HeartShare combines various data to improve heart failure treatment

HeartShare Deep Phenotyping Study

This study is trying to see if using different types of health data can help doctors create better, personalized treatments for people with heart failure.

Quick facts

• Study type: Observational
• Enrollment: 1000 (estimated)
• Ages: 30 Years and up
• Sex: All
• Sponsor: Northwestern University (Academic / other)
• Locations: 6 sites (Sacramento, California and 5 other locations)
• Trial ID: NCT05873634 on ClinicalTrials.gov

What this trial studies

HeartShare is an observational study focused on heart failure, aiming to classify the condition into subtypes for personalized treatment development. The study integrates extensive data from electronic health records, imaging studies, and molecular data to enhance understanding of heart failure. Participants will contribute new data through the HeartShare Deep Phenotyping Study, which will help identify specific treatment targets for different heart failure subtypes. By leveraging a comprehensive approach, the study seeks to improve outcomes for heart failure patients.

Who should consider this trial

Good fit: Ideal candidates include individuals aged 30 and older with a prior diagnosis of heart failure or those without a history of heart failure.

Not a fit: Patients with significant comorbidities that preclude participation or those under 30 years old may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to more personalized and effective treatments for heart failure patients.

How similar studies have performed: Other studies have shown promise in using integrated data approaches for heart failure, suggesting potential success for this novel methodology.

Eligibility criteria

Inclusion Criteria:

HF Inclusion Criteria (HeartShare Registry)

1. Age ≥30 years.
2. Prior diagnosis of HF in the EHR (any left ventricular ejection fraction).

Non-HF Group Inclusion Criteria (HeartShare Registry)

1. Age ≥30 years.
2. No known prior diagnosis of HF or use of loop diuretics.
3. No known prior history of BNP \>100 pg/ml or NTproBNP \>300 pg/ml, if prior laboratory tests are available in the EHR.

HFpEF Inclusion Criteria (HeartShare Deep Phenotyping Cohort)

1. Age ≥30 years.
2. Left ventricular ejection fraction ≥50% measured by echocardiography.
3. Definition of HFpEF: signs and symptoms of HF, NYHA functional class II-IV, and at least one of the following:

   1. Elevated BNP (≥75 pg/ml in sinus rhythm or ≥225 pg/ml in atrial fibrillation/flutter) or NTproBNP (≥225 pg/ml in sinus rhythm or ≥675 in atrial fibrillation/flutter) at baseline. Choice of BNP or NTproBNP is based on availability at each clinical center.
   2. Prior HF hospitalization (primary reason for the hospitalization is HF with elevated natriuretic peptide levels \[using the thresholds listed above\], requiring IV diuresis for HF, or pulmonary edema or pulmonary vascular congestion on chest radiography).
   3. Elevated pulmonary capillary wedge pressure (PCWP) at rest (≥15 mmHg) or during exercise (≥25 mmHg for supine exercise or PCWP/cardiac output ratio ≥2 mmHg/L/min for upright exercise).
   4. Elevated H2FPEF score26 (≥5) or HFA-PEFF27 score (≥5).

Non-HFpEF Group Inclusion Criteria (HeartShare Deep Phenotyping Cohort)

1. Age ≥30 years.
2. Left ventricular ejection fraction ≥50% measured by echocardiography.
3. No known prior diagnosis of HF or use of diuretics for fluid management.
4. No known prior history of BNP ≥75 pg/ml or NTproBNP ≥225 pg/ml, if prior laboratory tests are available in the EHR.
5. BNP \<75 pg/ml or NTproBNP \<225 pg/ml at the time of screening. Choice of BNP or NTproBNP is based on availability at each clinical center.

Exclusion Criteria:

Exclusion Criteria (HeartShare Registry) The following exclusion criteria apply to both HF and non-HF group participants, unless otherwise indicated.

1. For non-HF group: any prior known left ventricular ejection fraction \<50%.
2. Prior history of solid organ transplantation.
3. Prior history of mechanical circulatory support.
4. Prior history of non-cardiac cirrhosis.
5. Inability to provide written consent to the study.

Exclusion Criteria (HeartShare Deep Phenotyping Cohort) The following exclusion criteria apply to both HFpEF and non-HFpEF group participants, unless otherwise indicated.

1. Life expectancy estimated to be \< 1 year.
2. Primary cardiomyopathy (including amyloid, hypertrophic cardiomyopathy, cardiac sarcoidosis, hemochromatosis, or other infiltrative cardiomyopathies) or pulmonary arterial hypertension (WHO Group I, III, or IV pulmonary hypertension).
3. Any prior known left ventricular ejection fraction \<40%, except if this occurred only in the setting of an acute tachycardia episode (e.g., acute atrial fibrillation).
4. Clinically significant valvular heart disease defined as:

   1. Moderate to greater aortic stenosis, pulmonic stenosis, or tricuspid stenosis.
   2. Any mitral stenosis.
   3. Moderate or greater aortic regurgitation.
   4. Greater than moderate mitral regurgitation.
5. Any planned cardiac surgery or cardiac intervention in the next 3 months.
6. Alternative primary reason for symptoms of shortness of breath and exercise intolerance in HFpEF participants in the opinion of the enrolling investigator.
7. Cardiac surgery, acute coronary syndrome, percutaneous coronary intervention, stroke, transient ischemic attack, or carotid intervention in the preceding 6 months prior to enrollment.
8. Known symptomatic epicardial coronary artery disease that is not revascularized.
9. Any non-elective hospitalization in the preceding 2 weeks.
10. Prior history of solid organ transplantation.
11. Prior history of chronic infection (HIV, hepatitis C, hepatitis B, tuberculosis) unless treated and not clinically active in the opinion of the enrolling investigator.
12. Prior history of mechanical circulatory support.
13. Prior history of non-cardiac cirrhosis.
14. Estimated GFR \<20 ml/min/1.73m2 or currently on dialysis.
15. Any condition that may preclude participation or adherence to the study protocol, in the opinion of the enrolling investigator.
16. Inability to provide written consent to the study.
17. Current acute decompensated heart failure.
18. Currently pregnant.

Where this trial is running

Sacramento, California and 5 other locations

• University of California Davis — Sacramento, California, United States (Recruiting)
• Northwestern University — Chicago, Illinois, United States (Recruiting)
• Mass General Brigham — Boston, Massachusetts, United States (Not_yet_recruiting)
• Mayo Clinic — Rochester, Minnesota, United States (Recruiting)
• Wake Forest University — Winston-Salem, North Carolina, United States (Not_yet_recruiting)
• University of Pennsylvania — Philadelphia, Pennsylvania, United States (Recruiting)

Study contacts

• Principal investigator: Sanjiv Shah, MD — Northwestern University
• Study coordinator: Laura Alagna

Conditions Heart Failure; Heart Failure With Preserved Ejection Fraction