Efficacy of Verciguat in TR and RV Failure (VERT-HF)
Efficacy of Vericiguat in HFrEF Patients With Coexisting Severe Tricuspid Regurgitation and Right Heart Failure; Multicenter Pragmatic Randomized Controlled Trial
The goal of this clinical trial is to learn if the drug vericiguat works to improve right heart function in patients with worsening heart failure who have reduced left ventricular function. It will also examine the effects of the drug on tricuspid regurgitation (TR) and overall clinical outcomes.
The main questions it aims to answer are:
Does vericiguat improve right ventricular (RV) function and reduce tricuspid regurgitation (TR)? Does vericiguat reduce the risk of major adverse cardiovascular events (MACE), such as heart failure hospitalizations and cardiovascular death? Does vericiguat improve participants' exercise capacity, quality of life, and renal function?
Researchers have previously seen the benefits of vericiguat in the large-scale VICTORIA trial for worsening heart failure, and it is hypothesized that improvements in right heart function play a key role. This study aims to confirm these specific benefits.
Participants will:
Take vericiguat as prescribed during the study period. Undergo echocardiograms at enrollment and at 9 months to assess right heart function.
Complete questionnaires (KCCQ-12) and walking tests (6MWT) to evaluate quality of life and exercise capacity.
Provide blood samples to monitor NTproBNP levels and renal function (creatinine).
調査の概要
研究の種類
入学 (推定)
段階
- フェーズ 4
連絡先と場所
研究連絡先
- 名前:Principal Investigator
- 電話番号:+82-42-220-9943
- メール:tworugi@daum.net
研究場所
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Daejeon、韓国、34943
- Daejeon St.Mary's Hospital
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コンタクト:
- Principle Investigator
- 電話番号:+82-42-220-9943
- メール:tworugi@daum.net
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age more than 19 years old
- right ventricular malfunction confirmed with EKG data or cardiac MRI
- chronic heart failure with LVEF<45%
- Patients Who administrated standard treatment of Heart Failur for over the 4 weeks
- NTproBNP >1000, NTproBNP >1600 with atrial fibrillation or The patient who recently experienced worsening heart failure(Recent hospitalization for worsening heart failure or outpatient administration of intravenous diuretics)
- Tricuspid regurgitation of greater than moderate severity was confirmed by echocardiogram
- Subject who provided voluntary informed consent to participate in the study
- Patients who have not been administered vericiguat within the last 6 months
Exclusion Criteria:
- Patients with a systolic blood pressure (SBP) < 100 mmHg
- Patients currently treated with other sGC stimulators (including vericiguat) or phosphodiesterase-5 (PDE5) inhibitors
- Moderate-to-severe right ventricular (RV) failure requiring surgical intervention
- Patients who are currently pregnant or of childbearing potential
研究計画
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:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:Arm with administered with Vericiguat
Subjects assigned to the experimental arm will initiate vericiguat at a daily dose of 2.5 mg, concurrently with their baseline heart failure therapy including standard of care (loop diuretics, MRAs, and SGLT2i).
The dose will be targeted to double every 2 weeks, titrating up to a maximum dose of 10 mg.
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Participants will start vericiguat at 2.5 mg once daily, and the dose will be gradually uptitration every 2 weeks to a target dose of 10 mg once daily, depending on tolerability.
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介入なし:Arm with standard of care
This arm is classified as the standard of care control group, where participants receive baseline heart failure therapies including loop diuretics, MRAs, and SGLT2i.
During the study period, if a participant in this arm exhibits no symptomatic improvement or demonstrates clinical worsening despite baseline therapy, the investigator will re-evaluate the doses of the existing standard medications and titrate them up to the maximum recommended doses within a permissible range, or adjust the medication combination to prioritize patient safety.
Additionally, in cases of accompanied fluid overload, further pharmacological interventions, including the adjustment of diuretics, may be administered.
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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 |
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NTproBNP
時間枠:NTproBNP will be assessed from enrollment to the end of treatment at baseline, 3 and 9 months.
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NTproBNP will be assessed from enrollment to the end of treatment at baseline, 3 and 9 months.
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Echocardiographic RV function parameters
時間枠:From enrollment to the end of treatment at baseline and 9 months
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RVSP, RV volume, TAPSE, RV strain/PAP, TR grade
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From enrollment to the end of treatment at baseline and 9 months
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Composite endpoint of Major Adverse Cardiovascular Events (MACE)
時間枠:From enrollment to the end of treatment at 9 months
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Composite endpoint of Major Adverse Cardiovascular Events (MACE), including hospitalization for heart failure (requiring a minimum of 24 hours of hospitalization and intravenous diuretic therapy) and cardiovascular death.
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From enrollment to the end of treatment at 9 months
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Exercise capacity and quality of life
時間枠:From enrollment to the end of treatment at baseline and 9 months
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Kansas City Cardiomyopathy Questionnaire (KCCQ-12)
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From enrollment to the end of treatment at baseline and 9 months
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6-Minute Walk Test (6MWT distance)
時間枠:From enrollment to the end of treatment at baseline and 9 months
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6-Minute Walk Test (6MWT distance)
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From enrollment to the end of treatment at baseline and 9 months
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Renal Function
時間枠:from enrollment to the end of treatment at baseline, 3 and 9 months.
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Renal function: Serum creatinine (Cr)
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from enrollment to the end of treatment at baseline, 3 and 9 months.
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Metra M, Tomasoni D, Adamo M, Bayes-Genis A, Filippatos G, Abdelhamid M, Adamopoulos S, Anker SD, Antohi L, Bohm M, Braunschweig F, Gal TB, Butler J, Cleland JGF, Cohen-Solal A, Damman K, Gustafsson F, Hill L, Jankowska EA, Lainscak M, Lund LH, McDonagh T, Mebazaa A, Moura B, Mullens W, Piepoli M, Ponikowski P, Rakisheva A, Ristic A, Savarese G, Seferovic P, Sharma R, Tocchetti CG, Yilmaz MB, Vitale C, Volterrani M, von Haehling S, Chioncel O, Coats AJS, Rosano G. Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2023 Jun;25(6):776-791. doi: 10.1002/ejhf.2874. Epub 2023 May 19.
- Hashimoto T, Yoshitake T, Suenaga T, Yamamoto S, Fujino T, Shinohara K, Matsushima S, Ide T, Kinugawa S, Abe K. Effectiveness of Vericiguat on right ventricle to pulmonary artery uncoupling associated with heart failure with reduced ejection fraction. Int J Cardiol. 2024 Nov 15;415:132441. doi: 10.1016/j.ijcard.2024.132441. Epub 2024 Aug 10.
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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