[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"heart-failure-with-reduced-ejection-fraction-hfref\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:heart-failure-with-reduced-ejection-fraction-hfref":28},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,18,0,[8,52,82,108,134,162,191,217,252,290,324,350,380,404,427,460,498,532],{"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":4},"100053939","phase-4-comparing-the-efficacy-and-safety-of-vericiguat-with-standard-medical-treatment-in-heart-failure-patients-100053939",false,"NCT07697833","Comparing the Efficacy and Safety of Vericiguat With Standard Medical Treatment in Heart Failure Patients","Comparing the Efficacy and Safety of Vericiguat With Standard Medical Treatment in Patients With Heart Failure and Reduced Ejection Fraction: Randomized, Placebo-controlled, Parallel-group, Double-blind Trial","VERICIGUAT","Inclusion Criteria:\n\n1. Age \\>18 years of any gender\n2. Chronic heart failure (New York Heart Association \\[NYHA\\] functional class II, III, or IV), a reduced left ventricular ejection fraction of less than 45% within 12 months before randomization\n3. Elevated natriuretic peptide level: (For patients in sinus rhythm, the criteria include a plasma B-type natriuretic peptide (BNP) level of at least 300 pg per milliliter or an NT-proBNP level of at least 1000 pg per milliliter. For patients in atrial fibrillation, the criteria included a BNP level of at least 500 pg per milliliter or an NT-proBNP level of at least 1600 pg per milliliter).\n4. Evidence of worsening heart failure.\n5. The percentage of enrolled patients with an estimated glomerular filtration rate of 15 to 30 ml per minute per 1.73 m2 of body-surface area was capped at 15%.\n6. Patients on guideline-based medical therapy 3 months\n7. Written and informed consent.\n\nExclusion Criteria:\n\n1. Systolic blood pressure of less than 100 mm Hg.\n2. Concurrent or anticipated use of long-acting nitrates.\n3. Use of intravenous inotropes or implantable left ventricular assist devices.\n4. Not on standard of care medical treatment for heart failure.\n5. Unwillingness to give consent","ALL","18 Years","80 Years",{"count":21,"type":22},500,"ESTIMATED","INTERVENTIONAL",[25],"PHASE4","To compare the effectiveness and safety of Vericiguat with Standard Medical Treatment in Patients with Heart Failure and Reduced Ejection Fraction",[28],"Heart Failure With Reduced Ejection Fraction (HFrEF)",[30,31,32,33,34,35,36,37,38,39],"Vericiguat","Heart Failure","Reduced Ejection Fraction (HFrEF)","Chronic Heart Failure","Cardiovascular Diseases","Randomized Controlled Trial","Double Blind","Placebo-Controlled","Soluble Guanylate Cyclase Stimulator","NT-proBNP","NOT_YET_RECRUITING","2026-07-10",{"date":43,"type":44},"2026-07-13","ACTUAL",{"date":46,"type":22},"2026-07-15",{"date":48,"type":22},"2027-07-31",{"name":50,"class":51},"National Institute of Cardiovascular Diseases, Pakistan","OTHER",{"id":53,"slug":54,"hasResults":11,"nctId":55,"briefTitle":56,"officialTitle":56,"acronym":57,"eligibilityCriteria":58,"healthyVolunteers":11,"sex":17,"minAge":59,"maxAge":60,"enrollmentInfo":61,"targetDuration":4,"studyType":23,"phases":63,"briefSummary":65,"conditions":66,"keywords":67,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":73,"lastUpdatePostDateStruct":74,"startDateStruct":76,"completionDateStruct":78,"leadSponsor":80,"locationsCount":4},"100644556","implementation-of-an-encounter-based-patient-decision-aid-for-heart-failure-medications-in-heart-function-clinics-the-share-hf-pragmatic-stepped-wedge-trial-100644556","NCT07670845","Implementation of an Encounter-based Patient Decision Aid for Heart Failure Medications in Heart Function Clinics: the SHARE-HF Pragmatic, Stepped-wedge Trial","SHARE-HF","Inclusion Criteria:\n\n1. Patient in a participating HF clinic;\n2. In-person initial HF clinic visit;\n3. Age 40-85 years;\n4. Heart failure with reduced ejection fraction (HFrEF), as indicated by latest cardiac imaging demonstrating ejection fraction ≤40%.\n\nExclusion Criteria:\n\n1. Previous request to the clinic not to be contacted for research;\n2. Consent opt-out;\n3. Non-BC residents;\n4. Residents of long-term care facilities or hospice;\n5. Receiving palliative care;\n6. End-stage kidney disease on dialysis or latest estimated glomerular filtration rate (eGFR) \\\u003C30 mL\u002Fmin\u002F1.73 m2.","40 Years","85 Years",{"count":62,"type":22},1350,[64],"NA","The goal of this clinical trial is to learn if a shared decision-making tool called SHARE-HF can help more people with heart failure receive guideline-recommended medications. The study includes adults with a type of heart failure called heart failure with reduced ejection fraction (HFrEF), who attend heart function clinics in British Columbia, Canada. The main question it aims to answer is:\n\n\\- Does use of SHARE-HF during clinic visits lead to more participants receiving their recommended heart failure medications after 6 months?\n\nResearchers will compare clinics using the SHARE-HF tool to clinics providing usual care to see if the tool helps more participants get their recommended medications.\n\nParticipants will use the SHARE-HF web-based tool with their clinician during regular clinic visits. The tool shows participants how their heart failure may affect their health over time, explains their medication options, and helps them and their clinician make treatment decisions together.",[28],[68,69,70,71,72],"shared decision-making","decision aid","encounter-based decision aid","guideline-directed medical therapy","GDMT","2026-06-22",{"date":75,"type":44},"2026-06-26",{"date":77,"type":22},"2026-11-02",{"date":79,"type":22},"2030-10-31",{"name":81,"class":51},"University of British Columbia",{"id":83,"slug":84,"hasResults":11,"nctId":85,"briefTitle":86,"officialTitle":87,"acronym":88,"eligibilityCriteria":89,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":60,"enrollmentInfo":90,"targetDuration":4,"studyType":23,"phases":92,"briefSummary":94,"conditions":95,"keywords":96,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":98,"lastUpdatePostDateStruct":99,"startDateStruct":101,"completionDateStruct":103,"leadSponsor":105,"locationsCount":4},"100642086","phase-2-a-study-to-evaluate-the-safety-and-efficacy-of-ac01-compared-to-placebo-in-participants-with-chronic-heart-failure-100642086","NCT07584967","A Study to Evaluate the Safety and Efficacy of AC01 Compared to Placebo in Participants With Chronic Heart Failure","Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multicenter Study to Evaluate the Safety and Efficacy of 2 Dose Levels of the Oral Ghrelin Receptor Agonist AC01 Over 12 Weeks in Patients With Chronic Advanced Heart Failure With Reduced Ejection Fraction (HFrEF)","GOAL-HF2","Key Inclusion Criteria:\n\n* History of Chronic Heart Failure (CHF) diagnosed greater than or equal to (\\>=6) months before screening, and in NYHA Class II to IV at screening.\n* Chronic advanced HFrEF defined as:\n\n  * LVEF less than or equal to (\\\u003C=) 35 percentage (%) by local reading \\>=6 months before screening or a record of LVEF qualitatively described as severely reduced or moderately-severely reduced \\>=6 months before screening, and\n  * LVEF \\\u003C=35% at the screening echocardiography (confirmed by core lab), and\n  * no known LVEF greater than (\\>) 35% (or qualitatively described as less than moderately-severely reduced) between the 2 readings.\n* Sinus rhythm or permanent, persistent, or paroxysmal atrial fibrillation flutter (AFF) (AFF at screening is capped at maximum 15% of participants enrolled) with mean resting heart rate of \\>=55 and \\\u003C=90 beats per minute (bpm) at screening, and \\>=50 and \\\u003C=95 bpm at randomization, regardless of rhythm.\n* NT-proBNP \\>=400 picograms per milliliter (pg\u002FmL) in sinus rhythm and \\>=800 pg\u002FmL in AFF at screening (confirmed by central laboratory).\n* Transvenous implantable cardioverter-defibrillator (ICD) for primary prevention with back-up pacing set at 40 bpm.\n* Treated with optimal, stable, medical therapy for HF consistent with prevailing local and international guidelines unless contraindicated or not tolerated, as judged and documented by the investigator.\n\nKey Exclusion Criteria:\n\n* Any acute or serious co-morbid condition that could lead to premature termination of study participation or interfere with the measurement or interpretation of the efficacy and safety assessments in the study.\n* Admitted to hospital with the primary reason of HF within 24 hours before randomization or currently hospitalized with the primary reason of HF for more than 10 days. Current hospitalization (\\>24 hours and \\\u003C=10 days) is capped at a maximum of 15% of participants enrolled.\n* Acute coronary syndrome, stroke or transient ischemic attack, severe ventricular arrhythmia, or major cardiac intervention, percutaneous coronary intervention, valvuloplasty\u002Fother cardiac valve repair or implantation, or cardiac surgery within 60 days before randomization.\n* Systolic blood pressure \\>130 or ˂90 millimeters of mercury (mmHg) at screening, or \\>140 or ˂85 mmHg at randomization.\n* Uncontrolled diabetes mellitus, defined as Hemoglobin A1c (HbA1c) \\>=9.0% (\\>=75 millimoles per mole \\[mmol\u002Fmol\\]) at screening, or severe complications of diabetes.\n* Body weight \\\u003C50 kilogram (kg) or body mass index (BMI) \\\u003C18 kilograms per square meter (kg\u002Fm\\^2) or \\>45 kg\u002Fm\\^2 at screening.\n* Any of the following electrocardiogram (ECG) findings at screening: Corrected QT interval using Fridericia's formula (QTcF) \\>450 milliseconds (ms), 1st degree atrioventricular (AV) block with PQ \\>240 ms, or AV block 2nd or 3rd degree.\n* History of aborted cardiac arrest, sustained ventricular tachycardia, or Torsades-de Pointes, or congenital long QT syndrome. Family history of sudden cardiac death, unexplained death, long QT syndrome, or death from a primary dysrhythmia.\n* Cardiac resynchronization therapy, Cardiac Contractility Modulation, or pacemaker device other than the back-up pacing function of the ICD.\n* Mechanical hemodynamic support, kidney support, or ventilation within 7 days before randomization.\n* Treatment with i.v. inotropes, i.v. vasodilators, or i.v. vasopressors within 3 days before randomization.\n* Treatment with any i.v. diuretics or supplemental oxygen within 6 hours before randomization.\n* Use of any drugs or substances known to be strong inducers of Cytochrome P450 3A4 (CYP3A4) enzyme within 28 days before randomization or planned to be used during the study period or strong inhibitors of CYP3A4 within 7 days before randomization or planned to be used during the study period.\n* Use of any drug that is known to prolong the QT interval (for example, sotalol, dofetilide, macrolides, some antidepressants, and some antipsychotics) within 28 days before randomization or planned to be used during the study period.\n* Treatment changes in glucose lowering therapy within 28 days before randomization.\n* Estimated glomerular filtration rate (eGFR) \\\u003C20 milliliters per minute per 1.73 square meters (mL\u002Fmin\u002F1.73 m2) according to the Chronic Kidney Disease Epidemiology Collaboration formula, planned renal replacement therapy within the next 6 months, or receiving dialysis at screening.\n* Serum potassium \\\u003C3.5 or \\>5.2 milliequivalents per liter (mEq\u002FL) at screening.\n* Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \\>3 \\*upper limit of normal (ULN) or total bilirubin \\>2 \\* ULN, or known cirrhosis, severe liver, or pancreatic disease at screening.\n* Use of any anti-arrhythmic drugs within 28 days before randomization or planned to be used during the study period, except for amiodarone, ivabradine, digoxin, and beta blockers.",{"count":91,"type":22},400,[93],"PHASE2","The primary purpose of the study is to evaluate the safety and efficacy of 2 doses of AC01 compared to placebo over 12 weeks in participants with chronic advanced HFrEF.",[28],[97,34,31],"Heart Diseases","2026-06-11",{"date":100,"type":44},"2026-06-15",{"date":102,"type":22},"2026-08-15",{"date":104,"type":22},"2028-05-22",{"name":106,"class":107},"AnaCardio AB","INDUSTRY",{"id":109,"slug":110,"hasResults":11,"nctId":111,"briefTitle":112,"officialTitle":113,"acronym":114,"eligibilityCriteria":115,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":60,"enrollmentInfo":116,"targetDuration":4,"studyType":23,"phases":118,"briefSummary":119,"conditions":120,"keywords":121,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":124,"lastUpdatePostDateStruct":125,"startDateStruct":127,"completionDateStruct":129,"leadSponsor":131,"locationsCount":133},"100643421","olive-oil-supplementation-for-heart-failure-with-reduced-ejection-fraction-100643421","NCT07644806","Olive Oil Supplementation for Heart Failure With Reduced Ejection Fraction","Olive Oil Supplementation to Enhance Exercise Tolerance in Cardiac Rehabilitation in Patients With Heart Failure With Reduced Ejection Fraction: The OLEA-HF Study","OLEA-HF","Inclusion Criteria:\n\n* Diagnosed with HFrEF with left ventricular ejection fraction ≤35 %.\n* Referred to and enrolled in the standard cardiac rehabilitation program at Sentara Cardiac Rehabilitation Center, but has not yet initiated\u002Fstarted cardiac rehabilitation (i.e., has not attended the first cardiac rehab session).\n* Able and willing to comply with study procedures and provide informed consent.\n\nExclusion Criteria:\n\n* Co-morbidity expected to limit survival (e.g., terminal illness).\n* End-stage renal disease.\n* Unstable fluid overload.\n* Current pregnancy (self-disclose).\n* Habitual use of EVOO greater than 4 tablespoons per day.\n* Known allergy or sensitivity to olive oil or its components.\n* Unwillingness or inability to incorporate EVOO or dietary recommendations.",{"count":117,"type":22},40,[64],"The OLEA-HF study aims to explore whether daily supplementation of extra-virgin olive oil (EVOO) for 12 weeks during participation in a cardiac rehabilitation program (standard of care) is feasible in patients with heart failure with reduced ejection fraction (HFrEF). The investigators will also determine the effects of EVOO on functional capacity and quality of life.",[28],[122,123],"Cardiomyopathy","Dietary fat quality","2026-06-08",{"date":126,"type":44},"2026-06-12",{"date":128,"type":22},"2026-07-01",{"date":130,"type":22},"2028-03-31",{"name":132,"class":51},"Old Dominion University",1,{"id":135,"slug":136,"hasResults":11,"nctId":137,"briefTitle":138,"officialTitle":139,"acronym":140,"eligibilityCriteria":141,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":142,"targetDuration":4,"studyType":23,"phases":144,"briefSummary":145,"conditions":146,"keywords":147,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":153,"lastUpdatePostDateStruct":154,"startDateStruct":156,"completionDateStruct":158,"leadSponsor":160,"locationsCount":133},"100632772","telemedicine-guided-uptitration-of-therapy-in-chronic-heart-failure-100632772","NCT07518030","Telemedicine-guided Uptitration of Therapy in Chronic Heart Failure","TELEHEART Trial: Telemedicine-guided Uptitration of Therapy in Chronic Heart Failure","TELEHEART","Inclusion criteria: Participants must meet all of the following criteria:\n\n1. Provision of written informed consent.\n2. Age ≥18 years.\n3. Recent diagnosis of HFrEF, defined according to ESC criteria, established in either an inpatient or outpatient setting.\n4. No prior initiation of GDMT for HF at the time of enrollment, or treatment limited to a single agent with potential disease-modifying effects prescribed for a different clinical indication.\n5. Availability of adequate digital literacy, either by the patient or a caregiver, defined as the ability to use electronic devices for remote communication (phone\u002Fvideo calls), transmission of vital parameters (body weight, blood pressure, heart rate), and interaction with digital health tools. In cases of insufficient patient digital skills, the presence of a caregiver with adequate digital competence is acceptable.\n6. Any etiology of HF is eligible, including ischemic, valvular, primary or infiltrative cardiomyopathies, iatrogenic or toxic causes, and tachycardia-induced cardiomyopathy.\n\nExclusion Criteria:\n\n* Ongoing treatment with two or more guideline-directed heart failure medications at the time of HFrEF diagnosis\n* Presence of severe comorbidities or clinical instability requiring prolonged or continuous hospital management\n* Estimated life expectancy \\\u003C12 months\n* Pregnancy or breastfeeding",{"count":143,"type":22},80,[64],"This is a single-center, randomized, open-label, no-profit interventional trial designed to evaluate the effectiveness of a telemedicine-based follow-up strategy compared with standard ambulatory care in patients with newly diagnosed heart failure with reduced ejection fraction (HFrEF). The study aims to determine whether telemedicine-guided management improves the optimization of guideline-directed medical therapy (GDMT), measured as change in GDMT score at 6 months. Patients will be randomized to either a telemedicine group, involving remote multiparametric monitoring and structured teleconsultations, or a standard-of-care group based on conventional in-person follow-up. Secondary objectives include the assessment of safety, treatment adherence, quality of life, and heart failure-related urgent visits, emergency department access, and hospitalizations. This study will provide evidence on the role of telemedicine in facilitating early and effective optimization of heart failure therapy and improving clinical management in a real-world setting.",[28],[148,149,150,151],"Heart failure with reduced ejection fraction","Telemedicine","Guidelines direct medical therapy","Uptitration","RECRUITING","2026-05-15",{"date":155,"type":44},"2026-05-18",{"date":157,"type":44},"2026-03-20",{"date":159,"type":22},"2028-06-01",{"name":161,"class":51},"Azienda Unita Sanitaria Locale di Piacenza",{"id":163,"slug":164,"hasResults":11,"nctId":165,"briefTitle":166,"officialTitle":167,"acronym":4,"eligibilityCriteria":168,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":169,"targetDuration":4,"studyType":23,"phases":171,"briefSummary":172,"conditions":173,"keywords":174,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":182,"lastUpdatePostDateStruct":183,"startDateStruct":185,"completionDateStruct":187,"leadSponsor":189,"locationsCount":133},"100635687","relieve-metab-study-100635687","NCT07555925","RELIEVE METAB Study","Interatrial Shunt Device (IASD) Treatment in Symptomatic Heart Failure With Reduced Left Ventricular Ejection Fraction (HFrEF) Alleviates Elevated Myocardial Left Ventricular Pressures, Improves Myocardial Mitochondrial Function and Promotes Regional and Global Myocardial Recovery","Inclusion Criteria:\n\n1. Ischemic or non-ischemic cardiomyopathy with LVEF ≤ 40%\n2. Patient is eligible and scheduled to receive the Ventura IASD as per the current IFU.\n3. Symptoms: NYHA Class III\n4. Stability: Chronic heart failure for ≥ 6 months on stable, and at least 3 months on guideline-directed medical therapy (GDMT)\n5. Biomarkers: NTproBNP ≥ 1,200 pg\u002Fml\n6. Age 18 years or older\n7. Subject has signed informed consent form and is willing and able to attend all follow-up visits and is physically capable of performing all tests.\n\nExclusion Criteria:\n\n1. Hemodynamics: Resting SBP \\\u003C 90 or \\> 160 mmHg\n2. Severe PH (PASP \\>70 mmHg, PVR \\> 4 Wood Units)\n3. Anatomy\u002FStructure:\n\n   * intracardiac thrombus\n   * Severe RV dysfunction (TAPSE \\\u003C12 mm or RVFAC ≤25%)\n   * LVEDD \\> 8 cm\n   * Significant ASD or PFO\n4. Valvular Disease:\n\n   * Severe, untreated mitral stenosis or aortic stenosis or regurgitation\n   * Mitral repair device \\\u003C3 months prior to enrollment\n5. Recent Events:\n\n   * ACS, PCI, Cardiac Surgery (\\\u003C 3 months prior to enrollment)\n   * CAD requiring revascularization\n   * Stroke, TIA, PE, Thrombosis (\\\u003C 6 months prior to enrollment)\n6. Issues undergoing MRI: e.g non-compatible implant, claustrophobia, or physically not suitable for MRI\n7. Participation in the active treatment or follow-up phase of another clinical study of an investigational drug or device that has not reached its primary endpoint\n8. Any medical or psychiatric condition such as dementia, alcoholism or substance abuse which may preclude informed consent or interfere with any of the study procedures, including follow-up visits\n9. Any non-cardiac condition with life expectancy \\\u003C1 years (e.g., cirrhosis, cancer not in remission, etc.)\n10. Subject belongs to a vulnerable population",{"count":170,"type":22},15,[64],"This prospective, single-center post-market-follow-up study aims to fill knowledge gaps by combining advanced cardiac MRI\u002FMRS with systemic mitochondrial assays and exercise testing to characterize the energetic and functional impact of IASD therapy in HFrEF patients.",[28],[175,176,177,178,179,180,181],"Interatrial Shunt Device (IASD)","Ventura Shunt","Myocardial Energetics","Mitchondrial Function","MRI","CMR","MRS","2026-04-22",{"date":184,"type":44},"2026-04-29",{"date":186,"type":22},"2026-06-01",{"date":188,"type":22},"2027-07-01",{"name":190,"class":51},"Heinrich-Heine University, Duesseldorf",{"id":192,"slug":193,"hasResults":11,"nctId":194,"briefTitle":195,"officialTitle":196,"acronym":197,"eligibilityCriteria":198,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":60,"enrollmentInfo":199,"targetDuration":4,"studyType":23,"phases":201,"briefSummary":202,"conditions":203,"keywords":4,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":208,"lastUpdatePostDateStruct":209,"startDateStruct":211,"completionDateStruct":213,"leadSponsor":215,"locationsCount":133},"100611934","heart-failure-management-for-patient-with-cied-remotely-monitored-100611934","NCT07247032","Heart Failure Management for Patient With CIED Remotely Monitored","Prospective Real World Heart Failure Management for Patient With CIED Remotely Monitored","PROACT-HF","Inclusion Criteria:\n\n* Patient aged 18-85\n* Patient diagnosed with a New York Heart Association (NYHA) class II or III\n* Patients with left ventricular ejection fraction ≼ 40 %\n* Patient implanted with an ICD or CRT-D (BiV and\u002For LBBA pacing) since at least 30 days and compatible with SignalHF (Biotronik, Boston Scientific and Medtronic)\n* Non-activation of others HF multisensor algorithms\n* Patient remote monitored on Implicity CIED platform\n* Patient with a documented diagnosis of heart failure, eligible to reimbursement in France or Germany for HF remote monitoring\n* Patient is willing to be remotely monitored for heart failure\n* HF treated according to European Society of Cardiology (ESC) guidelines\n\nExclusion Criteria:\n\n* Patients undergoing or awaiting heart transplant or left ventricular assist device (LVAD) procedures\n* Patients with a life expectancy of less than 12 months\n* Patients enrolled in concurrent clinical studies\n* Patients with a history of non-compliance with medical care or inability to comply with the study protocol\n* Patients already receiving remote monitoring for heart failure\n* Pregnant or breastfeeding women\n* Subjects under legal protection",{"count":200,"type":22},1132,[64],"This randomized, controlled, open-label, parallel, multicenter clinical study evaluates the efficacy of SmartSignalHF compared with heart failure (HF) remote monitoring (RM) standard of care in implanted patients with heart failure. The primary objective is to determine whether SmartSignalHF reduces all-cause mortality and HF hospitalizations at 12 months.",[31,204,205,28,206,207],"Heart Failure NYHA Class II","Heart Failure NYHA Class III","Heart Failure With Decompensation","CRT and\u002For ICD","2026-03-26",{"date":210,"type":44},"2026-03-31",{"date":212,"type":44},"2025-12-19",{"date":214,"type":22},"2027-05",{"name":216,"class":107},"Implicity",{"id":218,"slug":219,"hasResults":11,"nctId":220,"briefTitle":221,"officialTitle":221,"acronym":222,"eligibilityCriteria":223,"healthyVolunteers":11,"sex":224,"minAge":18,"maxAge":60,"enrollmentInfo":225,"targetDuration":4,"studyType":23,"phases":227,"briefSummary":228,"conditions":229,"keywords":233,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":242,"lastUpdatePostDateStruct":243,"startDateStruct":245,"completionDateStruct":247,"leadSponsor":249,"locationsCount":251},"100615662","phase-4-pharmacological-optimization-in-prevention-in-heart-failure-a-sex-gap-100615662","NCT07295522","Pharmacological Optimization in Prevention in Heart Failure: A Sex-gap?","PopS-HF","Inclusion Criteria:\n\n1. Female patients \\>18 \\\u003C85 years.\n2. Hospital admission within the 72 hours prior to Screening for acute heart failure with dyspnea at rest and pulmonary congestion on chest X-ray, and other signs and\u002For symptoms of heart failure such as edema and\u002For positive rales on auscultation.\n3. All measures within 24 hours prior to Randomization of systolic blood pressure ≥ 100 mmHg, and of heart rate ≥ 60 bpm.\n4. All measures within 24 hours prior to Randomization of serum potassium ≤ 5.0 mEq\u002FL (mmol\u002FL).\n5. Biomarker criteria for persistent congestion:\n\n   5.1. At Screening, NT-proBNP \\>1,800 pg\u002FmL (2,350 pg\u002FmL in case of atrial fibrillation) 5.2. At the time of Randomization (1-2 days prior to discharge), NT-proBNP \\>1,000 pg\u002FmL (1,300 pg\u002FmL in case of Atrial Fibrillation) to ensure the persistence of congestion and the acuity of the index episode).\n6. At 1 week prior to admission, at Screening, and at Visit 2 6.1. If EF\\\u003C50% (ie HFrEF or HFmrEF) either \\\u003C½ the optimal dose of ACEi\u002FARB\u002FARNi and MRA and BB or no SGLT2i (see Table) must have been prescribed 6.2. If EF\\>50% (ie HFpEF): \\\u003C½ the optimal dose of MRA (see Table) or no SGLT2i.\n7. Written informed consent to participate in the study.\n\nExclusion Criteria:\n\n1. Male patients\n2. Age \\\u003C 18 or \\> 85 years.\n3. Mechanical ventilation (not including CPAP\u002FBIPAP) in the 24 hours prior to Screening.\n4. Significant pulmonary disease contributing substantially to the patients' dyspnoea such as FEV1 \\\u003C1 liter or need for chronic systemic or nonsystemic steroid therapy, or any kind of primary right heart failure such as primary pulmonary hypertension or recurrent pulmonary embolism.\n5. Myocardial infarction, unstable angina or cardiac surgery within 3 months, or cardiac resynchronization therapy (CRT) device implantation within 3 months, or percutaneous transluminal coronary intervention (PTCI), within 1 month prior to Screening or during the index event.\n6. Index Event (admission for Acute Heart Failure) triggered primarily by a correctable aetiology such as significant arrhythmia (e.g., sustained ventricular tachycardia, or atrial fibrillation\u002Fflutter with sustained ventricular response \\>130 beats per minute, or bradycardia with sustained ventricular arrhythmia \\\u003C45 beats per minute), infection, severe anaemia, acute coronary syndrome, pulmonary embolism, exacerbation of Chronic Obstructive Pulmonary Disease (COPD), planned admission for device implantation or severe non-adherence leading to very significant fluid accumulation prior to admission and brisk diuresis after admission. Troponin elevations without other evidence of an acute coronary syndrome are not an exclusion.\n7. Uncorrected thyroid disease, active myocarditis, or known amyloid or hypertrophic obstructive cardiomyopathy.\n8. History of heart transplant or on a transplant list or using or planned to be implanted with a ventricular assist device.\n9. Sustained ventricular arrhythmia with syncopal episodes within the 3 months prior to screening that is untreated.\n10. Presence at Screening of any hemodynamically significant valvular stenosis or regurgitation, except mitral or tricuspid regurgitation secondary to left ventricular dilatation, or the presence of any hemodynamically significant obstructive lesion\n11. Active infection at any time during the AHF hospitalization prior to Randomization based on abnormal temperature and elevated WBC or need for intravenous antibiotics.\n12. Stroke or Transient Ischemic Attack (TIA) within the 3 months prior to Screening.\n13. Primary liver disease considered to be life threatening.\n14. Renal disease or eGFR \\\u003C 30 mL\u002Fmin\u002F1.73m2 (as estimated by the simplified MDRD formula) at Screening or history of dialysis.\n15. Psychiatric or neurological disorder, cirrhosis, or active malignancy leading to a life expectancy \\\u003C 6 months.\n16. Prior (defined as less than 30 days from screening) or current enrollment in a CHF trial or participation in an investigational drug or device study within the 30 days prior to screening or 5 half-lives of the study drug, whichever is longer.\n17. Discharge for the AHF hospitalization anticipated to be \\>14 days from admission, or to a long-term care facility. Randomization must occur within 12 days following admission and at 1-2 days prior to anticipated discharge.\n18. Inability to comply with all study requirements, due to major co-morbidities, social or financial issues or a history of noncompliance with medical regimens, that might compromise the patient's ability to understand and\u002For comply with the protocol instructions or follow-up procedures.\n19. Pregnant or nursing (lactating) women.\n20. Hypersensitivity to the active substance or to any of the excipients as indicated in Summary of Product Characteristics of Investigational Medicinal Product (IMPs).\n21. Angioedema.\n22. Severe heart failure (NYHA class IV).","FEMALE",{"count":226,"type":22},368,[25],"The goal of this clinical trial is to learn whether a rapid and intensive optimization of heart failure medications in women can improve outcomes after hospitalization for heart failure. It will also investigate the safety and the tolerance of these treatments when given at full guideline-recommended doses.\n\nThe main questions it aims to answer are:\n\n1. Does intensive medication optimization reduce death or hospital readmissions for heart failure within one year?\n2. Do women benefit as much as men from intensive and full-dose heart failure therapy?\n3. Is this treatment protocol safe and feasible also in women?\n\nResearchers will compare two groups of women hospitalized for heart failure:\n\n* High-intensity care: starting and increasing all recommended heart-failure medications as quickly as possible and monitoring patients closely during the first weeks after discharge.\n* Usual care: medications are started and adjusted gradually, according to the judgment of the treating cardiologist and the patient's usual care team.\n\nThe study will follow participants for 12 months to see whether the high-intensity strategy reduces death, hospital readmission for heart failure, or worsening symptoms. It will also evaluate side effects, medication tolerance, and quality of life.\n\nParticipants will be randomly assigned to one of the two groups, attend regular follow-up visits for one year, complete a short quality-of-life questionnaire (EQ-5D).\n\nThis study will include about 360 women from 13 hospitals in Italy. It is sponsored by IRCCS Policlinico San Donato and funded by the Italian Medicines Agency (AIFA).",[31,230,28,231,232],"Acute Heart Failure","Heart Failure With Preserved Ejection Fraction (HFPEF)","Heart Failure With Mildly Reduced Ejection Fraction",[234,235,72,236,237,238,239,240,241],"heart failure","women","Pharmacological Optimization","phase IV","High intensity up-titration","Secondary prevention","Sex differences","Real world data","2026-03-25",{"date":244,"type":44},"2026-03-30",{"date":246,"type":22},"2026-04-08",{"date":248,"type":22},"2028-06-08",{"name":250,"class":51},"IRCCS Policlinico S. Donato",13,{"id":253,"slug":254,"hasResults":11,"nctId":255,"briefTitle":256,"officialTitle":257,"acronym":258,"eligibilityCriteria":259,"healthyVolunteers":11,"sex":17,"minAge":260,"maxAge":4,"enrollmentInfo":261,"targetDuration":4,"studyType":263,"phases":4,"briefSummary":264,"conditions":265,"keywords":267,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":281,"lastUpdatePostDateStruct":282,"startDateStruct":284,"completionDateStruct":286,"leadSponsor":288,"locationsCount":133},"100586000","ai-based-monitoring-system-for-chronic-heart-failure-with-advanced-wearable-and-mini-invasive-devices-100586000","NCT06909682","AI-Based Monitoring System for Chronic Heart Failure With Advanced Wearable and Mini-Invasive Devices","Smart Monitoring and Analysis System Based on Artificial Intelligence for Patients With Chronic Heart Failure Using Advanced Mini-Invasive and Wearable Medical Devices","SMART-CARE","Inclusion Criteria\n\n* Age ≥ 18 years (adults of any sex)\n* Confirmed diagnosis of chronic heart failure (CHF) for at least 6 months prior to screening\n* Stable on optimized heart failure therapy for at least one month before enrollment\n* Any left ventricular ejection fraction (LVEF) classification, including:\n\n  * Heart Failure with Reduced Ejection Fraction (HFrEF)\n  * Heart Failure with Mid-Range Ejection Fraction (HFmrEF)\n  * Heart Failure with Preserved Ejection Fraction (HFpEF)\n* NYHA Functional Class I, II, or III\n* History of at least one hospital admission or outpatient visit in the past 12 months requiring intravenous (IV) diuretics, vasodilators, or inotropes for CHF exacerbation\n* Ability to provide written informed consent or availability of a legally authorized representative Exclusion Criteria\n* NYHA Functional Class IV or anticipated heart transplant or ventricular assist device (VAD) implantation within 6 months of screening\n* Severe renal impairment (eGFR \\\u003C 30 mL\u002Fmin\u002F1.73 m²) or dialysis dependence\n* Terminal comorbidities (e.g., advanced cancer, end-stage pulmonary disease) significantly limiting life expectancy\n* Pregnancy\n* Presence of skin conditions or allergies preventing prolonged use of a wearable device\n* Inability to comply with study procedures (e.g., cognitive impairment, significant psychiatric disorders)","19 Years",{"count":262,"type":22},205,"OBSERVATIONAL","The goal of this observational, multicenter study is to evaluate whether AI-driven remote monitoring using a mini-invasive wearable device can improve clinical outcomes in adult patients (≥18 years) with chronic heart failure (CHF).\n\nThe main questions it aims to answer are:\n\n* Can continuous remote monitoring reduce hospital admissions (emergency visits and hospitalizations) by 20% compared to standard care?\n* Does wearable-based remote monitoring improve functional, biochemical, and instrumental parameters in CHF patients? Researchers will compare patients using the wearable device (intervention group) to those receiving standard clinical follow-up (control group) to assess whether AI-driven monitoring leads to fewer hospitalizations, better disease management, and improved quality of life.\n\nParticipants will:\n\n* Wear the EmbracePlus (Empatica Inc.) device continuously for six months (intervention group only).\n* Have their biometric data (SpO₂, HRV, EDA, respiratory rate, temperature, sleep quality) monitored remotely.\n* Receive automated alerts and teleconsultations if abnormal physiological changes are detected.\n* Attend scheduled follow-up visits (remote and in-person) for clinical evaluation and treatment adjustments.\n\nThe study aims to provide real-world evidence on whether integrating wearable health technology with AI analytics can enhance CHF management and improve patient outcomes.",[33,34,28,231,266],"Congestive Heart Failure Chronic",[268,269,270,271,272,273,274,275,276,277,278,279,280],"Wearable Medical Devices","Remote Patient Monitoring","Artificial Intelligence in Cardiology","Smart Wearables for Healthcare","Observational Study in Heart Failure","AI-Based Predictive Modeling","Telemedicine in Heart Failure","Non-Invasive Health Monitoring","Personalized Medicine for CHF","Quality of Life Improvement in Heart Failure","Heart Failure Readmission Prevention","Telehealth in Chronic Disease Management","Digital Health Solutions for Heart Disease","2026-03-09",{"date":283,"type":44},"2026-03-11",{"date":285,"type":44},"2025-08-01",{"date":287,"type":22},"2027-02-02",{"name":289,"class":51},"University of Salerno",{"id":291,"slug":292,"hasResults":11,"nctId":293,"briefTitle":294,"officialTitle":295,"acronym":296,"eligibilityCriteria":297,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":298,"targetDuration":4,"studyType":23,"phases":300,"briefSummary":301,"conditions":302,"keywords":303,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":316,"startDateStruct":318,"completionDateStruct":320,"leadSponsor":322,"locationsCount":133},"100624154","phase-4-vericiguat-and-reverse-remodeling-indices-in-heart-failure-100624154","NCT07405944","Vericiguat and Reverse Remodeling Indices in Heart Failure","Vericiguat's Effects on Reverse Remodeling Indices: Pathophysiologic Approach to Treatment of Heart Failure With Reduced Ejection Fraction","VERI-PATH","Inclusion Criteria:\n\n* Written informed consent from an adult patient (≥ 18 years old) to participate in the clinical study,\n* Stable HFrEF defined as no heart failure worsening in the 6 months before randomization that required hospitalization or outpatient diuretic treatment,\n* Confirmed diagnosis of chronic heart failure with reduced ejection fraction (LVEF ≤ 40%, confirmed by echocardiography) within 12 months before randomization,\n* Stable GDMT for HFrEF for at least 3 months prior to randomisation.\n\nExclusion Criteria:\n\n* Systolic blood pressure \\\u003C 100 mmHg or symptomatic hypotension,\n* Current or planned use of long-acting nitrates, soluble guanylate cyclase stimulators, or phosphodiesterase type V inhibitors,\n* Known allergy\u002Fhypersensitivity to soluble guanylate cyclase stimulators,\n* Awaiting heart transplantation or dependence on continuous inotropic therapy\n* Cardiac amyloidosis, sarcoidosis, myocarditis, stress cardiomyopathy, or tachycardic cardiomyopathy,\n* Acute coronary syndrome, coronary artery bypass grafting, or percutaneous coronary intervention in the past three months before randomisation,\n* Long-term mechanical circulatory support of the left ventricle,\n* Active infection,\n* Chronic kidney disease stage 4 or 5, and\n* Advanced liver failure classified as Child-Pugh B or C.",{"count":299,"type":22},60,[25],"The goal of this clinical trial is to investigate how vericiguat benefits adults with stable heart failure with reduced ejection fraction (HFrEF) who are already receiving guideline-directed medical therapy.\n\nThe main questions are:\n\n* Does vericiguat improve right ventricular systolic function, measured by tricuspid annular plane systolic excursion (TAPSE)?\n* Does vericiguat favourably influence myocardial remodeling, fibrosis, angiogenesis, inflammation, metabolism, renal function, and hematologic balance?\n* Do genetic and oxidative stress profiles modify treatment response? Researchers will compare a group receiving vericiguat plus usual care with a group receiving usual care alone to assess structural, functional, and biomarker changes over 12 months.\n\nParticipants will:\n\n* Have blood drawn at baseline and follow-up visits for biomarker, metabolomic, genetic, transcriptomic, and hematologic analyses, including platelet function testing\n* Perform oral glucose tolerance tests (OGTT) to assess insulin resistance\n* Undergo echocardiography, cardiac magnetic resonance imaging, and cardiac scintigraphy to evaluate heart structure, function, and perfusion\n* Attend follow-up visits at 1, 3, 6, and 12 months Open-label extension: After the 12-month randomized phase, participants originally assigned to usual care will be offered open-label vericiguat and followed for an additional 12 months. This exploratory extension will reassess study outcomes to evaluate the consistency and magnitude of response to vericiguat in the prior control cohort.",[28,33],[30,304,305,306,307,308,309,310,311,312,313,314],"Soluble Guanylate Cyclase","Cyclic GMP","Reverse Remodeling","Cardiac Magnetic Resonance Imaging","Myocardial Perfusion Imaging","Fibrosis","Inflammation","Angiogenesis","Oxidative Stress","Immunomodulation","Insulin Resistance","2026-02-08",{"date":317,"type":44},"2026-02-12",{"date":319,"type":44},"2025-11-01",{"date":321,"type":22},"2027-12-31",{"name":323,"class":51},"University Medical Centre Ljubljana",{"id":325,"slug":326,"hasResults":11,"nctId":327,"briefTitle":328,"officialTitle":329,"acronym":330,"eligibilityCriteria":331,"healthyVolunteers":11,"sex":17,"minAge":59,"maxAge":4,"enrollmentInfo":332,"targetDuration":4,"studyType":23,"phases":334,"briefSummary":335,"conditions":336,"keywords":337,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":340,"lastUpdatePostDateStruct":341,"startDateStruct":343,"completionDateStruct":345,"leadSponsor":347,"locationsCount":349},"100623932","endovascular-ablation-of-the-right-greater-splanchnic-nerve-in-subjects-with-reduced-ejection-fraction-100623932","NCT07403058","Endovascular Ablation of the Right Greater Splanchnic Nerve in Subjects With Reduced Ejection Fraction","Endovascular Ablation Of The Right Greater Splanchnic Nerve In Subjects Having Heart Failure With Reduced Ejection Fraction: Randomized Controlled Feasibility Trial","R-HFrEF","Inclusion Criteria:\n\n1. Chronic heart failure, defined as:\n\n   1. Symptoms of HF requiring current (QD or QOD or appropriate dosing as per screening committee) treatment with loop diuretics for at least 30 days prior to screening visit, AND\n   2. NYHA class II, NYHA class III, or ambulatory NYHA class IV symptoms at screening or signs of HF, AND\n   3. NT-proBNP \\>800 pg\u002Fml in normal sinus rhythm (\\>1400 pg\u002Fml in atrial fibrillation or flutter) within 3 months of consent, with no adjustment for BMI\n2. Ongoing stable GDMT HF management for a minimum of 30 days prior to screening (unless unable to tolerate GDMT) which refers to those HF drugs carrying a Class I indication, including:\n\n   1. An inhibitor of the renin-angiotensin system (RAS inhibitor), including an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) or angiotensin receptor-neprilysin inhibitor (ARNI) and beta-blocker (BB).\n   2. A mineralocorticoid receptor antagonist (MRA), Sodium-Glucose Transport 2 inhibitor (SGLT2i), or nitrates\u002Fhydralazine, should be used in appropriate patients, according to the published guidelines unless intolerant or not indicated.\n   3. Drug intolerance, contraindications, or lack of indications must be attested to by the investigator. Patients should be on appropriate doses of diuretics as required for volume control.\n   4. Stable GDMT refers to consistent dose (change is considered a more than 100% increase or 50% decrease in dose) for at least 30 days prior to screening visit or as appropriate per the screening committee.\n3. Participants cannot have started a glucagon-like peptide (GLP)-1 or gastric inhibitory peptide (GIP) agonist within the last 6 months or plan to start a GLP-1 or GIP agonist within the ensuing 6 months after enrollment.\n4. Considered for Class I recommended cardiac rhythm management device therapy. Specifically: if indicated by class I guidelines, cardiac resynchronization therapy (CRT), an implanted cardioverter- defibrillator (ICD) or a pacemaker should be implanted at least 3 months prior to enrollment. These criteria may be waived if a patient is clinically contraindicated for these therapies or refuses them and must be attested to by the investigator.\n5. LVEF 20% - 40% (at screening visit and determined by echo core lab).\n6. Age ≥40 years.\n7. Subject is willing and able to provide appropriate study-specific informed consent, follow protocol procedures, and comply with follow-up visit requirements.\n\nExclusion Criteria:\n\n1. MI (type I) and\u002For percutaneous cardiac intervention within 3 months prior to screening; CABG in past 3 months prior to screening, or current indication for coronary revascularization.\n2. Cardiac resynchronization therapy initiated within 3 months prior to enrollment.\n3. Advanced heart failure defined as one or more of the following:\n\n   1. ACC\u002FAHA\u002FESC Stage D HF or non-ambulatory NYHA Class IV HF.\n   2. Inotropic infusion (continuous or intermittent) within 6 months prior to screening.\n   3. Subject is on the cardiac transplant waiting list or has undergone transplant.\n   4. Presence of, or history of, mechanical circulatory support for HF.\n   5. Planned other advanced HF Therapies in the next 12 months.\n4. Right heart dysfunction defined as tricuspid annular plane systolic excursion (TAPSE) \\\u003C12 mm or right ventricular (RV) fractional area change (FAC) \\\u003C25% (at screening visit and determined by echo core lab).\n5. Body mass index (BMI) \\>45 kg\u002Fm2.\n6. 6-minute walk test distance \\\u003C100 meters OR \\>450 meters.\n7. Admission for HF within the 30 days prior to planned index procedure.\n8. Any known history of orthostatic hypotension or orthostatic hypotension at the time of screening (regardless of the presence of symptoms). Orthostatic hypotension is defined as a systolic blood pressure (BP) decrease of \\>20 mmHg upon going from supine to standing position or undergoing treatment with Midodrine.\n9. Orthostatic pulse pressure narrowing from supine to standing (+3 minutes) of ≥10mmHg in the absence of a HR increase \\>15bpm\n10. Postural orthostatic tachycardia syndrome or preload insufficiency syndrome or on medical therapy for neurogenic orthostatic hypotension (e.g., midodrine, droxidopa).\n11. Systolic BP \\\u003C100 mmHg or \\>170 mmHg despite appropriate medical management.\n12. Baseline screening ECG resting HR \\>100 beats per minute or ventricular tachycardia.\n13. Catheter ablation for atrial fibrillation within 6 months prior to screening or planned in the next 12 months at the time of screening.\n14. Presence of significant valve disease defined by the site cardiologist as:\n\n    1. Greater than mild mitral valve stenosis.\n    2. Greater than moderate mitral valve regurgitation.\n    3. Greater than moderate-to-severe tricuspid valve regurgitation.\n    4. Greater than moderate aortic valve stenosis or regurgitation.\n15. Any planned procedure to address valve disease in the past 6 months.\n16. Known hypertrophic cardiomyopathy, restrictive cardiomyopathy, constrictive pericarditis, cardiac amyloidosis, or other infiltrative cardiomyopathy (e.g., hemochromatosis, sarcoidosis).\n17. History of clinically significant liver cirrhosis.\n18. Prior weight loss surgery\n19. Dialysis dependent; or estimated GFR \\\u003C20 ml\u002Fmin\u002F1.73 m2 by CKD-EPI creatinine equation.\n20. Arterial oxygen saturation \\\u003C90% on room air.\n21. Chronic pulmonary disease requiring continuous home oxygen OR hospitalization for exacerbation of chronic pulmonary disease (including intubation) in the 12 months before study entry OR known history of GOLD Class III or worse chronic obstructive pulmonary disease (COPD).\n22. Participating in conflicting investigational drug or device study that is not completed within 30 days prior to the screening visit.\n23. Life expectancy \\\u003C12 months for non-cardiovascular reasons.\n24. Any condition, or history of illness or surgery that, in the opinion of the site investigator or Screening Committee, might confound the results of the study or pose additional risks to the patient.\n25. Females who are pregnant or lactating or planning to become pregnant during the next year.\n26. LVEDD \\> 7.5 cm (at screening visit and determined by echo core lab)\n27. Estimated peak pulmonary artery pressure (PAP) \\> 70 mmHg (at screening visit and determined by echo core lab).\n\n    Exclusion Criteria Assessed During the index procedure:\n28. Vessel tortuosity or variant vascular anatomy that could preclude the access or maneuvering of the interventional device from the access site to target vessel. This includes previous spine surgery that may impact the ability to access and treat the target sites of T11 and T10.",{"count":333,"type":22},50,[64],"This study is a small, early-stage clinical trial designed to test whether a new catheter-based procedure is safe and may help people with heart failure with reduced ejection fraction (HFrEF). The procedure uses the Satera Ablation System to treat the right greater splanchnic nerve, which may play a role in heart failure symptoms. The study also aims to identify which types of patients might benefit most from this treatment in the future.\n\nUp to 50 patients aged 40 or older with HFrEF will take part at as many as 10 hospitals worldwide. The study is prospective, meaning patients are followed forward in time, and it is randomized, double-blinded, and sham-controlled. Patients are randomly assigned in a 2:1 ratio to either receive the actual nerve ablation treatment or a sham (placebo) procedure. Randomization happens during the procedure, after anesthesia or sedation, to reduce the risk of revealing which treatment the patient receives.\n\nNeither the patient nor their heart failure doctor will know whether the patient received the real treatment or the sham. However, the doctor performing the procedure and certain study staff will know, mainly for safety and operational reasons.\n\nThe sham procedure is designed to mimic the real procedure as closely as possible without performing the nerve ablation. It involves placing a small needle in the groin or neck and accessing the vein, but no treatment catheter is inserted. The sham procedure takes about the same amount of time as the real treatment (around 45 minutes) to help account for any placebo effect.\n\nOverall, this study is focused on evaluating safety and early signs of benefit rather than proving long-term effectiveness.",[28],[31,338,339],"Reduced Ejection Fraction","Right Greater Splanchnic Nerve (GSN)","2026-02-04",{"date":342,"type":44},"2026-02-11",{"date":344,"type":22},"2026-03-01",{"date":346,"type":22},"2028-09-01",{"name":348,"class":107},"Axon Therapies, Inc.",6,{"id":351,"slug":352,"hasResults":11,"nctId":353,"briefTitle":354,"officialTitle":354,"acronym":355,"eligibilityCriteria":356,"healthyVolunteers":357,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":358,"targetDuration":360,"studyType":263,"phases":4,"briefSummary":361,"conditions":362,"keywords":364,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":371,"lastUpdatePostDateStruct":372,"startDateStruct":374,"completionDateStruct":376,"leadSponsor":378,"locationsCount":133},"100620243","precision-subtyping-and-prognostic-study-of-heart-failure-based-on-multi-omics-integration-and-clinical-indicators-a-prospective-single-center-cohort-study-100620243","NCT07355088","Precision Subtyping and Prognostic Study of Heart Failure Based on Multi-Omics Integration and Clinical Indicators: A Prospective Single-Center Cohort Study","HF-MultiOmics","Inclusion Criteria:(1)For chronic heart failure (CHF) patients:1.Meet the 2022 European Society of Cardiology (ESC) diagnostic criteria for CHF, classified into heart failure with reduced ejection fraction (HFrEF), heart failure with mildly reduced ejection fraction (HFmrEF), and heart failure with preserved ejection fraction (HFpEF) per ESC guidelines;2.Aged 18 to 80 years (inclusive);3.Able to provide written informed consent independently (or via a legal guardian if cognitively impaired, with a Mini-Mental State Examination \\[MMSE\\] score ≥ 24).\n\n(2)For healthy controls:1.No history of cardiovascular disease, confirmed by medical history review and baseline echocardiography;2.Aged 18 to 80 years (inclusive), matched 1:2 with CHF patients by age and gender;3.Able to provide written informed consent.\n\nExclusion Criteria:(1)Acute decompensated heart failure (admitted for acute HF exacerbation within 72 hours prior to enrollment);(2)End-stage renal disease, defined as an estimated glomerular filtration rate (eGFR) \\\u003C 15 mL\u002Fmin\u002F1.73m² (confirmed by serum creatinine testing);(3)Active malignancies (receiving systemic treatment within 6 months prior to enrollment) or severe systemic diseases (e.g., severe liver failure, active autoimmune diseases);(4)Antibiotic use within 2 weeks prior to enrollment (may interfere with gut microbiome analysis);(5)Inability to complete 12-month follow-up (e.g., planned long-term overseas residence) or provide required biological samples (e.g., venous blood, fecal samples).",true,{"count":359,"type":22},600,"12 Months","This is a prospective single-center cohort study conducted at The First Affiliated Hospital of Xinjiang Medical University, aiming to enroll 400 patients with chronic heart failure (including HFrEF, HFmrEF, HFpEF) and 200 healthy controls.We will collect clinical data (e.g., NYHA class, NT-proBNP), multi-omics samples (genome, proteome, metabolome, gut microbiome), and imaging indicators (e.g., EAT density, myocardial strain) from participants at baseline. For patients treated with SGLT2 inhibitors, we will also track dynamic changes in multi-omics during follow-up.The main purpose is to build a composite risk prediction model (integrating multi-omics and clinical indicators) to predict the 1-year composite endpoint (heart failure rehospitalization or all-cause death). Secondary goals include identifying specific molecular profiles related to heart failure phenotypes, exploring the \"gut-heart axis\" mechanism, and finding early biomarkers for SGLT2 inhibitor response.All participants will be followed up for at least 12 months, and the study will strictly comply with ethical norms and protect the privacy of participants.",[33,28,231,363],"Heart Failure With Mildly Reduced Ejection Fraction (HFmrEF)",[33,365,366,367,368,369,370],"Multi-omics","Gut-heart axis","SGLT2 inhibitors","Risk prediction model","Epicardial Adipose Tissue","Myocardial Strain","2026-01-12",{"date":373,"type":44},"2026-01-21",{"date":375,"type":22},"2026-01-01",{"date":377,"type":22},"2028-03-01",{"name":379,"class":51},"Xinjiang Medical University",{"id":381,"slug":382,"hasResults":11,"nctId":383,"briefTitle":384,"officialTitle":385,"acronym":4,"eligibilityCriteria":386,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":387,"targetDuration":4,"studyType":23,"phases":388,"briefSummary":389,"conditions":390,"keywords":392,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":395,"lastUpdatePostDateStruct":396,"startDateStruct":398,"completionDateStruct":400,"leadSponsor":402,"locationsCount":133},"100612894","phase-4-single-and-twice-daily-dosing-of-ramipril-on-renal-function-in-chronic-kidney-disease-patients-with-reduced-ejection-fraction-heart-failure-100612894","NCT07259512","Single and Twice-daily Dosing of Ramipril on Renal Function in Chronic Kidney Disease Patients With Reduced Ejection Fraction Heart Failure","Comparative Effects of Single Versus Twice-Daily Ramipril Dosing on Renal Function in Patients With Chronic Kidney Disease and Heart Failure With Reduced Ejection Fraction: Evaluation of Plasma Renin Activity, Malondialdehyde, Interleukin-6, Albuminuria, and Cystatin C","Inclusion Criteria:\n\n* Female or Male with age \\>18 years old\n* Patients with a diagnosis of CKD stage 3-5 non-dialysis with low ejection fraction heart failure (ejection fraction \\\u003C 40%)\n\nExclusion Criteria:\n\n* Receiving hemodialysis therapy\n* History of intolerance to ACE inhibitors\n* Refractory hyperkalemia\n* Pregnancy\n* History of angioedema to ACE inhibitors\n* Receiving sacubitril-valsartan therapy\n* Receiving ARB therapy\n* Hypotension with blood pressure \\\u003C90\u002F60, or patients in shock.",{"count":143,"type":22},[25],"This study compares the effects of once-daily versus twice-daily ramipril dosing on renal function in chronic kidney disease (CKD) patients with heart failure with reduced ejection fraction (HFrEF). Outcomes include changes in plasma renin activity, malondialdehyde, interleukin-6, albuminuria, and cystatin C after 30 days of therapy.",[391,28],"Chronic Kidney Disease",[391,393,394],"HFrEF","Ramipril","2025-12-02",{"date":397,"type":44},"2025-12-10",{"date":399,"type":44},"2025-06-30",{"date":401,"type":22},"2026-01-31",{"name":403,"class":51},"Evi Liliek Wulandari",{"id":405,"slug":406,"hasResults":11,"nctId":407,"briefTitle":408,"officialTitle":409,"acronym":410,"eligibilityCriteria":411,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":412,"enrollmentInfo":413,"targetDuration":4,"studyType":23,"phases":415,"briefSummary":416,"conditions":417,"keywords":4,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":418,"lastUpdatePostDateStruct":419,"startDateStruct":421,"completionDateStruct":423,"leadSponsor":425,"locationsCount":133},"100569043","correlation-of-typical-lbbb-mechanical-activation-pattern-by-2d-strain-echocardiography-with-acute-gwe-improvement-in-patients-receiving-lbbp-or-conventional-bivp-for-cardiac-resynchronization-therapy-echo-lbbp-100569043","NCT06689111","Correlation of Typical LBBB Mechanical Activation Pattern by 2D Strain Echocardiography With Acute GWE Improvement in Patients Receiving LBBp or Conventional BiVp for Cardiac Resynchronization Therapy (Echo LBBp)","Investigation of Whether the Presence of the Typical LBBB- Mechanical Stimulation Pattern - Documented Through 2DSE (Two-dimensional Strain Echocardiography) - is Associated With Increased Rates of Acute Improvement in Global Myocardial Work Efficiency (GWE) Compared to the Absence of This Activation Pattern, in Patients in Need of Device Implantation for Cardiac Resynchronization Therapy in Whom LBBp is Chosen Compared to the Classic Biventricular Pacing Method","ECHO-LBBp","Inclusion Criteria:\n\n* \\>18 years \\\u003C 90 years\n* Patients with a documented indication for resynchronization therapy \\[symptomatic patients despite optimal medication, HFrEF (EF\\\u003C35%), LBBB QRS morphology\\]\n* COMPLETE LBBB (LBBB defined as QRS\\>130msec, wide \"notched or slurred\" R wave in leads I, aVL, V5, V6 and occasional RS pattern in V5, V6, absence of Q waves in leads I, V5 and V6 but in lead aVL narrow Q wave may be present in the absence of myocardial pathology, R peak time \\>60ms in leads V5 and V6 but normal in leads V1, V2, V3 when small R's are discernible in precardial leads, ST and T usually opposite to QRS direction)\n* Patients with ntraventricular septum diameter \\>8 mm\n* Written informed consent\n\nExclusion Criteria:\n\n* Patients with RBBB or atypical LBBB QRS morphology\n* Patients eligible for an upgrade procedure (already carring a PM or ICD)\n* Patients with hypertrophic cardiomyopathy","90 Years",{"count":414,"type":22},100,[64],"The present study is a multicenter interventional non randomised study in patients requiring an implantable device for cardiac resynchronization therapy. Its primary objective is to investigate whether the presence of a specific echocardiographic contraction pattern before implantation is associated with increased rates of acute improvement in myocardial function (as measured by an ultrasound) and to compare the improvement in two groups of patients based on the type of pacing (biventricular or left-sided pacing)",[28],"2025-11-29",{"date":420,"type":44},"2025-12-05",{"date":422,"type":44},"2024-05-23",{"date":424,"type":22},"2026-11-30",{"name":426,"class":51},"University Hospital of Patras",{"id":428,"slug":429,"hasResults":11,"nctId":430,"briefTitle":431,"officialTitle":431,"acronym":432,"eligibilityCriteria":433,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":434,"targetDuration":4,"studyType":23,"phases":436,"briefSummary":437,"conditions":438,"keywords":443,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":451,"lastUpdatePostDateStruct":452,"startDateStruct":454,"completionDateStruct":456,"leadSponsor":458,"locationsCount":251},"100590211","phase-4-comparative-effectiveness-of-carvedilol-versus-metoprolol-succinate-in-heart-failure-patients-with-an-implantable-cardioverter-defibrillator-100590211","NCT06964464","Comparative Effectiveness of Carvedilol Versus Metoprolol Succinate in Heart Failure Patients With an Implantable Cardioverter Defibrillator","CARVTOP-ICD","Inclusion Criteria:\n\n* Age ≥ 18 years\n* ICD implanted for primary prevention for HFrEF (either ICM or NICM) with remote monitoring capability\n* Current treatment with metoprolol succinate and willing to switch to carvedilol\n* LVEF \\\u003C50% during the past 12 months prior to consent\n\nExclusion Criteria:\n\n* Unwilling or unable to follow the protocol\n* Treatment with any other ßB than metoprolol succinate or no ßB treatment\n* Known prior intolerance or contraindication to carvedilol\n* Systolic blood pressure \\\u003C100 mmHg\n* Enrollment in another clinical trial\n* Inability or unwilling to consent",{"count":435,"type":22},2000,[25],"This prospective, multicenter, open-label, randomized comparative effectiveness trial, titled CARVTOP-ICD, evaluates the impact of carvedilol versus metoprolol succinate in patients with heart failure with reduced ejection fraction (HFrEF) and an implantable cardioverter defibrillator (ICD). The study will enroll 2,000 participants across 100 U.S. sites and includes an 18-month feasibility phase with 100 participants from 15 sites. Eligible participants must be currently treated with metoprolol succinate and willing to switch to carvedilol, with randomization in a 1:1 ratio. Participants will be followed for up to 3 years, with regular assessments including ICD interrogations, medication adherence, healthcare utilization, and quality of life surveys. The primary endpoint is the first occurrence of any ICD therapy (appropriate or inappropriate), cardiovascular (CV) hospitalization, or CV death. Secondary endpoints include ICD shock burden, healthcare utilization, and patient-reported quality of life. The trial aims to provide high-quality comparative data to address clinical equipoise surrounding the two commonly used beta-blockers in HFrEF management.",[28,439,440,441,442,122],"Sudden Cardiac Death","Ventricular Arrhythmia","Implantable Cardioverter Defibrillator (ICD)","Beta-blocker Therapy",[444,234,445,446,447,448,449,450],"arrhythmia","ICD","implantable cardioverter defibrillator","ICD shock","carvedilol","metoprolol succinate","beta-blocker","2025-09-12",{"date":453,"type":44},"2025-09-18",{"date":455,"type":44},"2025-08-17",{"date":457,"type":22},"2031-07-01",{"name":459,"class":51},"University of Rochester",{"id":461,"slug":462,"hasResults":11,"nctId":463,"briefTitle":464,"officialTitle":465,"acronym":466,"eligibilityCriteria":467,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":468,"enrollmentInfo":469,"targetDuration":4,"studyType":23,"phases":471,"briefSummary":472,"conditions":473,"keywords":476,"overallStatus":152,"whyStopped":4,"lastUpdateSubmitDate":489,"lastUpdatePostDateStruct":490,"startDateStruct":492,"completionDateStruct":494,"leadSponsor":496,"locationsCount":133},"100597052","phase-4-ironica-iron-repletion-in-heart-failure---a-comparison-of-oral-and-iv-approaches-100597052","NCT07053475","IRONICA: IRON Repletion In Heart Failure - A Comparison of Oral and IV Approaches","IRONICA: IRON Repletion in Congestive Heart Failure - A Randomized Controlled Trial Comparing Oral Versus IV Approaches","IRONICA","Inclusion Criteria:\n\n* Age ≥18 years\n* BMI ≥18.0 kg\u002Fm²\n* Hemoglobin:\n\n\\> 9 g\u002FdL and \\\u003C14 g\u002FdL for men \\> 9 g\u002FdL and \\\u003C13 g\u002FdL for women\n\n* Diagnosed with Congestive Heart failure:\n\nHFrEF: EF ≤40% in any recent echocardiogram HFpEF: EF ≥50-55% without any prior EF ≤40%, and evidence of diastolic dysfunction per ASE\u002FEACVI 2023 criteria-defined as either grade ≥2 or ≥2 supporting echo parameters (septal e' \\\u003C7 cm\u002Fsec or lateral e' \\\u003C10 cm\u002Fsec, E\u002Fe' ≥15, TR velocity \\>2.8 m\u002Fs, LA volume index ≥34 mL\u002Fm², LV septal or posterior wall thickness ≥1.2 cm, or LA area ≥20 cm² \u002F diameter ≥3.8 cm.\n\n* Documented elevated NT-proBNP based on BMI and rhythm:\n\nBMI \\\u003C35: ≥220 pg\u002FmL (NSR) or ≥660 pg\u002FmL (A-Fib) BMI ≥35: ≥125 pg\u002FmL (NSR) or ≥375 pg\u002FmL (A-Fib)\n\n* NYHA Class II-IV\n* Transferrin saturation (TSAT) \\\u003C20%\n* Hemoglobin \\\u003C14 g\u002FdL for men, \\\u003C 13 g\u002FdL for women.\n* Stable on heart failure therapy for ≥2-4 weeks\n* Currently prescribed a diuretic at home\n* Ambulatory (able to walk \\>20 ft with minimal assistance)\n* Willing and able to give informed consent\n\nExclusion Criteria:\n\n* Received IV iron, ESA, or blood transfusion within the last 6-12 months\n* Received high-dose oral iron (\\>100 mg\u002Fday in past 7 days)\n* Severe renal impairment (eGFR \\\u003C15 mL\u002Fmin\u002F1.73 m² or on dialysis)\n* Patients with known cirrhosis or transaminitis with AST \\>141 or ALT \\>112 IU\u002FL\n* Active bleeding or known bleeding disorder\n* Recent cardiac surgery, myocardial infarction, or stroke within past 3 months\n* Active infection, defined as any systemic or deep-seated infection (e.g., bacteremia, sepsis, osteomyelitis, or infections requiring IV antibiotics or hospitalization) at the time of screening.\n* Active malignancy or undergoing chemotherapy\u002Fradiotherapy\n* Vitamin B12 or folate deficiency (unless corrected prior to enrollment)\n* Chronic liver disease (with LFTs \\>3× upper limit of normal)\n* Pregnant or breastfeeding women or those not using effective contraception\n* Lacks capacity to consent or unable to comply with study procedures","100 Years",{"count":470,"type":22},250,[25],"The goal of this clinical trial is to learn which iron treatment works better for adults with congestive heart failure and low iron levels: intravenous (IV) iron given through a vein or oral (PO) iron taken by mouth. Participants must have heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) and a transferrin-saturation (TSAT) level below 20 percent.\n\nThe main questions the study will answer are:\n\n1. Does IV iron raise walking distance on a 6-minute walk test more than oral iron after 24 weeks?\n2. Does IV iron improve symptoms and quality of life more than oral iron?\n3. How do the two treatments compare for safety, side effects, and hospital readmissions\u002F mortality?\n\nResearchers will compare IV ferric carboxymaltose with oral ferrous sulfate to see which option helps people feel and function better.\n\nWhat participants will do\n\n* Be randomly assigned by (like flipping a coin) to IV iron or oral iron.\n* Receive either a one-time IV iron infusion (with possible repeat at 12 weeks) or take iron pills twice each day for 24 weeks.\n* Visit the infusion clinic at 6 weeks for second dose of IV iron if needed.\n* Visit the clinic at 12 weeks for a follow-up to gather follow-up data including\n\n  1. A 6-minute walk test\n  2. Brief symptom and quality-of-life surveys\n  3. Blood tests to measure serum iron, ferritin, and transferrin saturation\n\nThis study will help doctors decide whether IV or oral iron is the safer, more effective way to treat iron deficiency in people with heart failure in our local community.",[31,28,231,474,475],"Iron Deficiency","Iron-deficiency Anemia (IDA)",[477,478,479,480,481,482,483,484,485,486,487,488,393],"Intravenous iron","Oral iron","Ferric carboxymaltose","Ferrous sulfate","Transferrin saturation (TSAT)","Functional iron deficiency","6-minute walk test (6MWT)","Kansas City Cardiomyopathy Questionnaire (KCCQ)","Quality of life","Randomized controlled trial","Congestive heart failure","HFpEF","2025-06-26",{"date":491,"type":44},"2025-07-08",{"date":493,"type":44},"2025-04-02",{"date":495,"type":22},"2027-03-31",{"name":497,"class":51},"Syed Hamza Mufarrih",{"id":499,"slug":500,"hasResults":11,"nctId":501,"briefTitle":502,"officialTitle":503,"acronym":4,"eligibilityCriteria":504,"healthyVolunteers":11,"sex":17,"minAge":505,"maxAge":4,"enrollmentInfo":506,"targetDuration":4,"studyType":23,"phases":508,"briefSummary":509,"conditions":510,"keywords":513,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":524,"lastUpdatePostDateStruct":525,"startDateStruct":526,"completionDateStruct":528,"leadSponsor":530,"locationsCount":4},"100585318","evaluating-dashboard-integrated-pharmacist-led-education-on-improving-sacubitrilvalsartan-adherence-in-heart-failure-pharmd-assist-hfref-100585318","NCT06900803","Evaluating Dashboard-Integrated Pharmacist-Led Education on Improving Sacubitril\u002FValsartan Adherence in Heart Failure (PharmD ASSIST HFrEF)","Pharmacist-Led Education Through Interactive Visualization Dashboards for Adherence Support and Sustained Involvement in Sacubitril\u002FValsartan Therapy for Patients With Heart Failure With Reduced Ejection Fraction (PharmD ASSIST HFrEF): Study Protocol for Implementation in a Parallel-Group, Pragmatic Randomized Controlled Trial","Inclusion Criteria:\n\n* adults aged 20 or older\n* a diagnosis of HFrEF, which is defined by a left ventricular ejection fraction of 40% or less\n* currently receiving sacubitril\u002Fvalsartan at the time of recruitment\n* receiving care at the cardiology department or cardiology ward at National Taiwan University Hospital\n* referral from the clinicians at National Taiwan University Hospital\n\nExclusion Criteria:\n\n* unable or unwilling to provide informed consent, adhere to study protocols, or complete required questionnaires in person during three scheduled visits (i.e., 3, 6, 12 months after the baseline measurement)\n* having received care at the pharmacist-led HF clinic at National Taiwan University Hospital","20 Years",{"count":507,"type":22},200,[64],"The goal of this pragmatic clinical trial is to evaluate whether pharmacist-led education, integrated with interactive visualization dashboards, can enhance medication adherence in patients with heart failure who are prescribed sacubitril\u002Fvalsartan. The main question it aims to answer is: Can pharmacist-led interactive visualization dashboards improve adherence to sacubitril\u002Fvalsartan compared to usual care without the dashboard intervention?\n\nResearchers will compare patients receiving pharmacist-led education with interactive dashboards to those receiving standard education, assessing differences in medication adherence and clinical outcomes, among others.\n\nParticipants will:\n\n* Complete baseline and follow-up questionnaires on medication adherence and satisfaction with pharmacist-provided services, and others.\n* Engage in education sessions led by pharmacists, with or without dashboard integration.\n\nThe study outcomes will include medication adherence, and secondary outcomes such as patient satisfaction with pharmacist-provided services, optimized guideline-directed medical therapy score, time to high medication adherence, the calculated proportion of days covered, New York Heart Association functional classification, and the net promoter score used for evaluating recommendation and satisfaction with the dashboard intervention.",[28,511,512],"Sacubitril\u002FValsartan","Medication Adherence",[514,515,516,517,518,519,520,521,522,523],"heart failure with reduced ejection fraction","medication adherence","dashboard","health information technology","patient education","pharmacist","pragmatic trial","randomized controlled trial","sacubitril\u002Fvalsartan","implementation","2025-03-27",{"date":493,"type":44},{"date":527,"type":22},"2025-04-07",{"date":529,"type":22},"2027-10-31",{"name":531,"class":51},"National Taiwan University Hospital",{"id":533,"slug":534,"hasResults":11,"nctId":535,"briefTitle":536,"officialTitle":537,"acronym":4,"eligibilityCriteria":538,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":539,"targetDuration":4,"studyType":23,"phases":541,"briefSummary":542,"conditions":543,"keywords":545,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":549,"lastUpdatePostDateStruct":550,"startDateStruct":552,"completionDateStruct":554,"leadSponsor":556,"locationsCount":4},"100579548","phase-4-metoprolol-in-patients-with-hfref-and-copd-100579548","NCT06825728","Metoprolol in Patients With HFrEF and COPD","Metoprolol in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Obstructive Pulmonary Disease","Inclusion Criteria:\n\n1. A definite diagnosis of HFrEF (LVEF≤40%), NYHA II to IV , and the disease is due to ischemic heart disease or dilated cardiomyopathy;\n2. A definite diagnosis of COPD with moderate or higher airflow limitation (FEV1\u002FFVC \\\u003C 0.7 and FEV1 \\\u003C 80% of the expected value);\n3. Age ≥18 years old;\n4. Informed consent has been obtained and signed.\n\nExclusion Criteria:\n\n1. the dose of Metoprolol before enrollment was more than 23.75mg\u002Fd;\n2. Resting heart rate \\\u003C 50 beats\u002Fmin;\n3. Second or third degree atrioventricular block;\n4. Atrial fibrillation;\n5. Sick sinus syndrome;\n6. Systolic blood pressure \\\u003C 90mmHg;\n7. Acute attack of bronchial asthma;\n8. Liver insufficiency (serum transaminase \\> 3 times the normal value);\n9. Renal insufficiency (eGFR \\\u003C 30ml\u002Fmin\u002F1.73m2, or serum creatinine \\> 2.5mg\u002FdL\\[\\> 221μmol\u002FL\\]);\n10. Patients with serious physical diseases, such as cancer;\n11. Patients who have a history of allergy to the investigational drug or its ingredients;\n12. Participating in other clinical investigators;\n13. During the study period, Patients cannot live in the selected center for a long time, which is not conducive to the follow-up;\n14. Patients with disability, mobility disability, intellectual disability and other factors that may prevent normal participation in the study and follow-up, and their frailty was assessed by the FRAIL frailty screening scale; Intellectual mental status was assessed by the Mini-Mental State Examination (MMSE).\n15. Poor adherence or other reasons considered by the researchers to be unsuitable for the clinical trial.",{"count":540,"type":22},311,[25],"The goal of the clinical trial was to see if Metoprolol was effective in treating patients with heart failure and chronic obstructive pulmonary disease. It will also learn about the safety of Metoprolol. The main questions it aims to answer are:\n\nDid Metoprolol reduce the frequency of all-cause deaths and re-hospitalizations in subjects? What medical problems do participants experience after taking Metoprolol? The researchers will compare different doses of Metoprolol to see the best dose for Metoprolol.\n\nParticipants will:\n\nTake Metoprolol 23.75mg\u002F day or the maximum tolerable dose of Metoprolol daily for 24 months.\n\nRegular outpatient follow-up visits to the research center. Their symptoms and Metoprolol dosage were recorded.",[28,544],"COPD (Chronic Obstructive Pulmonary Disease)",[546,547,548],"Heart Failure with Reduced Ejection Fraction","Chronic Obstructive Pulmonary Disease","Metoprolol","2025-02-07",{"date":551,"type":44},"2025-02-13",{"date":553,"type":22},"2025-02",{"date":555,"type":22},"2028-02",{"name":557,"class":51},"Xiangya Hospital of Central South University"]