CCM in Heart Failure With Preserved Ejection Fraction (CCM-HFpEF)
Primary Purpose
Heart Failure, Diastolic
Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Optimizer SMART
Sponsored by
About this trial
This is an interventional other trial for Heart Failure, Diastolic focused on measuring HFpEF
Eligibility Criteria
Inclusion criteria
- Baseline ejection fraction ≥ 50% (as assessed by echocardiogram within 30 days of enrollment and confirmed by the echo core laboratory).
- NYHA class II or III symptoms despite receiving stable optimal medical therapy (OMT) for at least 30 days based on patient's medical records (chronic stable, not transient or crescendo heart failure or angina pectoris)
- Stable optimal medical therapy for Heart failure for 3 months.
- NT-proBNP > 220 pg/ml for subjects in sinus rhythm or > 600 pg/ml for subjects in atrial fibrillation
Has the following (as assessed by the core lab):
- LAVi ≥ 34 ml/m² or LVH >12mm AND either
- E/e' ≥ 13 OR
- septal e' < 7 cm/s or lateral e' <10 cm/s
- Patient giving informed consent, willing to be available for scheduled study follow-up visits, and able to complete all testing of the study protocol
Exclusion criteria
- Age below 40 or greater than 80
- Patients with expected lifespan of less than 12 months from time of enrollment
- Subjects referred to an institution based on a judicial or administrative order
- Dilated left ventricle, as evidenced by LVEDVI >= 97 mL/m2 (as assessed by the echo core lab)
- Primary cardiac valvular disease (anything more than grade 2)
- Congenital or untreated ischemic heart disease
- Infiltrative / inflammatory / genetic cardiomyopathy as documented in the medical record (e.g. amyloid, hemochromatosis, myocarditis, hypertrophic cardiomyopathy, M. Fabry, cardiac tumor), or persistent large pericardial effusion
- Unstable or frequent (>1 episode/week) angina pectoris
- Hospitalization for HF requiring the use of inotropic support or IABP within 30 days of enrollment
- Systolic Blood Pressure > 160 mmHg
- Uncorrected severe anemia (e.g. hemoglobin <9g/dL)
- PR interval greater than 375 ms
- Exercise tolerance limited due to noncardiac disorders (e.g. deconditioning, severe lung disease, frailty)
- Scheduled for a cardiac surgery or a PCI procedure, or had a cardiac surgery procedure within 90 days or a PCI procedure within 30 days prior to enrollment
- Myocardial infarction within 90 days of enrollment
- Cardioversion within 30 days of enrollment
- History of significant ectopy either on 12-lead ECG or Holter monitoring (more than 10% PVCs).
- Heart rate > 110 bpm on ECG for patients with atrial fibrillation
- Mechanical tricuspid valve
- Prior heart transplant or ventricular assist device
- Pregnant or planning to become pregnant during the study
- Breastfeeding subjects
- Subject participating in another medical therapy or device related study, unrelated to CCM™, at the same time or within 30 days prior to enrollment into this study
- Subjects on dialysis, or with documented GFR<30 or with other major medical disorder (e.g. severe anemia, liver failure)
- Subjects with any active non-cardiac implants
Sites / Locations
- Friendly Society Private Hospital
- St. John of God Bunbury
- St. John of God Murdoch Hospital
- Hospital Na Homolce
- Kerckhoff-Klinik GmbH
- INRCA IRCCS Ancona
- Auxologico Institute
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego zakład leczniczy Centralnego Szpitala Klinicznego
- 4 Wojskowy Szpital Kliniczny z Poliklinika SPZOZ we Wroclawiu
- Uniwersytecki Szpital Kliniczny we Wrocław
- West Lisbon Hospital Center, E.P.E., hereinafter referred to as CHLO, E.P.E
- Santiago de Compostella -- Servicio de Cardiología y UCC/ Cardiology and Coronary Care Department Hospital Clínico Universitario. XXI de Santiago de Compostela SERGAS
- Hospital General de Alicante
- Hospital Universitario 12 de Octubre Unidad de Insuficiencia Cardiaca y Trasplante Servicio de Cardiología, Planta 6. Bloque D.Ciber 8
- Hospital Alvaro Cunquero
- Karolinska University Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
CCM therapy
Arm Description
Optimizer SMART
Outcomes
Primary Outcome Measures
KCCQ change
Mean change from baseline to 24 weeks in Kansas City Cardiomyopathy Questionnaire (KCCQ) overall score
Secondary Outcome Measures
Echocardiography
LAVi and diastolic function: septal E' velocity, septal E/E' ratio
NT-proBNP
Mean Change in 24 weeks
NYHA class
Mean Change in 24 weeks
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03240237
Brief Title
CCM in Heart Failure With Preserved Ejection Fraction
Acronym
CCM-HFpEF
Official Title
Cardiac Contractility Modulation Therapy in Subjects With Heart Failure With Preserved Ejection Fraction
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 1, 2018 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Impulse Dynamics
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This pilot study will evaluate the efficacy and safety of CCM therapy in heart failure patients with baseline EF≥50% (HFpEF) who have New York Heart Association (NYHA) Class II or III symptoms despite appropriate medication.
The terminology of the HF classification HFpEF is based on the 2016 European Society of Cardiology (ESC) Heart Failure Guidelines.
Detailed Description
This is a pilot clinical study of CCM in addition to optimal medical therapy (OMT) over a 24 week period.The primary endpoint shall be mean change from baseline to 24 weeks in Kansas City Cardiomyopathy Questionnaire (KCCQ) overall score (reflecting integrated information on physical limitations, symptoms, self-efficacy, social interference and quality of life).
This pilot study will collect efficacy and safety data in heart failure patients having NYHA class II and III symptoms despite appropriate medication with baseline ejection fraction equal or greater than 50% (HFpEF populations).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure, Diastolic
Keywords
HFpEF
7. Study Design
Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
This pilot study is designed and powered for evaluating the efficacy and safety of CCM therapy in heart failure patients with baseline EF≥50% (HFpEF) who have NYHA Class II or III symptoms despite appropriate medication, for potential expansion of the CE Mark indication for use in the HFpEF population.
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
CCM therapy
Arm Type
Experimental
Arm Description
Optimizer SMART
Intervention Type
Device
Intervention Name(s)
Optimizer SMART
Intervention Description
Cardiac Contractility Modulation
Primary Outcome Measure Information:
Title
KCCQ change
Description
Mean change from baseline to 24 weeks in Kansas City Cardiomyopathy Questionnaire (KCCQ) overall score
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Echocardiography
Description
LAVi and diastolic function: septal E' velocity, septal E/E' ratio
Time Frame
24 weeks
Title
NT-proBNP
Description
Mean Change in 24 weeks
Time Frame
24 weeks
Title
NYHA class
Description
Mean Change in 24 weeks
Time Frame
24 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria
Baseline ejection fraction ≥ 50% (as assessed by echocardiogram within 30 days of enrollment and confirmed by the echo core laboratory).
NYHA class II or III symptoms despite receiving stable optimal medical therapy (OMT) for at least 30 days based on patient's medical records (chronic stable, not transient or crescendo heart failure or angina pectoris)
Stable optimal medical therapy for Heart failure for 3 months.
NT-proBNP > 220 pg/ml for subjects in sinus rhythm or > 600 pg/ml for subjects in atrial fibrillation
Has the following (as assessed by the core lab):
LAVi ≥ 34 ml/m² or LVH >12mm AND either
E/e' ≥ 13 OR
septal e' < 7 cm/s or lateral e' <10 cm/s
Patient giving informed consent, willing to be available for scheduled study follow-up visits, and able to complete all testing of the study protocol
Exclusion criteria
Age below 40 or greater than 80
Patients with expected lifespan of less than 12 months from time of enrollment
Subjects referred to an institution based on a judicial or administrative order
Dilated left ventricle, as evidenced by LVEDVI >= 97 mL/m2 (as assessed by the echo core lab)
Primary cardiac valvular disease (anything more than grade 2)
Congenital or untreated ischemic heart disease
Infiltrative / inflammatory / genetic cardiomyopathy as documented in the medical record (e.g. amyloid, hemochromatosis, myocarditis, hypertrophic cardiomyopathy, M. Fabry, cardiac tumor), or persistent large pericardial effusion
Unstable or frequent (>1 episode/week) angina pectoris
Hospitalization for HF requiring the use of inotropic support or IABP within 30 days of enrollment
Systolic Blood Pressure > 160 mmHg
Uncorrected severe anemia (e.g. hemoglobin <9g/dL)
PR interval greater than 375 ms
Exercise tolerance limited due to noncardiac disorders (e.g. deconditioning, severe lung disease, frailty)
Scheduled for a cardiac surgery or a PCI procedure, or had a cardiac surgery procedure within 90 days or a PCI procedure within 30 days prior to enrollment
Myocardial infarction within 90 days of enrollment
Cardioversion within 30 days of enrollment
History of significant ectopy either on 12-lead ECG or Holter monitoring (more than 10% PVCs).
Heart rate > 110 bpm on ECG for patients with atrial fibrillation
Mechanical tricuspid valve
Prior heart transplant or ventricular assist device
Pregnant or planning to become pregnant during the study
Breastfeeding subjects
Subject participating in another medical therapy or device related study, unrelated to CCM™, at the same time or within 30 days prior to enrollment into this study
Subjects on dialysis, or with documented GFR<30 or with other major medical disorder (e.g. severe anemia, liver failure)
Subjects with any active non-cardiac implants
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carsten Tschoepe, Prof.
Organizational Affiliation
University Hospital Charite Berlin
Official's Role
Principal Investigator
Facility Information:
Facility Name
Friendly Society Private Hospital
City
Bundaberg
State/Province
Queensland
ZIP/Postal Code
4670
Country
Australia
Facility Name
St. John of God Bunbury
City
Bunbury
ZIP/Postal Code
6150
Country
Australia
Facility Name
St. John of God Murdoch Hospital
City
Perth
ZIP/Postal Code
6000
Country
Australia
Facility Name
Hospital Na Homolce
City
Praha 5
ZIP/Postal Code
15030
Country
Czechia
Facility Name
Kerckhoff-Klinik GmbH
City
Bad Nauheim
State/Province
Hesse
ZIP/Postal Code
61231
Country
Germany
Facility Name
INRCA IRCCS Ancona
City
Ancona
State/Province
Rome
Country
Italy
Facility Name
Auxologico Institute
City
Milan
Country
Italy
Facility Name
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
City
Rome
ZIP/Postal Code
00168
Country
Italy
Facility Name
Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego zakład leczniczy Centralnego Szpitala Klinicznego
City
Warsaw
ZIP/Postal Code
02-097
Country
Poland
Facility Name
4 Wojskowy Szpital Kliniczny z Poliklinika SPZOZ we Wroclawiu
City
Wroclaw
ZIP/Postal Code
50-981
Country
Poland
Facility Name
Uniwersytecki Szpital Kliniczny we Wrocław
City
Wrocław
ZIP/Postal Code
50-556
Country
Poland
Facility Name
West Lisbon Hospital Center, E.P.E., hereinafter referred to as CHLO, E.P.E
City
Lisbon
Country
Portugal
Facility Name
Santiago de Compostella -- Servicio de Cardiología y UCC/ Cardiology and Coronary Care Department Hospital Clínico Universitario. XXI de Santiago de Compostela SERGAS
City
Santiago De Compostela
State/Province
C/ A Choupana S.n
ZIP/Postal Code
15706
Country
Spain
Facility Name
Hospital General de Alicante
City
Alicante
ZIP/Postal Code
3010
Country
Spain
Facility Name
Hospital Universitario 12 de Octubre Unidad de Insuficiencia Cardiaca y Trasplante Servicio de Cardiología, Planta 6. Bloque D.Ciber 8
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Hospital Alvaro Cunquero
City
Vigo
ZIP/Postal Code
36312
Country
Spain
Facility Name
Karolinska University Hospital
City
Stockholm
Country
Sweden
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
26638055
Citation
Tschope C, Van Linthout S, Spillmann F, Klein O, Biewener S, Remppis A, Gutterman D, Linke WA, Pieske B, Hamdani N, Roser M. Cardiac contractility modulation signals improve exercise intolerance and maladaptive regulation of cardiac key proteins for systolic and diastolic function in HFpEF. Int J Cardiol. 2016 Jan 15;203:1061-6. doi: 10.1016/j.ijcard.2015.10.208. Epub 2015 Oct 27. No abstract available.
Results Reference
background
PubMed Identifier
35855646
Citation
Linde C, Grabowski M, Ponikowski P, Rao I, Stagg A, Tschope C. Cardiac contractility modulation therapy improves health status in patients with heart failure with preserved ejection fraction: a pilot study (CCM-HFpEF). Eur J Heart Fail. 2022 Dec;24(12):2275-2284. doi: 10.1002/ejhf.2619. Epub 2022 Aug 11.
Results Reference
result
Learn more about this trial
CCM in Heart Failure With Preserved Ejection Fraction
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