Heart failure is no longer one disease — it splits into preserved (HFpEF) and reduced (HFrEF) ejection fraction, and only in the past few years have effective treatments emerged for the preserved form. SGLT2 inhibitors, originally diabetes drugs, now help both types and have changed treatment guidelines worldwide.
What's actually going on in research
Trials are testing newer drugs that improve heart muscle function, devices that monitor pressures from inside the heart, and treatments for specific causes like cardiac amyloidosis. Research also focuses on combining the four pillars of heart-failure therapy faster after diagnosis, on reducing hospitalizations, and on heart failure after a heart attack.
SGLT2 inhibitors
These pills help both reduced and preserved ejection fraction heart failure, lowering hospitalizations and deaths. They are now part of standard treatment regardless of diabetes status.
Implanted monitors
Tiny pressure sensors placed in the pulmonary artery let doctors adjust medications before fluid buildup causes a hospital visit. Trials are expanding who benefits.
Cardiac amyloidosis
Many older adults with HFpEF actually have a treatable form of amyloidosis. New gene-silencing drugs and stabilizers are extending life dramatically in trials.
What to know before you search
Eligibility often depends on ejection fraction (preserved vs. reduced), heart-failure symptoms, kidney function, blood pressure, and underlying cause such as amyloidosis or prior heart attack.
What types of trials are currently open
- New medication trials — Testing new heart-failure drugs or combinations to see if they reduce hospitalizations and extend life.
- Device trials — Studies of implantable monitors, pumps, and stimulators designed to support a failing heart.
- Surgical trials — Testing newer valve procedures, bypass strategies, or heart-pump implants.
- Lifestyle and behavior trials — Testing structured exercise, diet, and remote-monitoring programs to keep people out of the hospital.
- Observational studies — Following people with heart failure to learn how the condition progresses and what helps.
Recently added Heart Failure trials
Impact of Optimized Pacing Strategies on Clinical and Hemodynamic Outcomes in Heart Failure Patients With Pacemaker
This study aims to evaluate the clinical impact of an optimized pacing strategy in patients with heart failure. * Intervention: Adjustment of the pacemaker lower rate limit to an individualized, hemodynamically optimized heart rate. * Primary Endpoint: Heart failure symptoms, assessed by the Kansas City Cardiomyopathy Questionnaire score. * Hypothesis: In patients with heart failure requiring permanent pacing, an optimized pacing strategy will lead to a significant improvement in heart failure symptoms (Kansas City Cardiomyopathy Questionnaire score) at 12 months compared with the conventional pacing strategy.
Coronary Artery Stents in Heart Failure With Preserved Ejection Fraction
HFpEF (heart failure with preserved ejection fraction) is a condition in which the heart muscle becomes stiff and can't pump blood properly. People living with HFpEF also often have coronary artery disease, where the blood vessels that supply the heart are narrowed or blocked. It is not yet know whether opening these arteries with stents improves symptoms or quality of life with HFpEF. REPRIEVED is a randomised clinical trial that aims to find out if heart stents can improve quality of life for people living with heart failure with preserved ejection fraction (HFpEF) and coronary artery disease. Researchers will compare two groups of people; those who have a stent procedure to those who have a placebo procedure. The placebo procedure feels the same as a stent procedure but does not include a stent. 350 people with HFpEF and coronary artery disease will be asked to take part. Participants will be monitored over a period of 6 months to see if and how quality of life changes. Before the procedure, participants will be asked to complete a short health questionnaire, have a blood test, undergo an electrocardiogram (heart tracing) and scans of their heart. On the day of the procedure, the participant will come to the hospital for an angiogram and will be randomly allocated to have either treatment with a stent or the placebo procedure without a stent. Participants will not know whether they have received heart stents. This helps researchers know that any improvements in their quality of life are not just related to how they feel about the stenting treatment. Participants will then be contacted by a member of the research team at 3 months and 6 months after their procedure. At 3 months, participants will complete a short health questionnaire either by phone or during a hospital visit. At 6 months, participants will attend the hospital to complete a short health questionnaire, have blood tests, a scan of the heart (echocardiogram) and an electrocardiogram (heart tracing) to measure any changes in the heart. Participants will be told whether they received the stent procedure or the placebo procedure.
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