同步膈肌刺激治疗症状性心力衰竭 (RECOVER-HF)
RECOVER-HF - 同步膈肌刺激 (SDS) 用于改善症状性射血分数降低心力衰竭的随机、多中心、双盲研究
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.
研究概览
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Calvin Flowers
- 电话号码:(503) 431-3823
- 邮箱:flowersc@viscardia.com
研究联系人备份
- 姓名:Joelle Duker
- 电话号码:(503) 431-3800
- 邮箱:dukerj@viscardia.com
学习地点
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Tbilisi、乔治亚州、0159
- 招聘中
- Tbilisi Heart and Vascular Clinic
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首席研究员:
- Tamaz Shaburishvili, MD
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接触:
- Tamaz Shaburishvili, MD
- 电话号码:0322 157 159
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Indiana
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Indianapolis、Indiana、美国、46260
- 招聘中
- Ascension St. Vincent Hospital
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接触:
- Sangita Sudharshan
- 电话号码:(317) 338-6666
- 邮箱:sangita.sudharshan@ascension.org
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首席研究员:
- Sangita Sudharshan, MD
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Oklahoma
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Tulsa、Oklahoma、美国、74136
- 招聘中
- Saint Francis Hospital
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首席研究员:
- Ralph D Ensley, MD
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接触:
- Ralph D Ensley, MD
- 电话号码:(918) 494-8500
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Pennsylvania
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Philadelphia、Pennsylvania、美国、19104
- 招聘中
- University of Pennsylvania
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首席研究员:
- Aditya Parikh, MD
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接触:
- Aditya Parikh, MD
- 电话号码:(215) 615-4949
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Texas
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Houston、Texas、美国、77030
- 招聘中
- Baylor College of Medicine
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首席研究员:
- Ajith Nair, MD
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接触:
- Ajith Nair, MD
- 电话号码:(713) 798-6230
- 邮箱:ajith.nair@bcm.edu
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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:
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Baseline 6-minute walk test > 500 meters or < 200 meters
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NT-proBNP< 250 if on loop diuretics, or NT-proBNP < 500 if not on loop diuretics
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Supine resting heart rate > 140 bpm
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Systolic blood pressure < 80 mmHg or > 170 mmHg
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Serum creatinine > 2.5 mg/dL
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Serum hepatic function 3x ULN
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Any of the following within the previous 3 months: unstable angina, AMI, CABG, PTCA, CVA/TIA, AF (episodes > 24 hours), symptomatic NSVT or DCCV
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Any inotropic drug treatment within the previous 3 months
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Bradycardia (heart rate < 50 beats/min), atrial arrhythmias with rates > 100 beats/min, sustained ventricular tachycardia or frequent ventricular ectopy >10% present during screening
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Significant uncontrolled symptomatic bradyarrhythmia, atrial fibrillation, unstable ventricular arrhythmias or frequent ventricular ectopy > 10% documented within the previous 3 months
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Reversible non-ischemic cardiomyopathy
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Valvular disease requiring intervention within the next 12 months or presence of significant valve disease as determined by the site cardiologist as:
- Greater than mild mitral valve stenosis
- Greater than moderate mitral valve regurgitation
- Greater than mild tricuspid valve stenosis
- Greater than moderate-severe tricuspid valve regurgitation
- Greater than moderate aortic stenosis
- Greater than moderate aortic regurgitation
- Greater than mild-moderate pulmonic stenosis
- Greater than moderate pulmonic regurgitation
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Severe primary pulmonary disease, including pulmonary arterial hypertension. PAP sys >70 mmHg at rest
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Severe COPD, other respiratory or lung diseases where FEV1 < 50%
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Presence of more than small pleural effusion or history of pleural drainage within the previous 6 months
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Known history of diaphragmatic paralysis or suspicion confirmed by unilateral or bilateral elevation of the diaphragm on chest x-ray
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Pericardial disease
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Non-cardiac condition substantially impairing ambulation of 6-minute hall walk test interpretation
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Existing diaphragmatic stimulation for respiration assist
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Present LVAD, Baroreflex Activation Therapy, Cardiac Contractility Modulation or interatrial shunt devices; temporary mechanical cardiac assist devices (current or within the previous 3 months)
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Contraindications to laparoscopic access to the diaphragm, as determined by the implanting physician
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Known intra-abdominal pathology which could increase the risk of laparoscopic access to the diaphragm.
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Previous open laparotomy within 1 year
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Previous thoracic or abdominal organ transplant
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Drug induced immuno-suppression
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Body mass index > 40
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Enrollment in a concurrent investigation / clinical study
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Having a life expectancy of <1 year due to any condition
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Pregnant or planning a pregnancy during the study period
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Known allergies to implantable device materials
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History of systemic infection requiring the use of intravenous antibiotics within the previous 3 months
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Received cardiac resynchronization therapy (CRT) within six months of randomization, or is actively receiving CRT
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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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:四人间
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:Device and Medical Management
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Implantable Pulse Generator system providing cardiac-gaited stimulation of the diaphragm and thereby influence cardiovascular properties relevant in heart failure.
其他名称:
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假比较器:Medical Management
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Implantable Pulse Generator system providing cardiac-gaited stimulation of the diaphragm and thereby influence cardiovascular properties relevant in heart failure.
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Left ventricular End-Systolic Volume (LVESV)
大体时间:6 months
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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
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Six Minute Hall Walk (6MHW)
大体时间:6 months
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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
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Minnesota Living with Heart Failure quality of Life Score (MLWHF QOL)
大体时间:6 months
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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
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Major Adverse Respiratory and Cardiovascular Events (MARCE)
大体时间:6 months
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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):
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6 months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Left Ventricular Ejection Fraction (LVEF)
大体时间:6 months
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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
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N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP)
大体时间:6 months
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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
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Left ventricular End-Systolic Volume (LVESV)
大体时间:12 months
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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
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Six Minute Hall Walk (6MHW)
大体时间:12 months
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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
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Minnesota Living with Heart Failure quality of Life Score (MLWHF QOL)
大体时间:12 months
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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
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Left Ventricular Ejection Fraction (LVEF)
大体时间:12 months
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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
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N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP)
大体时间:12 months
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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
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合作者和调查者
调查人员
- 首席研究员:Lee R Goldberg, MD、University of Pennsylvania
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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