This study will involve subjects undergoing clinically indicated Right heart catheterization for either idiopathic pulmonary arterial hypertension (IPAH) or heart failure with preserved ejection fraction (HFpEF). The catheter tip utilized in the procedure, which would otherwise be discarded, will be collected and tested. A test performed on the cells adhered to the end of the catheters has been developed which we believe can aid in the differentiation of patients diagnosed with IPAH vs. HFpEF.
This study will investigate the superiority of empagliflozin 10 mg versus placebo on top of guideline-directed medical therapy in patients with symptomatic, chronic HF and reduced ejection fraction and meet the following criteria:
1. Age ? 18 years at screening. For Japan only: Age ? 20 years at screening
2. Male or female patients. WOCBPa must be ready and able to use highly effective methods of birth control per ICH M3 (R2) [R09-1400] that result in a low failure rate of less than 1% per year when used consistently and correctly. A list of contraception methods meeting these criteria is provided in the patient information
3. Patients with chronic HF diagnosed for at least 3 months before Visit 1, and currently in HF NYHA class II-IV
4. Chronic HF with reduced EF defined as LVEF ? 40% per local reading (obtained under stable condition by echocardiography, radionuclide ventriculography, invasive angiography, MRI or CT). A historical LVEF may be used if it was measured within 6 months prior to visit 1 or the LVEF may be measured after study consent has been obtained. The LVEF must be documented in an official report prior to randomization.
5. In addition to LVEF ? 40%, patients must have at least one of the following evidence
a) If EF ?36% to ?40%: Elevated NT-proBNP at Visit 1 ?2500 pg/ml for
patients without AF, OR ?5000 pg/ml for patients with AF, analysed at the
b) If EF ?31% to ?35%: Elevated NT-proBNP at Visit 1 ?1000 pg/ml for
patients without AF, OR ?2000 pg/ml for patients with AF, analysed at the
c) If EF?30%: Elevated NT-proBNP at Visit 1 ?600 pg/ml for patients without
AF, OR ?1200 pg/ml for patients with AF, analysed at the Central Laboratory
d) For EF ? 40% and documented HHFc within 12 months prior to visit 1,
elevated NT-proBNP at Visit 1 ? 600 pg/ml for patients without AF and ?
1200 pg/ml for patients with AF, analysed at the Central Laboratory.
6. Appropriate dose of medical therapy for HF (such as ACEi, ARB, ?-blocker, oral
diuretics, MRA, ARNI, ivabradine) consistent with prevailing local and international
CV guidelines, stable for at least 1 week prior to Visit 1 and during screening period until Visit 2 (Randomization) with the exception of diuretics stable for only one week prior to Visit 2 to control symptoms. The investigator must document in the source documents the reason why patient not on target dose per local guidelines
7. Appropriate use of medical devices such as cardioverter defibrillator (ICD) or a
cardiac resynchronization therapy (CRT) consistent with prevailing local or
international CV guidelines (refer also to exclusion #29)
8. Body Mass Index (BMI) < 45 kg/m2 at Visit 1 (Screening)
9. Signed and dated written ICF in accordance with Good Clinical Practice (GCP) and local legislation prior to admission to the trial
1. Myocardial infarction (increase in cardiac enzymes in combination with symptoms of ischaemia or newly developed ischaemic ECG changes), coronary artery bypass graft surgery, or other major cardiovascular surgery, stroke or TIA in past 90 days prior to Visit 1
2. Heart transplant recipient, or listed for heart transplant
3. Currently implanted left ventricular assist device (LVAD)
001-MCS-40-106-RD-03 (13.0) / Saved on: 05 Aug 2015
4. Cardiomyopathy based on infiltrative diseases (e.g. amyloidosis), accumulation
diseases (e.g. haemochromatosis, Fabry disease), muscular dystrophies,
cardiomyopathy with reversible causes (e.g. stress cardiomyopathy), hypertrophic
obstructive cardiomyopathy or known pericardial constriction
5. Any severe (obstructive or regurgitant) valvular heart disease, expected to lead to surgery during the trial in the investigator's opinion
6. Acute decompensated HF (exacerbation of chronic HF) requiring i.v. diuretics, i.v. inotropes, or i.v. vasodilators, or LVAD within 1 week from discharge to Visit 1
(Screening) and during screening period until Visit 2 (Randomisation)
7. Atrial fibrillation or atrial flutter with a resting heart rate >110 bpm documented by ECG at Visit 1(Screening)
8. Untreated ventricular arrhythmia with syncope in patients without ICD documented within the 3 months prior to Visit 1
9. Diagnosis of cardiomyopathy induced by chemotherapy or peripartum within the 12 months prior to Visit 1
10. Symptomatic bradycardia or second or third degree heart block without a pacemaker after adjusting beta-blocker therapy, if appropriate
11. Systolic blood pressure (SBP) ? 180 mmHg at Visit 2. If SBP >150mmHg and
< 100 mmHg at Visit 1 or Visit 2
13. Chronic pulmonary disease requiring home oxygen, oral steroid therapy or
hospitalisation for exacerbation within 12 months, or significant chronic pulmonary
disease in the opinion of the investigator, or primary pulmonary arterial hypertension
14. Indication of liver disease, defined by serum levels of either ALT (SGPT), AST
(SGOT), or alkaline phosphatase above 3 x upper limit of normal (ULN) as
determined at Visit 1
15. Impaired renal function, defined as eGFR < 20 mL/min/1.73 m2 (CKD-EPI) or
requiring dialysis, as determined at Visit 1
16. Haemoglobin (HgB) < 10 ng/mL, and biopsy Gleason score of ? 6 and clinical stage T1c or T2a)
21. Presence of any other disease than heart failure with a life expectancy of s
opinion, makes them an unreliable trial subject or unlikely to complete the trial
27. Women who are pregnant, nursing, or who plan to become pregnant while in the trial
28. Any other clinical condition that would jeopardise patients safety while participating in this trial, or may prevent the subject from adhering to the trial protocol
29. Implanted cardioverter defibrillator (ICD) or a cardiac resynchronization therapy (CRT) within 3 months prior to Visit 1, or if there is an intent to implant ICD or CRT within 3 months of visit 1
The purpose of this study is to test whether the study drug (QPI-1002) prevents Major Adverse Kidney Events (MAKE) after heart surgery in adult patients who are at high risk of developing Acute Kidney Injuries (AKI). This study is a one-time infusion of the study drug (QPI-1002) with follow-up visits lasting for one year.
The purpose of the study is to generate a bio bank of specimens for research. We will tissue that would otherwise be discarded from clinical or surgical procedure and information from medical records. We will also collect discarded blood, urines and sputum. Collecting samples will help to better understanding the mechanisms of cardiovascular diseases, identify biomarkers for early diagnosis and to predict safety and efficacy of new therapies.
The purpose of the study is to show that the FlexAbility™ SE Ablation Catheter is safe and effective in reducing the number of Ventricular Tachycardia (VT) episodes in patients who continue to experience VT despite taking antiarrhythmic medications (medicines to prevent abnormal heart rhythms), or who are unable to take antiarrhythmic medications. Subject should be at least 18 years old. The entire duration of the study will be one year from the ablation procedure and consists of four follow up visits after the ablation procedure.
Heart failure affects over one million Americans and thousands of new cases are diagnosed each year. This syndrome tends to be progressive and is associated with an increased risk for hospitalizations and possbile death. The CardioMEMS™ HF System is an FDA approved device for individuals with class III heart failure. The system is placed in your heart during a short procedure. Following placement, your doctor is able to monitor the pressures in your heart from the comfort of your own home.The GUIDE-HF study will investigate to determine if the device is effective in individuals with class II, III, or IV heart failure with elevated labs and/or those who have had prior heart failure hospitalizations. During the study, patients will be seen 6 times in our research clinic. During these visits the study staff will ask you to fill out questionnaires, measure your vital signs (blood pressure, heart rate, weight), perform a 6 minute hall walk, draw blood to look at your heart function, and review medications. The device is permanent after implant.
Roughly 8-10 million patients complaining of chest pain come to an Emergency Department (ED) annually in the United States. Quickly determining if you are having a heart attack is critical for improving your chances of survival. Cardiac troponin is a protein that is used as a biomarker (biological marker) to indicate damage to the heart muscle. Cardiac troponin lab tests that are currently used in the United States do not have the ability to detect low levels of troponin. There are more sensitive troponin tests that are primarily used outside the US, that are able to detect lower levels of cardiac troponin within 90-180 minutes instead of 5 or 6 hours. This allows for the early identification of individuals at a higher risk for heart damage and these patients benefit from early diagnosis and treatment. Delaying the treatment of a heart attack increases the chance of dying or being permanently disabled. This study will collect blood samples from people coming to the Emergency Department complaining of chest pain in order to measure this troponin lab test's ability to accurately detect troponin levels.
A sample of patients will be drawn from a cross-sectional cohort of pre- and post-abdominal and cardiothoracic transplant recipients from March 2018 through May 2018. 10 to 15 minute key informant interviews will be conducted with patients to ascertain their views and perceptions related to adherence pre- and post-transplant and use of technolgy. This data will be used to educate the transplant community about adherence from the patient's perspective.
The purpose of the study is to test a new way to pace the left side of the heart without using pacing leads, using the WiSE CRT System. In this study, ultrasound will be used to transfer energy from a new type of pacemaker through your body to a special receiver that is placed inside the left ventricle of your heart. The receiver will use the ultrasound energy to pace the heart without using pacing leads.
The purpose of this study is to collect measurements related to the body such as blood pressure, the amount of oxygen in the blood, and heart rhythm recordings. Findings from this study may be used to help design new device-based monitoring technologies in the future.
Continuous blood pressure readings will be obtained during standard of care heart catheterization procedures that include the use of an arterial blood pressure line. Continuous readings of oxygen saturation and ECG will also be obtained. Participants will consist of subjects aged ? 18 years who are scheduled to undergo a cath-lab (cath-lab, percutaneous coronary intervention or equivalent) procedure that includes the use of an arterial blood pressure line.