Evaluating sacubitril-valsartan for heart failure patients with LVADs

Safety and Efficacy of Angiotensin Receptor-neprilysin Inhibitor After Left Ventricular Assist Device ImplanT (SEAL-IT) Study

Phase 4 Interventional The Cleveland Clinic · NCT04191681

This study is testing if a new heart medication called sacubitril-valsartan is safe and effective for adults with severe heart failure who have a special heart pump called an LVAD.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment50 (estimated)
Ages18 Years and up
SexAll
SponsorThe Cleveland Clinic Academic / other
Locations1 site (Cleveland, Ohio)
Trial IDNCT04191681 on ClinicalTrials.gov

What this trial studies

This pilot study aims to assess the safety and efficacy of sacubitril-valsartan, an angiotensin receptor-neprilysin inhibitor, in patients who have undergone implantation of a continuous flow left ventricular assist device (CF-LVAD). Participants will be monitored for short-term (3 months) and long-term (6 and 12 months) outcomes compared to standard oral vasodilator therapy. The study will include adults with stage D heart failure and will evaluate how well the new treatment is tolerated and its effectiveness in improving patient outcomes.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with a durable CF-LVAD and NYHA classification II to IV.

Not a fit: Patients with symptomatic hypotension, severely reduced kidney function, or a history of adverse reactions to similar medications may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a new treatment option that improves heart failure management in patients with LVADs.

How similar studies have performed: Other studies have shown promising results with similar approaches, but this specific application is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Adults (age ≥ 18 years)
2. Durable CF-LVAD for any indication
3. NYHA II to IV classification
4. LVEF \< 40%
5. Written informed consent

Exclusion Criteria:

1. Inability to comply with the conditions of the protocol
2. Any patient with durable CF-LVAD who has any one of the following:

   i. symptomatic hypotension or MAP \< 60 mm Hg at randomization,

   ii. eGFR \< 30 mL/min/1.73 m2 at randomization,

   iii. potassium \> 5.4 mM at randomization,

   iv. history of angioedema at randomization,

   v. history of unacceptable side effects with ACE inhibitor, ARB, or sacubitril-valsartan therapy at randomization,

   vi. use of vasoactive agents (e.g., dobutamine, dopamine, epinephrine, norepinephrine, phenylephrine, vasopressin, nitroglycerin, nitroprusside, epoprostenol) or parenteral diuretics in 24 hours preceding randomization.

Where this trial is running

Cleveland, Ohio

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Stage D Heart Failurecontinuous flow left ventricular assist devicesacubitril-valsartanoral vasodilatorHeart failure
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.