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).
研究概览
研究类型
注册 (估计的)
阶段
- 第四阶段
联系人和位置
学习联系方式
- 姓名:Principal Investigator
- 电话号码:+82-42-220-9943
- 邮箱:tworugi@daum.net
学习地点
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Daejeon、韩国、34943
- Daejeon St.Mary's Hospital
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接触:
- Principle Investigator
- 电话号码:+82-42-220-9943
- 邮箱:tworugi@daum.net
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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
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:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的: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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无干预: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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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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NTproBNP
大体时间: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
大体时间: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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Composite endpoint of Major Adverse Cardiovascular Events (MACE)
大体时间: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
大体时间: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)
大体时间: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
大体时间: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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合作者和调查者
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始 (估计的)
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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