Heart Failure With Normal Ejection Fraction Clinical Trial
Official title:
Interleukin-1 Blockade in Heart Failure With Preserved Ejection Fraction (HFpEF): a Randomized Placebo-controlled Double Blinded Study (D-HART2)
- Heart Failure with Preserved Ejection Fraction (HFpEF) is a common form of heart failure
- Standard treatment for heart failure, show less than ideal results in HFpEF
- Evidence of systemic inflammation is common in all forms of heart failure, including
HFpEF
- The main hypothesis of this study is that systemic inflammation contributes to heart
failure symptoms and exercise limitations in patients with HFpEF
- The main objective is to treat patients with HFpEF and evidence of systemic inflammation
with an anti-inflammatory drug targeting Interleukin-1 (or placebo) to determine effects
on cardiovascular function
Heart Failure with Preserved Ejection Fraction (HFpEF) is a common form of heart failure,
characterized by symptoms of congestion and impaired exercise tolerance, secondary to
impaired left ventricular filling (diastole) in absence of a significant impairment in
contractility (LVEF>50%) or significant valvular abnormalities, shunts or intra- or
extra-cavitary obstruction.
The standard treatment for patient with heart failure is very effective in Heart Failure with
Reduced Ejection Fraction (HFrEF), but it not very effective in HFpEF.
Evidence of systemic inflammation is common in all forms of heart failure, including HFpEF,
and predicts worse outcomes. C reactive protein (CRP) is the preferred inflammatory biomarker
used as risk predictor for cardiovascular disease. Patients with heart failure (HFpEF or
HFrEF) with elevated CRP levels are more likely to be severely limited by heart failure
symptoms, are more likely to be admitted to the hospital for heart failure, and are more
likely to die of cardiac causes.
Preclinical studies show that a key mediator of systemic inflammation, Interleukin-1 (IL-1),
impairs cardiac and vascular function, and may contribute to the pathogenesis of heart
failure.
The main hypothesis of this study is that systemic inflammation, and IL-1 in particular,
contributes to heart failure symptoms and exercise limitations in patients with HFpEF.
The main objective is to treat patients with HFpEF and evidence of systemic inflammation with
an IL-1 blocker, anakinra (recombinant human IL-1 receptor antagonist)(or placebo) to
determine effects on exercise capacity measured as peak oxygen consumption at maximal
cardiopulmonary exercise testing.
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