Tapering Heart Failure Medication in Patients with Heart Failure with Recovered Ejection Fraction; Open Label Prospective Random Trial

Launched by CHUNGNAM NATIONAL UNIVERSITY HOSPITAL · Dec 5, 2024

Keywords

ClinConnect Summary

This clinical trial is looking at how to adjust heart failure medications for patients who have shown improvement in their heart function. Specifically, it's studying patients whose heart function, measured by something called ejection fraction (EF), has improved from below 40% to 50% or higher after treatment. Participants will either have their medications gradually reduced or continue taking them as they are. This study aims to see if reducing medications is safe and effective for these patients.

To be eligible for this trial, participants need to be between 65 and 74 years old and must have had a heart function score (ejection fraction) that was initially low (below 40%) but improved to at least 50%. They should also be taking more than three types of heart failure medications. Patients will be monitored closely throughout the trial to ensure their heart health remains stable. It's important to note that this study is not yet recruiting participants, and there are certain health conditions that could prevent someone from joining, such as uncontrolled blood pressure or recent heart surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • initial echocardiogram ejection fraction less than 40%
• • follow up echocardiogram ejection fraction over 50% and LVEDD index normal range
• • NTprobnp criteria
• • 1. eGFR ≥60 ; less 440
• • 2. eGFR 45-59: less 980
• • 3. eGFR 30-44; less 1220
• • 4. eGFR \< 30 : less 5300
• • 5. in HD; no criteria for NTproBNP
• • on more than 3 heart failure medication ( RAS blocker, beta blocker, mineral corticoid receptor antagonist, SGLT 2 inhibitor)
• Exclusion Criteria:
• • 1. under age 18 year
• • 2. uncontrolled BP ( over 150/90)
• • 3. coronary revascularization within 6 months
• • 4. significant valve disease
• • 5. arrhythmia requiring rate control
• • 6. CKD with albuminuria ( over 30mg/g)
• • 7. Pregnancy