), or equivalent optical coherence tomography (OCT) measurements;\n4. The institutional Heart Team agrees that guideline-directed medical therapy (GDMT) has been initiated for ≥1 month in prevalent and newly diagnosed cases. In patients hospitalized with newly diagnosed iLVSD (with or without acute coronary syndrome (ACS)) requiring revascularization before discharge, GDMT needs to be initiated, when possible in-hospital before randomization, with the expectation that it will be titrated to maximally tolerated doses after revascularization;\n5. Signed informed consent.\n\nExclusion Criteria:\n\n1. Decompensated HF requiring inotropic\u002Fadrenergic support, invasive or non-invasive ventilation or intra-aortic balloon pump\u002Fventricular assist device therapy less than 48 hours prior to randomization;\n2. Recent (\\\u003C4 weeks) ST-elevation MI;\n3. Concomitant severe valvular disease or other condition such as left ventricular aneurysm requiring surgical repair or replacement;\n4. Planned major concomitant surgical procedures (LAAO and AF ablation surgical procedures permitted);\n5. Prior PCI within the past 12 months (to reduce restenosis events from prior PCIs contributing to the primary outcome);\n6. Prior cardiac surgery;\n7. Prohibitive bleeding risk mandating avoidance of dual antiplatelet therapy;\n8. Circumstances likely to lead to poor treatment adherence;\n9. Severe end-organ dysfunction (such as dialysis, liver failure, respiratory failure, cancer) that reduces life expectancy to less than 5 years;\n10. Current pregnancy;\n11. Patient not amenable to both CABG or PCI according to the Heart Team;\n12. Takotsubo\u002FTakotsubo Cardiomyopathy\u002FBroken Heart Syndrome.",{"count":150,"type":22},754,[25],"The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy (STICH3C) trial is a prospective, unblinded, international multi-center randomized trial of 754 subjects enrolled in approximately 45 centers comparing revascularization by percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) in patients with multivessel\u002Fleft main (LM) coronary artery disease (CAD) and reduced left ventricular ejection fraction (LVEF).\n\nThe primary objective is to determine whether CABG compared to PCI is associated with a reduction in all-cause death, stroke, spontaneous myocardial infarction (MI), urgent repeat revascularization (RR), or heart failure (HF) readmission over a median follow-up of 5 years in patients with multivessel\u002FLM CAD and ischemic left ventricular dysfunction (iLVSD).\n\nEligible patients are considered by the local Heart Team appropriate and amenable for non-emergent revascularization by both modes of revascularization.\n\nThe secondary objectives are to describe the early risks of both procedures, and a comprehensive set of patient-reported outcomes longitudinally.",[154,155],"Coronary Artery Disease","Heart Failure Systolic",[157,158,159,160],"Left ventricular dysfunction","CABG","PCI","MACCE","2026-04-27",{"date":163,"type":44},"2026-04-28",{"date":165,"type":44},"2023-06-22",{"date":167,"type":22},"2029-12",{"name":169,"class":51},"Sunnybrook Health Sciences Centre",43,{"id":172,"slug":173,"hasResults":11,"nctId":174,"briefTitle":175,"officialTitle":176,"acronym":4,"eligibilityCriteria":177,"healthyVolunteers":178,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":179,"targetDuration":4,"studyType":64,"phases":4,"briefSummary":181,"conditions":182,"keywords":4,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":184,"lastUpdatePostDateStruct":185,"startDateStruct":187,"completionDateStruct":189,"leadSponsor":191,"locationsCount":52},"100541967","cardiac-performance-during-steep-trendelenburg-position-in-patients-undergoing-robotic-surgery-surgery-100541967","NCT06336746","Cardiac Performance During Steep Trendelenburg Position in Patients Undergoing Robotic Surgery Surgery.","Effects of Steep Trendelenburg and Pneumoperitoneum on Cardiac Performance During Robotic-assisted Surgery in Patients With Normal and Low Ejection Fraction.","Inclusion Criteria:\n\n1\\. Consecutive Patients Scheduled for Robotic Surgery with Trendelenburg positioning.\n\n\\-\n\nExclusion Criteria:\n\n1. Age \\\u003C18;\n2. Dementia,\n3. Not able to give written consent -",true,{"count":180,"type":22},80,"The field of robotic-assisted laparoscopic surgery increases all the time. Older and more fragile patients which are not suitable for major open surgery could be scheduled for robotic- assisted surgery. The peroperative anesthesiological challenges and stresses during this type of surgery could anyway be even more prominent.\n\nThe extreme positioning of patients during robotic surgery in the pelvis, often 30 degrees head down tilting (Trendelenburg positioning), should increase the work load of the heart significantly. There are no studies concerning fragile patients with heart failure during these conditions.\n\nIn this study the circulatory effects in patients with normal heart function and preexisting heart failure will be studied during robotic surgery in extreme Trendelenburg positioning\n\nDuring surgery the work load and performance of the heart will be monitored using an esophageal doppler and optical spectrophotometry measuring regional saturation of the brain. This study can identify patients at risk of developing critical circulatory failure during this type of surgery.",[28,183],"Robotic Surgery","2026-02-10",{"date":186,"type":44},"2026-02-12",{"date":188,"type":44},"2024-11-21",{"date":190,"type":22},"2026-12-31",{"name":192,"class":51},"Karlstad Central Hospital",{"id":194,"slug":195,"hasResults":11,"nctId":196,"briefTitle":197,"officialTitle":197,"acronym":4,"eligibilityCriteria":198,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":199,"targetDuration":4,"studyType":64,"phases":4,"briefSummary":201,"conditions":202,"keywords":4,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":205,"lastUpdatePostDateStruct":206,"startDateStruct":208,"completionDateStruct":210,"leadSponsor":212,"locationsCount":52},"100516803","associations-between-the-microbiome-skeletal-muscle-perfusion-and-fitness-status-100516803","NCT06009276","Associations Between the Microbiome, Skeletal Muscle Perfusion, and Fitness Status","Inclusion Criteria:\n\n* Subjects must be able to communicate meaningfully with the investigator and must be legally competent to provide written informed consent.\n* Subjects may be of either sex with age 18 years.\n\nExclusion Criteria:\n\n* Oral antibiotic use within previous four weeks\n* Oral disease or poor oral health as determined by the Oral Health Questionnaire\n* Using an antibacterial mouthwash or a mouthwash containing chlorhexidine and unwilling to discontinue use\n* Tobacco smokers\n* Pregnant or lactating females\n* Hypersensitivity to any ultrasound contrast agent\n* Inability to perform exercise\n* Unable to communicate effectively in English to the study team.\n* Diagnosis of chronic renal failure (GFR \\\u003C 60 ml\u002Fmin\u002F1.73m)\n* Subjects taking nitroglycerine (or inorganic nitrates), PDE-5 inhibitors (ex: Cialis, Viagra), and xanthine oxidase inhibitors (ex: Allopurinol).",{"count":200,"type":22},70,"The purpose of the study is to determine associations between fitness status, bacteria in the mouth, and the blood flow to muscle. This study is trying to find out if fitness status impacts the bacteria that are present in the oral microbiome (environment in the mouth) or the ability of the body to send blood to the skeletal muscle.\n\nParticipants will complete all or some of the following:\n\n* A mouth swab to assess the bacteria in their mouths.\n* Produce a saliva sample into a tube.\n* Cycle on a bike until you reach maximum effort.\n* Undergo blood draws\n* Wear a 24-hour non-invasive device that monitors blood pressure.\n* Drink 70mL (1\u002F3 of a cup) of concentrated beetroot juice once",[28,98,203,204],"Peripheral Arterial Disease","Overweight and Obesity","2025-12-17",{"date":207,"type":44},"2025-12-24",{"date":209,"type":44},"2023-08-30",{"date":211,"type":22},"2026-12",{"name":213,"class":51},"University of Virginia",{"id":215,"slug":216,"hasResults":11,"nctId":217,"briefTitle":218,"officialTitle":218,"acronym":4,"eligibilityCriteria":219,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":220,"targetDuration":4,"studyType":23,"phases":221,"briefSummary":222,"conditions":223,"keywords":4,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":225,"lastUpdatePostDateStruct":226,"startDateStruct":228,"completionDateStruct":230,"leadSponsor":232,"locationsCount":52},"100608248","comparative-efficacy-and-safety-of-acetazolamide-versus-metolazone-as-an-adjunct-to-standard-therapy-in-patients-with-acute-decompensated-heart-failure-100608248","NCT07199088","Comparative Efficacy and Safety of Acetazolamide Versus Metolazone as an Adjunct to Standard Therapy in Patients With Acute Decompensated Heart Failure","Inclusion Criteria:\n\n* Aged 18 years or older.\n* Diagnosed with Acute Decompensated Heart Failure (ADHF), with either preserved or reduced ejection fraction (EF).\n* At least one clinical sign of volume overload, such as:\n* Pleural effusion (confirmed by chest X-ray or ultrasound).\n* Oedema or ascites (verified by abdominal ultrasonography).\n* Plasma NT-proBNP level \\> 1000 pg\u002FmL or BNP level \\> 250 ng\u002FmL at screening.\n* Receiving at least 40 mg of furosemide as oral maintenance therapy for at least one month prior to the study initiation.\n\nExclusion Criteria:\n\n* Previous use of acetazolamide or metolazone prior to the study period.\n* Known hypersensitivity or allergies to the study drugs (acetazolamide or metolazone) or their components.\n* Patients with electrolyte disturbances, especially hypokalemia.\n* End-stage renal disease requiring dialysis or GFR \\\u003C 20 mL\u002Fmin\u002F1.73 m².\n* Pregnant or breastfeeding women.\n* Severe hypotension (systolic blood pressure \\\u003C 90 mmHg) or other significant comorbidities like congenital cardiac illness requiring surgery.\n* Patients requiring renal replacement therapy during the hospitalization.\n* History of significant electrolyte imbalances or acid-base disturbances.",{"count":120,"type":22},[25],"This clinical trial aims to compare the efficacy and safety of acetazolamide versus metolazone as adjunctive treatments to standard therapy in patients with acute decompensated heart failure (ADHF). ADHF is a life-threatening condition, and current treatments often involve loop diuretics to alleviate volume overload. This study will assess the added benefit of acetazolamide and metolazone in improving decongestion, reducing hospital stays, and preventing complications such as renal dysfunction or electrolyte imbalances. Participants will be randomized to receive either acetazolamide or metolazone in addition to standard diuretic therapy. The trial will evaluate primary outcomes including successful decongestion, in-hospital mortality, and length of hospital stay, with secondary outcomes focusing on renal function, electrolyte disturbances, and overall safety. The study is conducted at Bahawal Victoria Hospital, Bahawalpur, and aims to provide valuable insights into the management of ADHF, especially in the Pakistani population.",[224,98,28],"Acute Decompensated Heart Failure","2025-09-29",{"date":227,"type":44},"2025-10-03",{"date":229,"type":22},"2025-10-11",{"date":231,"type":22},"2026-10-30",{"name":233,"class":51},"University of Health Sciences Lahore",{"id":235,"slug":236,"hasResults":11,"nctId":237,"briefTitle":238,"officialTitle":238,"acronym":4,"eligibilityCriteria":239,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":240,"targetDuration":4,"studyType":23,"phases":242,"briefSummary":243,"conditions":244,"keywords":249,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":251,"lastUpdatePostDateStruct":252,"startDateStruct":254,"completionDateStruct":256,"leadSponsor":258,"locationsCount":260},"100510949","mcnair-study-comparative-effectiveness-of-in-person-and-telehealth-cardiac-rehabilitation-100510949","NCT05933083","MCNAIR Study: coMparative effeCtiveness of iN-person and teleheAlth cardIac Rehabilitation","Inclusion Criteria:\n\n1. Age 18 or older\n2. Eligible for cardiac rehabilitation\n\n   1. Diagnosis within 1 year prior to consent\n\n      * Myocardial infarction\n      * Percutaneous coronary intervention\n      * Coronary artery bypass\n      * Heart valve repair or replacement\n      * Heart transplant\n   2. Chronic stable angina, or\n   3. Chronic systolic heart failure (ejection fraction ≤ 35%)\n   4. Referred to cardiac rehabilitation by a doctor or advanced practice provider for another indication that is covered by the participant's insurance, such as heart failure with preserved ejection fraction or aortic surgery.\n3. Willing to be randomized to in-person or telehealth cardiac rehabilitation\n4. Able to communicate in English or Spanish\n\nExclusion Criteria:\n\n1. Unstable arrhythmias which may make unmonitored exercise unsafe (e.g., history of ventricular tachycardia not on medical therapy and without an implantable cardioverter defibrillator)\n2. Unsafe for patient to participate in the opinion of the investigator\n3. Hospice\n4. Unable to consent for self",{"count":241,"type":22},516,[25],"Cardiac rehabilitation is a medically recommended program for patients with certain heart conditions. It includes exercise training, health education, and counseling. Unfortunately, many patients do not participate in cardiac rehabilitation. Some find it challenging to attend the in-person sessions. This study aims to compare two methods of delivering cardiac rehabilitation: in-person and through telehealth. The investigators want to know if the effects of these two programs are alike and if certain individuals benefit more from one program over the other.",[245,28,246,247,154,248],"Myocardial Infarction","Heart Valve Diseases","Angina, Stable","Heart Transplant",[250],"cardiac rehabilitation, telehealth","2025-09-09",{"date":253,"type":44},"2025-09-11",{"date":255,"type":44},"2023-10-27",{"date":257,"type":22},"2027-10-15",{"name":259,"class":51},"University of California, San Francisco",5,{"id":262,"slug":263,"hasResults":11,"nctId":264,"briefTitle":265,"officialTitle":266,"acronym":267,"eligibilityCriteria":268,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":269,"targetDuration":4,"studyType":64,"phases":4,"briefSummary":271,"conditions":272,"keywords":293,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":251,"lastUpdatePostDateStruct":299,"startDateStruct":301,"completionDateStruct":303,"leadSponsor":305,"locationsCount":52},"100435439","prevalence-and-risk-factors-associated-with-cardiac-comorbidity-in-psoriasis-100435439","NCT04950218","Prevalence and Risk Factors asSOciated With CArdiac comorbiDIty in psoriAsis","PSOCADIA: Prevalence and Risk Factors asSOciated With CArdiac comorbiDIty in psoriAsis","PSOCADIA","Inclusion Criteria:\n\n* Patients 18 years or older with a diagnosis of psoriasis will be invited to participate\n\nExclusion Criteria:\n\n* Patients not able to cooperate to the study\n* Patients unable understand and sign informed consent",{"count":270,"type":22},1000,"In a prospective cohort study (n = 1.000), the investigators aim to investigate the correlation between cardiac biomarkers and advanced echocardiography and determine whether these are prognostic markers of heart disease in patients suffering from psoriasis.",[273,274,275,276,277,278,279,280,281,282,283,284,285,286,287,288,289,245,290,68,291,292,28,98],"Psoriasis","Cardiovascular Diseases","Cardiovascular Risk Factor","Cardiovascular Pathology","Psoriasis Vulgaris","Psoriatic Nail","Psoriasis Face","Psoriasis Guttate","Psoriasis Gyrata","Psoriasis Diffusa","Psoriasis Palmaris","Psoriasis Annularis","Psoriasis Circinata","Psoriasis Plantaris","Psoriasis Universalis","Psoriasis Geographica","Left Ventricular Dysfunction","Myocardial Ischemia","Stroke","Heart Diseases",[273,294,295,296,297,298],"Echocardiography","Advanced echocardiography","Biomarkers","Mortality","Cardiovascular mortality",{"date":300,"type":44},"2025-09-15",{"date":302,"type":44},"2021-09-01",{"date":304,"type":22},"2034-10-01",{"name":306,"class":51},"Herlev and Gentofte Hospital",{"id":308,"slug":309,"hasResults":11,"nctId":310,"briefTitle":311,"officialTitle":312,"acronym":4,"eligibilityCriteria":313,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":314,"targetDuration":4,"studyType":23,"phases":316,"briefSummary":318,"conditions":319,"keywords":4,"overallStatus":99,"whyStopped":4,"lastUpdateSubmitDate":321,"lastUpdatePostDateStruct":322,"startDateStruct":324,"completionDateStruct":326,"leadSponsor":328,"locationsCount":52},"100534559","phase-2-digoxin-and-senolysis-in-heart-failure-and-diabetes-mellitus-100534559","NCT06240403","Digoxin and Senolysis in Heart Failure and Diabetes Mellitus","Digoxin: a New Senolytic to Repair Dysfunctional Adipose Tissue in Patients With Heart Failure and Type II Diabetes Mellitus","Inclusion Criteria:\n\n* Aged ≥18yrs,\n* HFrEF (LVEF\\\u003C40%)\n* T2DM (taking anti-diabetic medication, fasting plasma glucose ≥7.0 mmol\u002FL and\u002For a serum HbA1c \\>48mmol\u002FL\n* On optimal medical therapy,\n* Able\u002Fprepared to give informed written consent.\n\nExclusion Criteria:\n\n* Significant cognitive impairment,\n* Important co-morbidity limiting ability to comply with study procedures,\n* Hyperkalemia (\\>5.5mmol\u002FL)\n* eGFR\\\u003C30ml\u002Fmin\u002F1.73m2\n* Current\u002Fprevious (\\\u003C6m) participation in other studies.",{"count":315,"type":22},100,[317],"PHASE2","In pilot studies the investigators have shown that subcutaneous adipose tissue (SAT) from patients with reduced ejection fraction heart failure (HFrEF) and type 2 diabetes mellitus (T2DM) is dysfunctional. Endothelial cells from the adipose tissue from these patients are senescent and have deleterious effects on healthy human subcutaneous adipocytes, including increasing expression of IL-6 (gene and protein) and reducing glucose uptake. Digoxin, a well-established treatment for HFrEF, selectively clears these senescent endothelial cells and prevents adipocyte dysfunction. This study will examine the effect of digoxin on adipose tissue on the burden of senescent cells.",[28,320],"Diabetes Mellitus, Type 2","2024-12-04",{"date":323,"type":44},"2024-12-06",{"date":325,"type":22},"2025-09-01",{"date":327,"type":22},"2029-08-28",{"name":329,"class":51},"University of Leeds",{"id":331,"slug":332,"hasResults":11,"nctId":333,"briefTitle":334,"officialTitle":335,"acronym":336,"eligibilityCriteria":337,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":338,"targetDuration":4,"studyType":23,"phases":340,"briefSummary":342,"conditions":343,"keywords":4,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":345,"lastUpdatePostDateStruct":346,"startDateStruct":348,"completionDateStruct":350,"leadSponsor":352,"locationsCount":52},"100377935","phase-2-optimising-pacing-for-contractility-2-100377935","NCT04201015","Optimising Pacing for Contractility 2","Mechanisms, Safety and Efficacy of Optimising Pacemaker Heart Rate for Contractility: Effects on Walk Time, Cardiac Remodelling and Quality of Life","OPT-cont 2","Inclusion Criteria:\n\n* Clinical, echocardiographic and neurohormonal evidence of heart failure\n* Cardiac pacemaker,\n* Able to perform a peak exercise test,\n* Willing and able to give informed consent.\n\nExclusion Criteria:\n\n* Angina pectoris symptoms limiting exercise tolerance,\n* Unstable heart failure symptoms (medical therapy changes in last three months), Poor image quality,\n* Calcium channel blockers (CCBs).",{"count":339,"type":22},400,[317,341],"PHASE3","The investigators have demonstrated that they can reliably identify an optimum heart rate range for contractility of the left ventricle in patients with chronic heart failure (CHF). They have also demonstrated in an acute cross-over and a small parallel group feasibility study that keeping the heart rate in this range (versus standard rate-response programming) in patients with CHF is associated with increased exercise time on a treadmill (around 60s or 10%). They now want to explore in a randomised, placebo-controlled 3-arm parallel group trial whether optimal programming versus standard rate-response programming versus no rate-response programming for 6 months leads to appreciable improvements in exercise time and quality of life, while having no adverse effects on left ventricular function and battery longevity and what the mechanisms of this might be.\n\n450 patients with CHF and a pacemaker will undergo the non-invasive echocardiographic assessment to establish the force frequency relationship and the optimal heart rate for contractility. They will then perform a treadmill walk test, complete quality of life questionnaires and be offered the opportunity to participate in a series of mechanistic substudies. They will then be randomised to optimal rate-response settings, standard rate response settings or no rate-response settings and followed up at 6 months at which point the tests will be repeated.",[28,344],"Pacemaker","2024-09-24",{"date":347,"type":44},"2024-09-26",{"date":349,"type":44},"2020-06-01",{"date":351,"type":22},"2025-03-31",{"name":329,"class":51},{"id":354,"slug":355,"hasResults":11,"nctId":356,"briefTitle":357,"officialTitle":357,"acronym":358,"eligibilityCriteria":359,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":360,"targetDuration":4,"studyType":23,"phases":361,"briefSummary":362,"conditions":363,"keywords":4,"overallStatus":99,"whyStopped":4,"lastUpdateSubmitDate":365,"lastUpdatePostDateStruct":366,"startDateStruct":368,"completionDateStruct":370,"leadSponsor":372,"locationsCount":4},"100554609","photobiomodulation-for-patients-with-advanced-heart-failure-100554609","NCT06501313","PhotobiomoduLation for pAtientS With Advanced hEart failuRe","LASER","Inclusion Criteria:\n\nAdvanced-stage HFrEF patients who were ineligible for heart transplantation Patients over 18 years of age The expected lifespan exceeds 1 year Consent form\n\nExclusion Criteria:\n\nNon-compliant patient Pregnant women Drug or alcohol abuse The patient is participating in another clinical trial",{"count":200,"type":22},[25],"The objective of the study is to examine the effectiveness of photobiomodulation therapy in patients with advanced-stage heart failure with reduced ejection fraction (HFrEF), who have been referred but ineligible for a heart transplantation. The primary endpoint is a 15% relative reduction in left ventricular end-systolic volume (LV ESV) as determined by echocardiography over a 12-month follow-up period. The secondary objective is to determine the change in NT-proBNP, a biomarker for heart failure, the change in heart failure symptoms based on the NYHA functional classification, the change in quality of life questionnaire (KCCQ), additional echocardiographic parameters, and the detection of changes in heart failure and fibrosis biomarkers. Additionally, the study aims to examine hospitalization due to heart failure and overall mortality.",[364,28],"Heart Failure With Reduced Ejection Fraction","2024-07-08",{"date":367,"type":44},"2024-07-15",{"date":369,"type":22},"2024-08-01",{"date":371,"type":22},"2026-05-01",{"name":373,"class":51},"Semmelweis University Heart and Vascular Center",{"id":375,"slug":376,"hasResults":11,"nctId":377,"briefTitle":378,"officialTitle":379,"acronym":380,"eligibilityCriteria":381,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":382,"targetDuration":4,"studyType":23,"phases":384,"briefSummary":385,"conditions":386,"keywords":388,"overallStatus":99,"whyStopped":4,"lastUpdateSubmitDate":393,"lastUpdatePostDateStruct":394,"startDateStruct":396,"completionDateStruct":398,"leadSponsor":400,"locationsCount":52},"100549438","phase-3-iv-iron-and-sglt2-inhibitor-on-ventricular-function-and-myocardial-iron-content-in-heart-failure-with-iron-deficiency-100549438","NCT06434025","IV Iron and SGLT2 Inhibitor on Ventricular Function and Myocardial Iron Content in Heart Failure With Iron Deficiency","Effect of Combination of Intravenous Iron and SGLT2 Inhibitor on Ventricular Function and Myocardial Iron Content in Patients With Heart Failure and Iron Deficiency.","COMBINED-HF","Inclusion Criteria:\n\n1. Age 18 years or over;\n2. Ejection fraction (EF) ≤40%, estimated by color Doppler echocardiography or CMR or radionuclide ventriculography;\n3. Serum ferritin \\\u003C100 µg\u002FL or serum ferritin between 100 and 299 µg\u002FL and transferrin saturation \\\u003C20%;\n4. Serum hemoglobin between 9.5 and 13.5 mg\u002FdL;\n5. Patients must be SGLT2 naive;\n6. Informed consent form (ICF) signed.\n\nExclusion Criteria:\n\n1. Kidney disease requiring dialysis or chronic kidney disease not requiring dialysis with an estimated glomerular filtration rate \\\u003C30 mL\u002Fmin\u002F1.73 m2 calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation;\n2. Severe primary valve disease;\n3. Acute coronary syndrome requiring cardiac surgery or coronary artery bypass surgery in the past 3 months;\n4. Patients already being treated for some type of non-iron deficiency anemia;\n5. Blood transfusion within 30 days prior to CMR examination;\n6. Patients with a pacemaker, cardiac resynchronization therapy, or implantable defibrillator;\n7. Diagnosis of hemochromatosis.",{"count":383,"type":22},99,[341],"Background. Treatment with intravenous iron has been shown to improve symptoms, functional capacity, and quality of life in patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency. However, the mechanisms underlying these beneficial effects remain unknown. SGLT2i seem to alter hematocrit and other hematological markers or iron content.\n\nThis study aims to measure cardiac magnetic resonance changes in myocardial iron content and in left ventricular function after administration of intravenous iron with and without the concomitant use of SGLT2 inhibitor in patients with HFrEF and iron deficiency.",[28,387],"Iron Deficiencies",[30,389,390,391,392],"iron deficiency","SGLT2 inhibitor","intravenous iron","clinical trial","2024-05-30",{"date":395,"type":44},"2024-06-03",{"date":397,"type":22},"2024-05-24",{"date":399,"type":22},"2026-11-24",{"name":401,"class":51},"Hospital de Clinicas de Porto Alegre",{"id":403,"slug":404,"hasResults":11,"nctId":405,"briefTitle":406,"officialTitle":407,"acronym":408,"eligibilityCriteria":409,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":410,"enrollmentInfo":411,"targetDuration":4,"studyType":23,"phases":413,"briefSummary":414,"conditions":415,"keywords":421,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":433,"lastUpdatePostDateStruct":434,"startDateStruct":436,"completionDateStruct":438,"leadSponsor":439,"locationsCount":52},"100487848","atrial-appendage-micrograft-transplants-to-assist-heart-repair-after-cardiac-surgery-100487848","NCT05632432","Atrial Appendage Micrograft Transplants to Assist Heart Repair After Cardiac Surgery","Autologous Atrial Appendage Micrografts Transplanted During Coronary Artery Bypass Surgery: the AAMS2 Randomized, Double-blinded, and Placebo-controlled Trial","AAMS2","Inclusion Criteria:\n\n* Informed consent obtained\n* Left ventricular ejection fraction (LVEF) between ≥ 15% and ≤ 40% at recruitment (transthoracic echocardiography)\n* New York Heart Association (NYHA) Class II-IV heart failure symptoms\n\nExclusion Criteria:\n\n* Heart failure due to left ventricular outflow tract obstruction\n* Acute myocardial infarction (AMI) within last 30 days\n* History of life-threatening and possibly repeating ventricular arrhythmias or resuscitation, or an implantable cardioverter-defibrillator\n* Stroke or other disabling condition within 3 months before screening\n* Severe valve disease or scheduled valve surgery\n* Renal dysfunction (GFR \\\u003C45 ml\u002Fmin\u002F1.73m2)\n* Other disease limiting life expectancy\n* Contraindications for coronary angiogram or LGE-CMRI\n* Participation in some other clinical trial\n\nScreening Failure:\n\n* After optimization of medications, no visible scar or LVEF ≥ 50% in preoperative LGE-CMRI\n* Preoperative LGE-CMRI has not been performed prior scheduled CABG","75 Years",{"count":412,"type":22},50,[25],"Ischemic heart disease (IHD) leads the global mortality statistics. Atherosclerotic plaques in coronary arteries hallmark IHD, drive hypoxia, and may rupture to result in myocardial infarction (MI) and death of contractile cardiac muscle, which is eventually replaced by a scar. Depending on the extent of the damage, dysbalanced cardiac workload often leads to emergence of heart failure (HF).\n\nThe atrial appendages, enriched with active endocrine and paracrine cardiac cells, has been characterized to contain cells promising in stimulating cardiac regenerative healing.\n\nIn this AAMS2 randomized controlled and double-blinded trial, the patient's own tissue from the right atrial appendage (RAA) is for therapy. A piece from the RAA can be safely harvested upon the set-up of the heart and lung machine at the beginning of coronary artery bypass (CABG) surgery. In the AAMS2 trial, a piece of the RAA tissue is processed and utilized as epicardially transplanted atrial appendage micrografts (AAMs) for CABG-support therapy.\n\nIn our preclinical evaluation, epicardial AAMs transplantation after MI attenuated scarring and improved cardiac function. Proteomics suggested an AAMs-induced glycolytic metabolism, a process associated with an increased regenerative capacity of myocardium. Recently, the safety and feasibility of AAMs therapy was demonstrated in an open-label clinical study. Moreover, as this study suggested increased thickness of the viable myocardium in the scarred area, it also provided the first indication of therapeutic benefit.\n\nBased on randomization with estimated enrolment of a total of 50 patients with 1:1 group allocation ratio, the piece of RAA tissue is either perioperatively processed to AAMs or cryostored. The AAMs, embedded in a fibrin matrix gel, are placed on a collaged-based matrix sheet, which is then epicardially sutured in place at the end of CABG surgery. The location is determined by preoperative late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRI) to pinpoint the ischemic scar. The controls receive the collagen-based patch, but without the AAMs. Study blood samples, transthoracic echocardiography (TTE), and LGE-CMRI are performed before and at 6-month follow-up after the surgery.\n\nThe trial's primary endpoints focus on changes in cardiac fibrosis as evaluated by LGE-CMRI and circulating levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP). Secondary endpoints center on other efficacy parameters, as well as both safety and feasibility of the therapy.",[416,417,28,418,419,420,154],"Ischemic Heart Disease","Ischemic Cardiomyopathy","Heart Failure NYHA Class III","Heart Failure NYHA Class II","Heart Failure NYHA Class IV",[422,423,424,425,426,427,428,429,430,431,432],"Ischemic heart failure","Ischemic heart disease","Coronary artery disease","Coronary artery bypass grafting","Atrial appendage micrografts","Tissue-engineering","Ischemic cardiomyopathy","Atrial appendage","Micrografts","Cell Therapy","Epitranscriptomics","2024-04-18",{"date":435,"type":44},"2024-04-19",{"date":437,"type":44},"2024-04-01",{"date":190,"type":22},{"name":440,"class":51},"Hospital District of Helsinki and Uusimaa",{"id":442,"slug":443,"hasResults":11,"nctId":444,"briefTitle":445,"officialTitle":446,"acronym":447,"eligibilityCriteria":448,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":449,"enrollmentInfo":450,"targetDuration":4,"studyType":23,"phases":452,"briefSummary":453,"conditions":454,"keywords":4,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":457,"lastUpdatePostDateStruct":458,"startDateStruct":460,"completionDateStruct":462,"leadSponsor":464,"locationsCount":260},"100416528","phase-1-modulation-of-serca2a-of-intra-myocytic-calcium-trafficking-in-heart-failure-with-reduced-ejection-fraction-100416528","NCT04703842","Modulation of SERCA2a of Intra-myocytic Calcium Trafficking in Heart Failure With Reduced Ejection Fraction","A Phase 1\u002F2 Trial of the Safety and Efficacy of SRD-001 (AAV1\u002FSERCA2a) in Subjects With Heart Failure With Reduced Ejection Fraction","MUSIC-HFrEF1","Main Inclusion Criteria:\n\n* Chronic ischemic or non-ischemic cardiomyopathy\n* NYHA class III\u002FIV\n* LVEF ≤35%\n* Guideline-directed medical therapy for heart failure; ICD\n\nMain Exclusion Criteria:\n\n* Restrictive cardiomyopathy, hypertrophic cardiomyopathy, acute myocarditis, pericardial disease, amyloidosis, infiltrative cardiomyopathy, uncorrected thyroid disease or discrete left ventricular (LV) aneurysm\n* Prior heart transplantation, left ventricular reduction surgery (LVRS), cardiomyoplasty, passive restraint device (e.g., CorCap™ Cardiac Support Device), mechanical circulatory support device (MCSD) or cardiac shunt\n* Likely to receive cardiac resynchronization therapy, cardiomyoplasty, LVRS, conventional revascularization procedure or valvular repair in the 6 months following treatment\n* Likely need for an immediate heart transplant or MCSD implant due to hemodynamic instability\n* Inadequate hepatic and renal function\n* Diagnosis of, or treatment for, any cancer within the last 5 years except for basal cell carcinoma or carcinomas in situ where surgical excision was considered curative","80 Years",{"count":451,"type":22},57,[95,317],"It is believed that targeted SERCA2a enzyme replacement in HFrEF patients will correct defective intracellular Ca2+ hemostasis, resulting in improved cardiac contractile function and energetics which will, in turn, translate to improved clinical outcomes. Additionally, it is hypothesized that correcting SERCA2a dysfunction will also improve coronary blood flow through correction of the impaired endothelium-dependent nitric oxide-mediated vasodilatation observed in heart failure.",[455,28,68,456],"Congestive Heart Failure","HFrEF - Heart Failure With Reduced Ejection Fraction","2024-03-24",{"date":459,"type":44},"2024-03-26",{"date":461,"type":44},"2021-09-23",{"date":463,"type":22},"2028-12",{"name":465,"class":82},"Sardocor Corp.",{"id":467,"slug":468,"hasResults":11,"nctId":469,"briefTitle":470,"officialTitle":471,"acronym":472,"eligibilityCriteria":473,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":474,"targetDuration":4,"studyType":64,"phases":4,"briefSummary":476,"conditions":477,"keywords":502,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":514,"lastUpdatePostDateStruct":515,"startDateStruct":517,"completionDateStruct":519,"leadSponsor":521,"locationsCount":523},"100541040","contemporary-cardiac-stimulation-in-clinical-practice-left-biventricular-right-and-conduction-system-pacing-100541040","NCT06324682","ConTempoRary Cardiac Stimulation in Clinical practicE: lEft, BivEntriculAr, Right, and conDuction System Pacing","Evaluation of conTempoRary Cardiac Stimulation in Clinical practicE: lEft, BivEntriculAr, Right, and conDuction System Pacing","TREEBEARD","Inclusion Criteria:\n\n* Indication for cardiac stimulation\n* Having performed the implantation of a device for cardiac stimulation\n\nExclusion Criteria:\n\n* Age \\\u003C 18 years;\n* Pregnancy status;",{"count":475,"type":22},8400,"The goal of this observational study is to evaluate the clinical characteristics of patients undergoing permanent cardiac pacing and to compare procedural efficacy and safety of different implantation approaches in the clinical practice of the participating centres. The contribution of non-fluoroscopic anatomical and electrophysiological reconstruction systems to device implantation procedures will also be evaluated.\n\nParticipants \\[patients over 18 years old with an indication to receive a definitive pacemaker\u002Fintracardiac defibrillator implant\\] will receive a permanent cardiac pacing implant as requested according to European Society of Cardiology (ESC) guidelines; the investigators will evaluate procedural efficacy and safety of different implantation approaches.",[478,479,480,481,482,483,484,485,486,487,488,489,490,491,492,493,28,494,495,496,497,498,499,500,501],"Arrhythmias, Cardiac","Atrioventricular Block","Reduced Systolic Function","Atrial Fibrillation","Bradyarrhythmia","Ventricular Tachycardia","Ventricular Dysfunction","Ventricular Fibrillation","Ventricular Arrythmia","Atrioventricular Nodal Disease","Atrioventricular Conduction Defects","Atrioventricular Block Complete","Atrioventricular Block Incomplete","Atrioventricular Junctional Rhythm","Bundle-Branch Block","Left Bundle-Branch Block","Block;Atrioventricular","Block; Arrhythmic","Block; Mobitz","Block, Heart","Block, Fascicular","Block Branch Bundle Left","Heart Failure，Congestive","Heart Arrhythmia",[503,504,479,482,484,505,506,507,508,509,510,511,512,489,513,486,485,483],"Pace maker (PM)","Implantable cardioverter defibrillator (ICD)","Cardiac Resynchronization therapy","Conduction System Pacing","His Pacing","Left bundle branch area pacing (LBBAP)","CRT","CSP","Primary prevention","Secondary prevention","Heart failure","2024-03-19",{"date":516,"type":44},"2024-03-22",{"date":518,"type":44},"2023-01-01",{"date":520,"type":22},"2034-12-31",{"name":522,"class":51},"University Hospital of Ferrara",31,{"id":525,"slug":526,"hasResults":11,"nctId":527,"briefTitle":528,"officialTitle":529,"acronym":4,"eligibilityCriteria":530,"healthyVolunteers":11,"sex":17,"minAge":531,"maxAge":532,"enrollmentInfo":533,"targetDuration":4,"studyType":23,"phases":535,"briefSummary":536,"conditions":537,"keywords":4,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":538,"lastUpdatePostDateStruct":539,"startDateStruct":541,"completionDateStruct":543,"leadSponsor":545,"locationsCount":52},"100316346","mechanistic-clinical-trial-of-advanced-imaging-for-crt-100316346","NCT03398369","Mechanistic Clinical Trial of Advanced Imaging for CRT","Advanced Imaging and Inflammatory Markers to Define Mechanisms of Response to CRT","Inclusion Criteria:\n\n1. Chronic systolic HF\n2. LVEF 35% or less\n3. Guideline-based class I or II indication for CRT\n\nExclusion Criteria:\n\n1. Inability to provide informed consent\n2. Pregnancy\n3. Presence of metal embedded in the body due to prior accident or injury, as documented by skull films or other imaging\n4. Cerebral aneurysm clips\n5. Cochlear implants\n6. Other metallic implants known to be contraindications to CMR (does not include pacemakers and ICDs)\n7. Severe claustrophobia\n8. Acute kidney injury\n9. Acute renal failure or chronic kidney disease with GFR \\\u003C 45 cc\u002Fmin\u002F1.73m2\n10. Liver transplant\n11. Gadolinium allergy\n12. \\>10% premature ventricular contraction (PVC) burden; and 13) estimated \\>10% atrial fibrillation (AF) burden based on available clinical data.","20 Years","90 Years",{"count":534,"type":22},180,[25],"This is a mechanistic clinical trial with randomization to guidance for the CRT procedure using cardiac magnetic resonance (CMR) and computed tomography angiography (CTA) versus a standard procedure.",[28],"2020-02-04",{"date":540,"type":44},"2020-02-06",{"date":542,"type":44},"2018-01-05",{"date":544,"type":22},"2025-01-15",{"name":213,"class":51}]