
Comparing Diuretic Strategies in Hospitalized Heart Failure
Heart FailureWe will conduct a pragmatic randomized trial comparing whether using a combination of two types of diuretics (loop + thiazide) compared with using a single diuretic (loop only) will result in shorter hospital stays for patients hospitalized with heart failure.

Artificial Intelligence and Smart Wearable Technologies for Early Detection of Acute Heart Failure...
Heart Failure,CongestiveHeart failure is the major pandemic of the 21st century. The number of patients and of Heart Failure-related deaths is progressively increasing. This means a devastating economic and health organization burden. In fact, chronic heart failure patients are at high risk of death, and the course of the disease is often insidious and uncertain with a progressive deterioration requiring the need for repeated and successive hospitalizations with an ominous prognosis: with each admission for acute heart failure there is a short-term improvement, a phase characterized by a degree of stability, and then a worsening phase follows until a new need for a new hospitalization. Moreover, with each subsequent hospitalization, myocardial function progressively declines, gradually worsening the patient's quality of life until the fatal event. For these reasons, one of the major unmet needs is the identification of patients with a negative trajectory of Heart Failure. Accordingly, early identification of Heart Failure worsening is mandatory to improve patient condition and reduce Heart Failure costs, which are mainly associated with hospitalizations. Our main goal through this project is to create clinical tool for detection of early signs of chronic heart failure (CHF) worsening that will allow timely therapeutic intervention. This timely manner intervention can lead to a much better outcome for the patient, possibly reducing the need for hospitalization or lower the number of hospitalization days. The aim of this project is to develop clinical decision tool based on artificial intelligence (AI) algorithms to early detect the signs of exacerbation of chronic heart failure and predict the risk of its progression, by integrating high quality medical data obtained through a wearable device (L.I.F.E. Italia Srl's "wearable clinic" - a vest with accessories, which is a TRL 9 medical grade sensorized garment, already available on the market). Specifically, the focus will be on the early detection of CHF worsening in patients who have already been diagnosed with CHF.

Evaluation of Outcomes of CRT and MitraClip for Treatment of Low Ejection Fraction and Functional...
Functional Mitral RegurgitationHeart FailureAt present, the optimal treatment strategy for heart failure patients and moderate-to-severe (3+) or severe (4+) mitral regurgitation with a class IIa recommendation for CRT is uncertain.Whether these patents should also be treated for functional mitral regurgitation or with CRT also remains unclear. We therefore propose a randomized 2x2 factorial design in this patient population to understand the the impact of both CRT and transcatheter mitral valve repair with the MitraClip on their functional status and quality of life.

The Effects of a CONCOR Smartphone Application
Congenital Heart DiseaseSmartphone Application4 moreLife expectancy of children with congenital heart disease (CHD) has increased dramatically during the past years, due to the successes of cardiac surgery. Nearly all of these children with CHD can be operated at young age and more than 90% reach adulthood. However, many adults with CHD are life-long affected by cardiac events, particularly arrhythmias and heart failure, putting them at risk of premature death. These events have a large impact on quality of life of patients and their families and merit life-long hospital visits in a medical center specialized in adult CHD. Especially for adults with CHD patient care with a smartphone is suited because of their young age and chronic condition. So far, data are lacking on smartphone interventions in patients with CHD.

Cognition and Exercise Training
Metabolic SyndromeCoronary Heart Disease1 moreThe aim of study is to investigate the impact of two different training modalities (high intensity interval training (HIIT) versus moderate intensity continuous exercise training (MICET) on cognitive performance, cerebral oxygenation, cardiac output and physical fitness in older healthy adults, patients with metabolic syndrome, coronary heart disease and heart failure. The investigators hypothesized that HIIT modality will lead to a larger improvement in physical fitness (i.e. VO2peak), cardiovascular parameters (cardiac output and stroke volume) and cognitive performance at rest and during submaximal exercise. The primary endpoint will be the improvement in cognitive performance.

Exercise, Heart Failure, and Type 2 Diabetes
Heart FailureType 2 DiabetesThe purpose of this study is to understand the differences in how patients with heart failure respond to exercise training compared to patients with heart failure and type 2 diabetes.

Integration of Follow-up by First and Second Line Practitioners by Telemonitoring in Heart Failure....
Chronic Heart FailureThe aim of this study is to evaluate this model of telemonitoring-assisted close supervision and interaction between first and second line health professionals versus a model of telemonitoring without this integrated approach.

Results of Tc99m-Maraciclatide Scintigraphy in Subjects With Diabetes Mellitus and Heart Failure...
Diabetes MellitusHeart FailureThe purpose of this study is to evaluate the results of 99mTc maraciclatide scintigraphy in diabetic subjects with HFPEF. A maximum of 20 subjects with Diabetes Mellitus (DM) and Heart Failure With Preserved Left Ventricular Ejection Fraction (HFPEF) will be enrolled and imaged with 99mTc maraciclatide. In addition, a maximum of 10 subjects with DM and diastolic dysfunction but no diagnosis of heart failure (HF) will be enrolled and imaged with 99mTc-maraciclatide.

Associations Between the Microbiome, Skeletal Muscle Perfusion, and Fitness Status
Heart FailureSystolic4 moreThe purpose of the study is to determine associations between fitness status, bacteria in the mouth, and the blood flow to muscle. This study is trying to find out if fitness status impacts the bacteria that are present in the oral microbiome (environment in the mouth) or the ability of the body to send blood to the skeletal muscle. Participants will complete all or some of the following: A mouth swab to assess the bacteria in their mouths. Produce a saliva sample into a tube. Cycle on a bike until you reach maximum effort. Undergo blood draws Wear a 24-hour non-invasive device that monitors blood pressure. Undergo a test to assess blood flow to the muscles measured with an ultrasound. Drink 70mL (1/3 of a cup) of concentrated beetroot juice once

Optimizing Treatments for Heart Failure During Hospitalization
Decompensated Heart FailureHeart failure reaches 1.5 million people in France and is responsible for 200,000 hospitalizations per year. Over the past ten years, new therapies have emerged (treatment of martial deficiency, Entresto, iSGLT2). Hospitalization in a context of acute heart failure is a moment of choice in the history of the disease to introduce recommended treatments under closer supervision (clinical, biological) than in ambulatory, and allows a decrease in hospitalizations, morbidity and mortality. The purpose of this study is to describe the introduction of heart failure drugs (including iSGLT2) in real-life settings in patients hospitalized for decompensated heart failure.