Alleviate-HF-2 Study

Evaluation of the Safety and Effectiveness of a Percutaneously Created Interatrial Shunt to Alleviate Heart Failure Symptoms in Patients With Chronic Heart Failure and Preserved or Mid-Range Left Ventricular Ejection Fraction

Patients with heart failure and preserved left ventricular ejection fraction (HFpEF, EF ≥ 50%) or mid-range left ventricular ejection fraction (HFmrEF, 40% < EF < 50%) with mild to moderate functional limitation will be evaluated for treatment via creation of a no-implant interatrial shunt using clinical, echocardiographic, and invasive hemodynamic data

Study Overview

• Status: Completed
• Conditions: Heart Failure
• Intervention / Treatment: Device: ALV1 System

• Study Type: Interventional
• Enrollment (Actual): 13
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Australia
  • Adelaide, Australia
    • Flinders Medical Centre
  • Clayton, Australia
    • Monash Medical Centre
• Canada
  • Montréal, Canada
    • Centre Hospitalier de l'Universite de Montreal (CHUM)
• New Zealand
  • Dunedin, New Zealand
    • Southern District Health Board
• Sweden
  • Stockholm, Sweden
    • Karolinska University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. NYHA Class II at screening with a prior history of greater than NYHA Class II, OR NYHA Class III at screening, OR ambulatory Class IV at screening: with documented medical history of heart failure for at least 6 months prior to the screening visit.
2. Medical history within the past 12 months of at least one hospitalization with heart failure as the primary or secondary diagnosis OR treatment with IV diuretics for heart failure..
3. LVEF (by Echo) > 40% as measured by the study-specific transthoracic echocardiography.

4. Echocardiographic evidence of diastolic dysfunction documented by one or more of the following as measured by the study-specific transthoracic echocardiography protocol:

   1. LA diameter > 4cm
   2. LA volume index >28 mL
   3. Lateral e' <10 cm/s
   4. Septal e' <8 cm/s
   5. Lateral E/e' >10
   6. Septal E/e' >15
5. As measured by the study-specific exercise hemodynamic right heart catheterization protocol performed during screening: Elevated left atrial pressure WITH a gradient compared to right atrial pressure (RAP) documented by: (1) end-expiratory PCWP at peak supine cycle ergometer exercise ≥ 25mmHg AND (2) PCWP greater than RAP by ≥ 5 mmHg, OR (1) ≥ 10 mmHg increase of end-expiratory PCWP at peak supine cycle ergometer exercise compared to resting PCWP AND (2) PCWP greater than RAP by ≥ 5 mmHg. Patients must also have PCWP greater than RAP by ≥ 5 mmHg at rest.

Exclusion Criteria:

1. Presence of advanced heart failure defined as one or more of the following:

   • ACC/AHA/ESC Stage D heart failure, non-ambulatory NYHA Class IV HF.
   • Cardiac index less than 2.0 L/min/m2.
   • Patient is on the cardiac transplant waiting list.
   • Inotropic infusion (continuous or intermittent) for EF less than 40% within the past 6 months.

2. Presence of moderate or worse valve disease, defined as one or more of the following:

   • Moderate or worse mitral valve regurgitation or moderate or worse mitral stenosis.
   • Moderate or worse tricuspid valve regurgitation.
   • Moderate or worse aortic valve disease defined as moderate or worse AS or AI.

3. . Presence of chronic pulmonary disease defined by one or more of the following:

   • Requirement for continuous home oxygen use.
   • Hospitalization within the past 12 months for treatment of pulmonary disease.
   • Significant chronic pulmonary disease defined as FEV1 less than 50%.
4. Documented as currently requiring dialysis or estimated GFR less than 25ml/min/1.73m2
5. 6-minute walk distance less than 50 m or greater than 450 m performed during screening.
6. Documented atrial fibrillation with ventricular rate greater than 100 BPM at screening.
7. Presence of moderate or worse right heart dysfunction OR RV dysfunction defined as TAPSE less than 14 mm or RVFAC less than or equal to 30%
8. Presence of pulmonary hypertension with PASP greater than or equal to 70 mmHg OR PVR greater than 4 Wood units.
9. Presence of anatomic anomaly that precludes creation of interatrial shunt (including patent foramen ovale, atrial septal defect, target septal thickness greater than 3 mm)
10. SBP greater than 170 mmHg at screening.
11. Documented left ventricular end diastolic diameter greater than 6 cm.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The composite incidence of one or more major adverse cardiac, cerebrovascular and thromboembolic events and change in supine exercise PCWP at peak exercise.	Defined as cardiovascular death, embolic stroke, embolic myocardial infarction, pulmonary or arterial embolism, device-and/or procedure-related serious adverse cardiac events.	At 1 month and through 12 months

Collaborators and Investigators

• Sponsor: Alleviant Medical, Inc.

Study record dates

Study Major Dates

• Study Start (Actual): April 3, 2021
• Primary Completion (Actual): September 1, 2023
• Study Completion (Actual): December 31, 2023

Study Registration Dates

• First Submitted: April 1, 2021
• First Submitted That Met QC Criteria: April 6, 2021
• First Posted (Actual): April 9, 2021

Study Record Updates

• Last Update Posted (Actual): October 4, 2024
• Last Update Submitted That Met QC Criteria: October 3, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Heart Diseases; Cardiovascular Diseases; Heart Failure
• Other Study ID Numbers: CIP-0002

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No