Tapering Heart Failure Medication in Patients with Heart Failure with Recovered Ejection Fraction; Open Label Prospective Random Trial

Last updated: December 5, 2024
Sponsor: Chungnam National University Hospital
Overall Status: Active - Not Recruiting

Phase

N/A

Condition

Hyponatremia

Congestive Heart Failure

Chest Pain

Treatment

RAS blocker tapering group

Beta blocker tapering out

Clinical Study ID

NCT06724653
IRB 2024-09-039-002
2024-09-039-002
  • Ages > 18
  • All Genders

Study Summary

Study start date is on Nov 27th 2024.

A patient with an initial ejection fraction (EF) of less than 40%, whose follow-up shows an improvement to an EF of 50% or higher, along with the left ventricular end-diastolic diameter returning to the normal range and taking 3 more heart failure medication randomed to drug tapering group ( RAS blocker or beta blocker) or continuing medication group.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • initial echocardiogram ejection fraction less than 40%

  • follow up echocardiogram ejection fraction over 50% and LVEDD index normal range

  • NTprobnp criteria

  1. eGFR ≥60 ; less 440

  2. eGFR 45-59: less 980

  3. eGFR 30-44; less 1220

  4. eGFR < 30 : less 5300

  5. in HD; no criteria for NTproBNP

  • on more than 3 heart failure medication ( RAS blocker, beta blocker, mineralcorticoid receptor antagonist, SGLT 2 inhibitor)

Exclusion

Exclusion Criteria:

  1. under age 18 year

  2. uncontrolled BP ( over 150/90)

  3. coronary revascularization within 6 months

  4. significant valve disease

  5. arrhythmia requiring rate control

  6. CKD with albuminuria ( over 30mg/g)

  7. Pregnancy

Study Design

Total Participants: 150
Treatment Group(s): 2
Primary Treatment: RAS blocker tapering group
Phase:
Study Start date:
December 06, 2025
Estimated Completion Date:
November 26, 2027

Study Description

Patients described above randomly assigned to drug tapering group and drug maintaining group.

Drug tapering group is 2 groups, which one is RAS blocker tapering group and others is beta blocker tapering group.

Drug tapering group is monitored ejection fraction, LV dimension and LV GLS by 1-3 month.