UPBEAT: Using Polygenic Scores to Guide BB Therapy in HF With Mildly Reduced EF

Launched by DAVID LANFEAR · Jun 27, 2025

Keywords

ClinConnect Summary

This clinical trial, called UPBEAT, is studying how genetic information (called polygenic scores) might help doctors decide if beta blocker medications work well for people with a certain type of heart failure. Specifically, it looks at patients whose heart’s pumping ability, measured by something called ejection fraction, is mildly reduced (between 41% and 50%). The study will also use MRI scans to see how beta blockers affect the heart’s size and function over time.

People who might join the study are adults aged 18 to 89 who have been diagnosed with heart failure within the last year and have an ejection fraction in that specific range. Participants should not already be on a high dose of beta blockers or have certain health conditions like very low blood pressure, recent heart procedures, or active cancer treatment. If eligible, participants can expect to have genetic testing and heart scans, and their response to beta blockers will be closely monitored. This study is not yet recruiting, but it aims to help doctors personalize heart failure treatment based on a person’s genetic makeup.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age 18-89 years
• • Ejection Fraction (EF) \>40% and =\<50% by any modality within 1 year (must be most recent)
• • Clinical diagnosis of HF within 1 year, evidenced by any one: Hospital discharge with primary or secondary HF diagnosis, ER discharge with primary diagnosis of HF, ambulatory diagnostic code for HF and diuretic use, BNP\>35 ng/L or NTproBNP \>125 ng/L at any time
• Exclusion Criteria:
• • Unable to provide informed consent
• • Previous documented EF =\< 35%
• • Currently on BB \>25% target dose
• • Uncontrolled hypertension (systolic BP \> 180 at enrollment)
• • Has contraindications to all BB or intolerance to metoprolol
• • Systolic BP \< 100 or heart rate \<70
• • Current cancer requiring active treatment
• • Heart transplant or LVAD or expected in the next year
• • Life expectancy \< 1 year for any reason
• • Dialysis dependence or ESRD
• • MI/ PCI/ CABG within 90 days prior to enrollment or planned in the future
• • Absolute indication for BB other than heart failure (e.g. tachyarrhythmia required BB for rate control, angina)
• • If PI decides for any reason participation in trial is not in best interest of the patient