このページは自動翻訳されたものであり、翻訳の正確性は保証されていません。を参照してください。 英語版 ソーステキスト用。

症候性心不全における同期横隔膜刺激 (RECOVER-HF)

2026年10月19日 更新者：VisCardia Inc.

RECOVER-HF - 症候性駆出率低下心不全の改善を目的とした同期横隔膜刺激 (SDS) の無作為化多施設二重盲検研究

RECOVER HF is a clinical study designed to evaluate the safety and efficacy of Synchronized Diaphragmatic Stimulation delivered using the VisONE System in the treatment of patients with heart failure.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

Symptomatic Diaphragmatic Stimulation (SDS) is a novel extra-cardiac device for patients who have symptomatic heart failure. Elevated intracardiac pressures are the hallmark of heart failure (HF) and a key pathological driver of disease progression and limited exertional capacity. The degree of cardiac pressure elevation is determined by preload, afterload, and pericardial restraint. The pericardium restrains the heart, and the degree of restraint is determined by the pericardial structure itself and the intrathoracic pressure. This aspect of HF pathophysiology is among the fundamental drivers behind the SDS therapy concept. SDS induces a temporal modulation of intrathoracic pressure.. When synchronized with the cardiac cycle, SDS may improve cardiac filling, cardiovascular pressure conditions, and cardiac performance

RECOVER HF is a prospective, randomized, doubled-blinded study of Synchronized Diaphragmatic Stimulation (SDS) delivered in an imperceptible manner in subjects with heart failure defined as New York Heart Association (NYHA) functional class II/III, left-ventricular ejection fraction (LVEF) <=40%, and QRS duration <=130ms despite receiving the appropriate heart failure guideline directed medical therapy (GDMT). All subjects will receive an implanted VisONE System. Two-weeks post implant subjects will be randomized in a 1:1 ratio into a SDS therapy active or control (SDS therapy inactive) arm with both arms receiving GDMT. At 6 months the control arm will have SDS therapy activated with all patients receiving therapy and GDMT throughout the remainder of the study period. The study will be conducted at up to 30 investigational sites in the United States and several outside the U.S. These centers will enroll subjects with the goal of randomizing approximately 270 subjects who meet the entry criteria.

研究の種類

介入

入学 (推定)

270

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

  • アメリカ
    • Indiana
      • Indianapolis、Indiana、アメリカ、46260
        • 募集
        • Ascension St. Vincent Hospital
        • コンタクト：
        • 主任研究者：
          • Sangita Sudharshan, MD
    • Oklahoma
      • Tulsa、Oklahoma、アメリカ、74136
        • 募集
        • Saint Francis Hospital
        • 主任研究者：
          • Ralph D Ensley, MD
        • コンタクト：
          • Ralph D Ensley, MD
          • 電話番号：(918) 494-8500
    • Pennsylvania
      • Philadelphia、Pennsylvania、アメリカ、19104
        • 募集
        • University of Pennsylvania
        • 主任研究者：
          • Aditya Parikh, MD
        • コンタクト：
          • Aditya Parikh, MD
          • 電話番号：(215) 615-4949
    • Texas
      • Houston、Texas、アメリカ、77030
        • 募集
        • Baylor College of Medicine
        • 主任研究者：
          • Ajith Nair, MD
        • コンタクト：
  • グルジア
      • Tbilisi、グルジア、0159
        • 募集
        • Tbilisi Heart and Vascular Clinic
        • 主任研究者：
          • Tamaz Shaburishvili, MD
        • コンタクト：
          • Tamaz Shaburishvili, MD
          • 電話番号：0322 157 159

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • NYHA classes II/III on optimal Guideline Directed Medical Therapy (GDMT) for 3 months
  • EF≤ 40%
  • At the time of consent, willing and able to comply with protocol requirements, including attending all required visits
  • Willing to participate in the study and able to sign an informed consent form
  • ≥18 years of age at the time of consent

Exclusion Criteria:

  • Baseline 6-minute walk test > 500 meters or < 200 meters

  • NT-proBNP< 250 if on loop diuretics, or NT-proBNP < 500 if not on loop diuretics

  • Supine resting heart rate > 140 bpm

  • Systolic blood pressure < 80 mmHg or > 170 mmHg

  • Serum creatinine > 2.5 mg/dL

  • Serum hepatic function 3x ULN

  • Any of the following within the previous 3 months: unstable angina, AMI, CABG, PTCA, CVA/TIA, AF (episodes > 24 hours), symptomatic NSVT or DCCV

  • Any inotropic drug treatment within the previous 3 months

  • Bradycardia (heart rate < 50 beats/min), atrial arrhythmias with rates > 100 beats/min, sustained ventricular tachycardia or frequent ventricular ectopy >10% present during screening

  • Significant uncontrolled symptomatic bradyarrhythmia, atrial fibrillation, unstable ventricular arrhythmias or frequent ventricular ectopy > 10% documented within the previous 3 months

  • Reversible non-ischemic cardiomyopathy

  • Valvular disease requiring intervention within the next 12 months or presence of significant valve disease as determined by the site cardiologist as:

    1. Greater than mild mitral valve stenosis
    2. Greater than moderate mitral valve regurgitation
    3. Greater than mild tricuspid valve stenosis
    4. Greater than moderate-severe tricuspid valve regurgitation
    5. Greater than moderate aortic stenosis
    6. Greater than moderate aortic regurgitation
    7. Greater than mild-moderate pulmonic stenosis
    8. Greater than moderate pulmonic regurgitation

  • Severe primary pulmonary disease, including pulmonary arterial hypertension. PAP sys >70 mmHg at rest

  • Severe COPD, other respiratory or lung diseases where FEV1 < 50%

  • Presence of more than small pleural effusion or history of pleural drainage within the previous 6 months

  • Known history of diaphragmatic paralysis or suspicion confirmed by unilateral or bilateral elevation of the diaphragm on chest x-ray

  • Pericardial disease

  • Non-cardiac condition substantially impairing ambulation of 6-minute hall walk test interpretation

  • Existing diaphragmatic stimulation for respiration assist

  • Present LVAD, Baroreflex Activation Therapy, Cardiac Contractility Modulation or interatrial shunt devices; temporary mechanical cardiac assist devices (current or within the previous 3 months)

  • Contraindications to laparoscopic access to the diaphragm, as determined by the implanting physician

  • Known intra-abdominal pathology which could increase the risk of laparoscopic access to the diaphragm.

  • Previous open laparotomy within 1 year

  • Previous thoracic or abdominal organ transplant

  • Drug induced immuno-suppression

  • Body mass index > 40

  • Enrollment in a concurrent investigation / clinical study

  • Having a life expectancy of <1 year due to any condition

  • Pregnant or planning a pregnancy during the study period

  • Known allergies to implantable device materials

  • History of systemic infection requiring the use of intravenous antibiotics within the previous 3 months

  • Received cardiac resynchronization therapy (CRT) within six months of randomization, or is actively receiving CRT

  • Currently have a Class I indication for a cardiac resynchronization therapy (CRT) device according to AHA/ACC/ESC guidelines for the treatment of congestive heart failure

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：ランダム化
  • 介入モデル：並列代入
  • マスキング：4倍

武器と介入

参加者グループ / アーム
介入・治療
実験的：Device and Medical Management

  • Subjects will be implanted with the VisONE System programmed to deliver SDS (Therapy On) and receive optimal, stable, Guideline Directed Medical Therapy (GDMT) for heart failure (American Heart Association [AHA] / American College of Cardiology [ACC] guidelines) including those drugs to be determined by the subject's physician

  • Assigned Interventions:

    • Device: VisONE System (SDS)
    • Drug: Medical Management
デバイス：Synchronized Diaphragmatic Stimulation

Implantable Pulse Generator system providing cardiac-gaited stimulation of the diaphragm and thereby influence cardiovascular properties relevant in heart failure.

他の名前：
  • SDS
  • 無症候性の横隔膜刺激
  • ADS
  • VisONE SDS
偽コンパレータ：Medical Management

  • Subjects will be implanted with the VisONE System programmed not to deliver SDS (Therapy Off) and receive optimal, stable, Guideline Directed Medical Therapy (GDMT) for heart failure (American Heart Association [AHA] / American College of Cardiology [ACC] guidelines) including those drugs to be determined by the subject's physician

  • Assigned Interventions:

    • Drug: Medical Management
デバイス：Synchronized Diaphragmatic Stimulation

Implantable Pulse Generator system providing cardiac-gaited stimulation of the diaphragm and thereby influence cardiovascular properties relevant in heart failure.

他の名前：
  • SDS
  • 無症候性の横隔膜刺激
  • ADS
  • VisONE SDS

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Left ventricular End-Systolic Volume (LVESV)
時間枠：6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger percent improvement in LVESV at 6 months post-randomization from baseline than medical management alone.
6 months
Six Minute Hall Walk (6MHW)
時間枠：6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in 6MHW at 6 months post-randomization from baseline than medical management alone.
6 months
Minnesota Living with Heart Failure quality of Life Score (MLWHF QOL)
時間枠：6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in MLWHF QOL at 6 months post-randomization from baseline than medical management alone.
6 months
Major Adverse Respiratory and Cardiovascular Events (MARCE)
時間枠：6 months

To demonstrate the safety of the VisONE System by analyzing Major Adverse Respiratory and Cardiovascular Events (MARCE) occurring within 6 months post implant for the rate, severity and association with the device or procedure (goal >70% freedom):

  • Cardiovascular Death
  • Stroke
  • Cardiac Arrest
  • Interaction with cardiac rhythm device requiring permanent termination of SDS therapy
  • Acute Heart Failure Decompensation
  • Infection requiring device/lead explant
  • Diaphragmatic dysfunction leading to a clinically significant reduction is respiratory function
  • Inadequate SDS therapy delivery requiring surgical intervention
  • Injury to abdominal organs requiring surgical intervention
  • Pneumothorax
  • Hemothorax
6 months

二次結果の測定

結果測定
メジャーの説明
時間枠
Left Ventricular Ejection Fraction (LVEF)
時間枠：6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in LVEF at 6 months post-randomization from baseline than medical management alone.
6 months
N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP)
時間枠：6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger reduction in NT-proBNP (log-10 transformed) at 6 months post-randomization from baseline than medical management alone.
6 months
Left ventricular End-Systolic Volume (LVESV)
時間枠：12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger percent improvement in LVESV at 12 months post-randomization from baseline than medical management alone.
12 months
Six Minute Hall Walk (6MHW)
時間枠：12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in 6MHW at 12 months post-randomization from baseline than medical management alone.
12 months
Minnesota Living with Heart Failure quality of Life Score (MLWHF QOL)
時間枠：12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in MLWHF QOL at 12 months post-randomization from baseline than medical management alone.
12 months
Left Ventricular Ejection Fraction (LVEF)
時間枠：12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in LVEF at 12 months post-randomization from baseline than medical management alone.
12 months
N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP)
時間枠：12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger reduction in NT-proBNP (log-10 transformed) at 12 months post-randomization from baseline than medical management alone.
12 months

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

VisCardia Inc.

協力者

Duke Clinical Research Institute
Clinical Accelerator

捜査官

  • 主任研究者：Lee R Goldberg, MD、University of Pennsylvania

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年7月8日

一次修了 (推定)

2028年7月1日

研究の完了 (推定)

2029年12月1日

試験登録日

最初に提出

2024年8月6日

QC基準を満たした最初の提出物

2024年8月9日

最初の投稿 (実際)

2024年8月14日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月23日

QC基準を満たした最後の更新が送信されました

2026年10月19日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • VisCardia H03_22

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

はい

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

購読する