Active clinical trials for "Heart Failure"

The effects of Cardiac Contractility Modulation (CCM) treatment are observed in patients with heart failure.

The purpose of this clinical investigation is to report the long term survival and incidence of adverse events in the patients who were implanted with HM3 in the CE Mark Study and continue to be ongoing with the HeartMate 3 LVAS after the CE Mark Study 2 year follow-up. The study will be a single arm, prospective, multi-center, non-blinded and non-randomized study, intended to report on the long term use of the HeartMate 3 LVAS in those patients that completed the 2-year follow-up in the HeartMate 3 CE Mark study.

Background: Type 2 Diabetes Mellitus (T2DM) is a multi factorial disease, affecting clinical outcomes in failing heart (HF) patients treated by Cardiac Resynchronization Therapy with a defibrillator (CRT-d). Methods: One hundred and ninety five T2DM patients will receive a CRT-d treatment. Randomly the study population will receive a CRT-d via multipolar left ventricle (LV) lead pacing (n 99 as Multipolar group), v/s a CRT-d via bipolar LV pacing (n 96, as Bipolar group). These patients will be followed by clinical, and instrumental assessment, and telemetric device control at follow up. Study design will be to evaluate, in failing heart T2DM patients, cardiac deaths, all cause deaths, arrhythmic events, CRT-d responders rate, hospitalizations for HF worsening, phrenic nerve stimulation (PNS), and LV catheter dislodgment events (and re-intervention for LV catheter re-positioning), comparing multipolar CRT-d v/s bipolar CRT-d group of patients at follow up.

Primary Aims Evaluate the safety of high-dose spironolactone in combination of patiromer in acute decompensated heart failure patients. Evaluate the efficacy of high-dose spironolactone in combination of patiromer in causing volume loss and symptom relief in patients with ADHF treated with high-dose spironolactone. Secondary Aims 1: Evaluate the effect of high-dose spironolactone on urinary sodium excretion and renal function.

Preventing heart failure (HF) deterioration is a great challenge for contemporary medicine. The progress course of HF is with increasing frequency of subsequent hospitalizations (approximately 30% of hospitalizations are the repeated ones). It is estimated that the costs of hospital stays constitute nearly 2/3 of healthcare costs provided for HF patients. The difficulty in treatment of patients with HF deterioration is associated with numerous comorbidities and coexisting complications (i.e. aggravation of ischaemic heart disease, lung diseases, infections, electrolyte disturbances, anaemia, renal failure as well as operations, in particular emergency ones). Our study is aimed to evaluation the complex pathophysiological background related to heart failure deterioration with respect to the effect of applied in-hospital treatment.

This study aims to determine whether subjects who underwent large-diameter metal-on-metal hip arthroplasty are more likely to have developed heart failure or other conditions as compared to subjects with conventional hip replacements. We plan to link the National Joint Registry for England, Wales and Northern Ireland to the National Heart Failure Audit and GP records.

The HIV/HEART study (HIVH) is an ongoing, prospective, multicentre trial that was conducted to assess the incidence, the prevalence and the clinical course of cardiovascular diseases (CVD) in HIV-infected patients. The study population includes outpatients from specialized HIV-care units of the German Ruhr region, who were at least 18 years of age, were known to have a HIV-infection and exhibited a stable disease status within 4 weeks before inclusion into the trial. From March 2004 (Pilot phase) to May 2014 (7,5 year Follow-up) 1481 HIV+ patients were recruited in a consecutive manner. The standardised examinations included a targeted assessment of medical history and physical examination. Blood was drawn for comprehensive laboratory tests including HIV specific parameters (CD4 cell count, HIV-1 RNA levels) and cardiovascular items (lipid concentrations, BNP values and renal parameters). Furthermore, non-invasive tests were performed during the initial visit, including additional heart rate and blood pressure measurements, electrocardiogram (ECGs) and transthoracic echocardiography (TTE). Examinations were completed in accordance with previously defined standard operating procedures. CVD were defined as coronary, cerebrovascular, peripheral arterial disease, heart failure or cardiac vitium.

Heart failure (HF) with preserved (HFpEF) or reduced (HFrEF) ejection fraction is associated with poor prognosis and quality of life. While the incidence of HFrEF is declining and HF treatment is effective, HFpEF is increasing, with no established therapy. PREFERS Stockholm is an epidemiological study with the aim of improving clinical care and research in HF and to find new targets for drug treatment in HFpEF starting with a cardiac biopsy study in elective CABG patiens.

Medtronic is sponsoring the Apogee study to further enhance scientific understanding of the implant procedure, optimized blood pressure management, and anticoagulation/ antiplatelet therapy in patients receiving a Medtronic HeartWare™ Ventricular Assist Device (HVAD™) for destination therapy. The Apogee study is conducted within Medtronic's Product Surveillance Platform.

Impaired renal function and heart failure with preserved ejection fraction (HFpEF) are two often co-existing medical conditions and are known to be associated with adverse cardiovascular outcome and increased mortality. The relationship between HFpEF and renal impairment is bidirectional. On the one hand, renal dysfunction has been shown to be an independent risk factor for the development of HFpEF. On the other hand, an increase in central venous pressure leading to renal dysfunction by a reduction of renal blood flow (RBF) and perfusion pressure (RPP) as well as activation of the renin-angiotensin-aldosterone system (RAAS) in patients with HFpEF has been previously described. In the literature, several studies aimed to investigate the association between renal (dys-) function and HFpEF. In all these studies, renal function was assessed by determination of standard kidney function parameters such as serum creatinine, eGFR and urinary albumin to creatinine ratio (UACR). Constant infusion input clearance technique however offers a more detailed evaluation of renal function and hemodynamics. To the best of knowledge, renal hemodynamics in patients with HFpEF have not yet been investigated by clearance technique. Therefore, the aim of the present study is to evaluate renal function and hemodynamics by means of constant infusion input clearance technique with sodium p-aminohippuric acid (PAH) and Iohexol in 40 patients with HFpEF. The constant infusion input clearance technique offers an exact evaluation of renal function by measuring (not estimating) glomerular filtration rate and renal hemodynamic parameters such as renal plasma flow (RPF), filtration fraction (FF) and intraglomerular pressure (IGP). These results will be compared to 140 subjects without HFpEF that have participated in various studies and have been analyzed with the same constant infusion input clearance technique performed in the Clinical Research Center of the University Hospital Erlangen-Nuremberg. Additionally, flow mediated vasodilation (FMD), pulse wave velocity and parameters of retinal vascular remodeling by means of scanning laser Doppler flowmetry (SLDF) will be assessed in patients with HFpEF thereby allowing to examine the relationship between vascular remodeling in the systemic and renal circulation.