Heart failure affects more than 6 million Americans and happens when the heart can't pump blood efficiently enough to meet the body's needs. Treatment includes medications like ACE inhibitors, beta-blockers, and SGLT2 inhibitors, plus devices like pacemakers and defibrillators for some people. Despite these advances, many people still experience symptoms and hospitalizations.
What's actually going on in research
Trials are testing newer SGLT2 inhibitors that work in both reduced and preserved ejection fraction, gene therapies targeting specific inherited forms, cardiac contractility modulators that help the heart pump more effectively, and anti-inflammatory approaches. Researchers are also studying whether finerenone and other drugs can prevent heart failure in people with diabetes or kidney disease.
SGLT2 inhibitors expanding
Drugs like empagliflozin and dapagliflozin, originally for diabetes, now reduce hospitalizations across different types of heart failure. Trials continue to test them in earlier stages and new combinations.
Gene therapy
For inherited cardiomyopathies like hypertrophic cardiomyopathy, gene-silencing treatments are showing promise in early trials. These therapies aim to reduce the abnormal protein production causing heart muscle thickening.
Cardiac remodeling
Drugs targeting fibrosis and inflammation may help reverse the structural changes that happen in heart failure. Several compounds are in trials to see if they can improve heart function rather than just manage symptoms.
What to know before you search
Eligibility typically depends on ejection fraction type (reduced or preserved), symptom severity, medications already tried, kidney function, and whether you have devices like a pacemaker.
What types of trials are currently open
- Medication trials — Testing new drugs or combinations to reduce symptoms, improve heart function, or prevent hospitalization. Many compare new treatments to standard medications like ACE inhibitors or beta-blockers.
- Device trials — Studies of implantable devices like cardiac contractility modulators, newer pacemakers, or mechanical support devices for advanced heart failure.
- Gene therapy trials — Testing treatments that target the genetic causes of inherited heart muscle disease, aiming to slow or reverse damage.
- Exercise and rehabilitation trials — Studies testing whether specific exercise programs, cardiac rehab approaches, or remote monitoring improve outcomes and quality of life.
- Registry studies — Large tracking studies that follow people with heart failure to understand which treatments work best for different patient groups.
Recently added Heart Failure trials
dPmax for Predicting Right Ventricular Failure After Left Ventricular Assist Device Implantation
This single-center, prospective observational study aims to evaluate whether dPmax, a measure of the maximum rate of arterial pressure rise obtained through pulse contour analysis, can predict right ventricular failure after left ventricular assist device (LVAD) implantation in adults. Measurements collected during routine monitoring before and after anesthesia induction will be analyzed alongside preoperative echocardiographic findings. The primary outcome is right ventricular failure within 30 days after surgery, assessed using Mechanical Circulatory Support-Academic Research Consortium (MCS-ARC) criteria. Secondary objectives include comparing the predictive performance of dPmax with the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/SPAP) and identifying an optimal dPmax threshold for predicting right ventricular failure. No additional invasive procedures will be performed for research purposes.
Remote Rehabilitation in Patients With HFpEF (PATRON-HF)
Heart failure with preserved ejection fraction (HFpEF) is characterized by typical symptoms of heart failure, structural and functional cardiac abnormalities, and elevated serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), despite preserved left ventricular ejection fraction. Typical symptoms of HFpEF include reduced exercise tolerance, exertional dyspnea, paroxysmal nocturnal dyspnea, and orthopnea. It is estimated that approximately 35 million people worldwide suffer from HFpEF, including approximately 3 million patients in the United States. The exact number of patients with HFpEF remains unknown; however, the prevalence of the disease is increasing. Risk factors for HFpEF include obesity, arterial hypertension, atrial fibrillation, diabetes mellitus, dyslipidemia, and advanced age. Patients with HFpEF are hospitalized an average of 1.4 times per year, and the annual mortality rate is approximately 15%. To date, the most effective approach to the management of HFpEF has been the control of comorbidities, including diabetes mellitus, arterial hypertension, coronary artery disease, and obesity. Remote rehabilitation (RR) has already become an established component of modern cardiology. It is widely used in developed countries, and its popularity continues to increase. Its main advantages include reduced costs for both patients and healthcare payers compared with traditional, center-based rehabilitation. In addition, for patients living far from rehabilitation centers or those with limited access to transportation, remote rehabilitation provides a solution to improve access to care. The efficacy and safety of remote rehabilitation have been demonstrated in cardiac patients with coronary artery disease and in patients with heart failure with reduced ejection fraction (HFrEF). However, to date, the safety and efficacy of remote rehabilitation in patients with HFpEF have not been sufficiently investigated. Therefore, the aim of the proposed study is to assess the safety and efficacy of remote rehabilitation in patients with HFpEF.
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