Heart Failure Clinical Trial
Official title:
A Pilot Feasibility Study in Recovered Heart Failure
One third of patients diagnosed with heart failure demonstrate left ventricular reverse remodelling and recovery of cardiac function following a period of medical therapy. These patients have an excellent long-term prognosis. Whether they need to remain on long-term medical therapy is not clear. The investigators will investigate the safety of therapy withdrawal in patients with a previous diagnosis of heart failure and recovered cardiac function, in a randomised controlled trial.
Patients with a previous diagnosis of heart failure, who have recovered cardiac function,
without symptoms, normal serum biomarker concentrations and who are currently still taking
heart failure medications, will be recruited. Participants will be randomised to withdrawal
of therapy and control arms and will undergo imaging investigations and cardiopulmonary
exercise tests at baseline along with serum biomarker tests. Those participants randomised to
withdrawal of therapy will have a gradual, supervised reduction of medications. If, at
anytime, there are signs of recurring heart failure, medications will be restarted.
Participants in the control arm will continue their medical therapy as usual.
Participants will be followed up with further biomarker testing, cardiopulmonary exercise
testing and imaging investigations at 6 months.
The primary end-point will be a relapse in heart failure, defined by adverse remodelling,
increase in left ventricular size, rise in serum biomarkers or clinical evidence of heart
failure as judged by the clinical team.
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