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Remote Monitoring and Optimization of Heart Failure Therapy (REMODEL-HF)

1. juni 2026 opdateret af: Zoll Medical Corporation

Heart failure is a condition in which the heart cannot pump blood effectively, often leading to symptoms such as shortness of breath and fluid retention. After hospitalization for heart failure, patients remain at high risk of worsening symptoms, emergency visits, and hospital readmission.

This study is designed to evaluate whether using a wearable monitoring device, called the Heart Failure Management System (HFMS), can help improve the management of patients after a recent hospitalization for heart failure.

Participants in this study will be randomly assigned to one of two groups. One group will receive standard medical care alone. The other group will receive standard medical care in combination with the HFMS device. The HFMS device is worn on the body and continuously collects information such as heart rate, breathing, activity level, and signs of fluid accumulation. These data are reviewed by the clinical care team and may help detect early worsening of heart failure.

Participants will wear the device for 90 days (if assigned to the device group) and will be followed for up to one year. During the study, information will be collected on serious health events such as death, hospitalizations, emergency visits, and changes in heart failure status, as well as quality of life.

The goal of this study is to determine whether this monitoring approach can improve outcomes for patients with heart failure by enabling earlier and more effective clinical management.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The REMODEL-HF study is a prospective, multi-center, randomized, open-label clinical investigation designed to evaluate whether the use of HFMS in addition to usual care improves clinical outcomes in patients recently hospitalized for acute heart failure.

Approximately 800 participants will be enrolled and randomized in a 1:1 ratio to either: standard of care alone (control group), or standard of care plus HFMS-guided management (intervention group).

The primary objective is to determine whether HFMS-guided management results in improved overall clinical outcomes compared to usual care. Outcomes of interest include major clinical events such as cardiovascular death and heart failure hospitalization, as well as earlier indicators of clinical deterioration and changes in relevant biomarkers.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

800

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Manon Lemaire, Master
  • Telefonnummer: +33 (0)6 33 57 18 52
  • E-mail: mlemaire@zoll.com

Undersøgelse Kontakt Backup

  • Navn: Lars Weber, PhD
  • Telefonnummer: +49 (0) 151 611 404 98
  • E-mail: lweber@zoll.com

Studiesteder

  • Det Forenede Kongerige
      • Southampton, Det Forenede Kongerige
        • Southampton University Hospital NHS Foundation Trust
        • Kontakt:
        • Ledende efterforsker:
          • Peter COWBURN, MD
  • Frankrig
    • Grand Est
      • Nancy, Grand Est, Frankrig, 54000
        • CHU Nancy
        • Kontakt:
        • Ledende efterforsker:
          • Nicolas Girerd, Professor
  • Holland
      • Utrecht, Holland
        • UMC Utrecht
  • Italien
      • Roma, Italien
        • Policlinico Casilino
        • Kontakt:
          • Manon Lemaire, Master
          • Telefonnummer: +33 (0)6 33 57 18 52
          • E-mail: mlemaire@zoll.com
  • Polen
      • Warsaw, Polen
        • PIM MSWiA Hospital
        • Kontakt:
          • Manon Lemaire, Master
          • Telefonnummer: +33 (0)6 33 57 18 52
          • E-mail: mlemaire@zoll.com
        • Ledende efterforsker:
          • Agnieszka Pawlak, Professor
  • Schweiz
      • Zurich, Schweiz
        • University Zurich
        • Kontakt:
          • Manon Lemaire, Master
          • Telefonnummer: +33 (0)6 33 57 18 52
          • E-mail: mlemaire@zoll.com
  • Spanien
      • Madrid, Spanien
        • Hospital Universitario 12 de Octubre
        • Kontakt:
          • Manon Lemaire, Master
          • Telefonnummer: +33 (0)6 33 57 18 52
          • E-mail: mlemaire@zoll.com
  • Sverige
      • Uppsala, Sverige
        • Uppsala University Hospital
        • Kontakt:
          • Manon Lemaire, Master
          • Telefonnummer: +33 (0)6 33 57 18 52
          • E-mail: mlemaire@zoll.com
  • Tyskland
      • Giessen, Tyskland, 35390
        • Justus-Liebig University Giessen
        • Kontakt:
        • Ledende efterforsker:
          • Brigit Assmus, MD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age ≥18 years
  • Ability and willingness to provide written informed consent and comply with study procedures
  • Hospital admission for acute heart failure with dyspnea at rest and pulmonary congestion on chest X-ray, and other signs and/or symptoms of heart failure such as edema and/or positive rales on auscultation.
  • All measures within 24 hours prior to randomization of systolic blood pressure ≥ 100 mmHg, and of heart rate ≥ 60 bpm.
  • All measures within 24 hours prior to randomization of serum potassium ≤ 5.5 mEq/L (mmol/L).

  • Biomarker criteria for persistent congestion:

    • NT-proBNP >1500 pg/mL at the time of admission, and;
    • NT-proBNP >1000 pg/mL >=3 days after initial admission measure
  • At 1 week prior to admission, either (a) ≤ ½ the optimal dose of ACEi/ARB/ARNi (see Table) prescribed, no beta-blocker prescribed, and ≤ ½ the optimal dose of MRA prescribed or (b) no ACEi/ARB/ARNi prescribed, ≤ ½ the optimal dose of beta-blocker prescribed, and ≤ ½ the optimal dose of MRA prescribed. All study participants prescribed per label and commercially fit with the HFMS device will be eligible for enrollment.

Exclusion Criteria:

  • Age < 18 years
  • Clearly documented intolerance to high doses (≥50% of target dose) of beta-blockers.
  • Clearly documented intolerance to high doses (≥50% of target dose) of RAS blockers (both ACEi and ARB).
  • Mechanical ventilation (not including CPAP/BIPAP) in the 24 hours prior to Screening.
  • Significant pulmonary disease contributing substantially to the patients' dyspnea such as FEV1< 1 liter or need for chronic systemic or nonsystemic steroid therapy, or any kind of primary right heart failure such as precapillary pulmonary hypertension or chronic thromboembolic pulmonary hypertension.
  • Cardiac surgery within 3 months prior to Screening
  • Index Event (admission for AHF) triggered primarily by a correctable etiology such as significant arrhythmia (e.g., sustained ventricular tachycardia, or atrial fibrillation/flutter with sustained ventricular response >130 beats per minute, or bradycardia with sustained ventricular arrhythmia <45 beats per minute), severe anemia, acute coronary syndrome, pulmonary embolism, planned admission for device implantation or severe nonadherence leading to very significant fluid accumulation prior to admission and brisk diuresis after admission. Troponin elevations without other evidence of an acute coronary syndrome are not excluded.
  • Uncorrected thyroid disease, active myocarditis, or known amyloid, sarcoidosis, or hypertrophic obstructive cardiomyopathy.
  • History of heart transplant or on a transplant list, or using or planned to be implanted with a ventricular assist device.
  • Adhesive allergy/sensitivity (e.g., acrylic adhesives).
  • Compromised skin at the device application site (wound, severe dermatitis, etc.) .
  • Having a prescribed wearable cardioverter defibrillator
  • Pulmonary artery pressure implant (e.g. CardioMems)
  • Expected survival <1 year

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Ingen indgriben: Control Group
Participants receive standard medical care for heart failure according to local clinical practice without use of the HFMS device.
Aktiv komparator: Intervention Group
Participants receive standard medical care in addition to remote monitoring using the Heart Failure Management System (HFMS). Clinical teams review device data and may adjust treatment based on observed trends and alerts.
Enhed: Wearable Monitoring Device for Heart Failure

Participants assigned to the intervention group will use a noninvasive wearable physiological monitoring device (Heart Failure Management System, HFMS) designed to continuously collect data related to cardiopulmonary status, including heart rate, respiratory parameters, activity levels, and indicators of fluid status (Thoraic Fluid Index = TFI).

Clinical care teams perform regular reviews of device-derived data and may respond to alerts or trends suggestive of worsening heart failure.

Based on these data, the care team may adjust patient management, including modification of guideline-directed medical therapy or scheduling of follow-up assessments. The device does not deliver therapy and is used to support clinical decision-making in the outpatient management of heart failure.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Hierarchical Composite Outcome (Win Ratio)
Tidsramme: 90 days
A hierarchical composite outcome comparing the intervention and control groups using a win ratio approach. The components are prioritized as follows: (1) cardiovascular death, (2) heart failure hospitalization, (3) Unplanned visit (emergency room or other emergency facilities) requiring intravenous diuretic treatment, and (4) change in NT-proBNP concentration. Participants are compared pairwise, with outcomes evaluated sequentially according to this hierarchy.
90 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of Participants Achieving Target Doses of Guideline-Directed Medical Therapy (GDMT)
Tidsramme: 90 days
Percentage of participants reaching target doses of guideline-directed medical therapy for heart failure during the first 90 days after randomization.
90 days
Quality of Life Assessed by KCCQ-12
Tidsramme: Baseline, 90 days,180 days and 365 days
Change in health-related quality of life measured using validated questionnaire : the Kansas City Cardiomyopathy Questionnaire (KCCQ-12)
Baseline, 90 days,180 days and 365 days
Time to First Clinical Event Composite
Tidsramme: Up to 365 days
Time to First Occurrence of Cardiovascular Death, Heart Failure Hospitalization, or Unplanned Visit Requiring Intravenous Diuretic Treatment
Up to 365 days
Quality of Life Assessed by EQ-5D-5L
Tidsramme: Baseline, 90 days,180 days and 365 days
Change in health-related quality of life measured using validated questionnaire : the EQ-5D-5L
Baseline, 90 days,180 days and 365 days
Hierarchical Composite Outcome (Win Ratio at 1 Year)
Tidsramme: 365 days
Hierarchical composite outcome using the same win ratio methodology as the primary endpoint, evaluated at 1 year.
365 days
Cardiovascular Death
Tidsramme: 90 days and 365 days
Occurrence of death due to cardiovascular causes.
90 days and 365 days
Heart Failure Hospitalization
Tidsramme: 90 days and 365 days
Occurrence of hospitalization due to heart failure.
90 days and 365 days
Unplanned Visit Requiring Intravenous Diuretic Treatment
Tidsramme: 90 days and 365 days
Occurrence of an unplanned visit requiring intravenous diuretic treatment. Scheduled or planned intravenous diuretic treatments are not considered events.
90 days and 365 days
NT-proBNP Response
Tidsramme: Baseline to 90 days
Change in NT-proBNP concentration from baseline. Response defined as ≥30% decrease from baseline.
Baseline to 90 days

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Zoll Medical Corporation

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

1. august 2028

Studieafslutning (Anslået)

1. august 2029

Datoer for studieregistrering

Først indsendt

18. maj 2026

Først indsendt, der opfyldte QC-kriterier

1. juni 2026

Først opslået (Faktiske)

3. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

3. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 90d0278
  • 101253160 (Andet bevillings-/finansieringsnummer: Granting Authority :Innovative Health Initiative Joint Undertaking (IHI JU) and Funding Program: Horizon Europe)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ja

produkt fremstillet i og eksporteret fra U.S.A.

Ja

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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