Tapering heart-failure medicines in people whose ejection fraction recovered

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is an open-label, prospective randomized trial that enrolls adults whose initial ejection fraction was <40% and later improved to ≥50% with normalized left ventricular end-diastolic diameter and who are taking three or more heart-failure medications. Eligible participants are randomized to continue all medications or to a drug-tapering strategy in which either the RAS blocker or the beta blocker is gradually reduced. The tapering arms are monitored with echocardiographic measures (EF, LV dimensions, and LV global longitudinal strain), NT-proBNP, and clinical assessment every 1–3 months with predefined thresholds to stop tapering and restart therapy. Key exclusion criteria include uncontrolled hypertension, recent coronary revascularization, significant valve disease, arrhythmia requiring rate control, albuminuric CKD, pregnancy, and specific NT-proBNP/renal function limits at screening.

Why it matters

Who can join: the full rules

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, mineral corticoid receptor antagonist, SGLT 2 inhibitor)

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

Where it's running

• Jeonbuk national university hospital
  Jeonju, Jeollabuk-do, South Korea Recruiting
• Chungnam national university hospital
  Daejeon, Republic of Korea, South Korea Recruiting

Study contacts

• Study coordinator: Yujin Yang
• Email: wjsdudtns9@gmail.com
• Phone: 821043311245

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.