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    HP:0001635: Congestive heart failure

    Developed by Shray Alag, The Harker School
    Sections: Correlations, Clinical Trials, and HPO

    Correlations computed by analyzing all clinical trials.

    Navigate: Clinical Trials and HPO


    Correlated Drug Terms (21)


    Name (Synonyms) Correlation
    drug2180 Low Dose (10 mg) Control Wiki 0.29
    drug1298 ECG from handheld device Wiki 0.29
    drug1305 EHR-based Clinician Jumpstart Wiki 0.29
    Name (Synonyms) Correlation
    drug3222 REGN10933+REGN10987 Wiki 0.29
    drug2862 Performance of WHEELS-I in promoting DASH/SRD adoption Wiki 0.29
    drug1584 Furosemide Injection Solution for subcutaneous administration (80 mg) Wiki 0.29
    drug178 AZD9977 Wiki 0.29
    drug1585 Furosemide Injection, USP Wiki 0.29
    drug26 12 weeks of bicycle exercise Wiki 0.29
    drug318 Antibody testing Wiki 0.29
    drug3918 Tele-medicine platform Wiki 0.29
    drug1118 CytoSorb 300 mL device Wiki 0.29
    drug735 COVID visitation restrictions Wiki 0.29
    drug1347 Effects of a 2-week DASH/SRD intervention vs. control diet on HFpEF functional cardiovascular risk factors Wiki 0.29
    drug2854 Pemziviptadil (PB1046) Wiki 0.29
    drug69 50 mg/mL Virazole Wiki 0.20
    drug24 100 mg/mL Virazole Wiki 0.20
    drug1152 Dapagliflozin Wiki 0.14
    drug1060 Convalescent plasma Wiki 0.06
    drug1047 Convalescent Plasma Wiki 0.05
    drug2916 Placebo Wiki 0.04

    Correlated MeSH Terms (51)


    Name (Synonyms) Correlation
    D006333 Heart Failure NIH 1.00
    D054143 Heart Failure, Systolic NIH 0.41
    D002561 Cerebrovascular Disorders NIH 0.29
    Name (Synonyms) Correlation
    D019462 Syncope, Vasovagal NIH 0.29
    D013575 Syncope NIH 0.29
    D054144 Heart Failure, Diastolic NIH 0.29
    D013616 Tachycardia, Sinus NIH 0.29
    D054058 Acute Coronary Syndrome NIH 0.24
    D003327 Coronary Disease NIH 0.22
    D013896 Thoracic Diseases NIH 0.20
    D000075902 Clinical Deterioration NIH 0.20
    D002546 Ischemic Attack, Transient NIH 0.20
    D000787 Angina Pectoris NIH 0.20
    D013610 Tachycardia NIH 0.20
    D007022 Hypotension NIH 0.20
    D015673 Fatigue Syndrome, Chronic NIH 0.17
    D016491 Peripheral Vascular Diseases NIH 0.17
    D011654 Pulmonary Edema NIH 0.17
    D006331 Heart Diseases NIH 0.15
    D002318 Cardiovascular Diseases NIH 0.15
    D058729 Peripheral Arterial Disease NIH 0.14
    D001281 Atrial Fibrillation NIH 0.14
    D014652 Vascular Diseases NIH 0.14
    D016584 Panic Disorder NIH 0.14
    D008103 Liver Cirrhosis, NIH 0.14
    D005356 Fibromyalgia NIH 0.13
    D003693 Delirium NIH 0.13
    D024821 Metabolic Syndrome NIH 0.13
    D009203 Myocardial Ischemia NIH 0.13
    D009362 Neoplasm Metastasis NIH 0.13
    D051437 Renal Insufficiency, NIH 0.12
    D007676 Kidney Failure, Chronic NIH 0.11
    D051436 Renal Insufficiency, Chronic NIH 0.10
    D011665 Pulmonary Valve Insufficiency NIH 0.10
    D003324 Coronary Artery Disease NIH 0.10
    D008175 Lung Neoplasms NIH 0.08
    D013577 Syndrome NIH 0.08
    D017563 Lung Diseases, Interstitial NIH 0.08
    D007674 Kidney Diseases NIH 0.08
    D002908 Chronic Disease NIH 0.08
    D029424 Pulmonary Disease, Chronic Obstructive NIH 0.07
    D008171 Lung Diseases, NIH 0.06
    D007249 Inflammation NIH 0.05
    D009369 Neoplasms, NIH 0.05
    D016638 Critical Illness NIH 0.04
    D012127 Respiratory Distress Syndrome, Newborn NIH 0.02
    D055371 Acute Lung Injury NIH 0.02
    D012128 Respiratory Distress Syndrome, Adult NIH 0.02
    D011014 Pneumonia NIH 0.02
    D045169 Severe Acute Respiratory Syndrome NIH 0.01
    D018352 Coronavirus Infections NIH 0.01

    Correlated HPO Terms (24)


    Name (Synonyms) Correlation
    HP:0011703 Sinus tachycardia HPO 0.29
    HP:0012668 Vasovagal syncope HPO 0.29
    HP:0001279 Syncope HPO 0.29
    Name (Synonyms) Correlation
    HP:0001649 Tachycardia HPO 0.20
    HP:0002615 Hypotension HPO 0.20
    HP:0002326 Transient ischemic attack HPO 0.20
    HP:0001681 Angina pectoris HPO 0.20
    HP:0100598 Pulmonary edema HPO 0.17
    HP:0001626 Abnormality of the cardiovascular system HPO 0.15
    HP:0004757 Paroxysmal atrial fibrillation HPO 0.14
    HP:0001395 Hepatic fibrosis HPO 0.14
    HP:0001658 Myocardial infarction HPO 0.13
    HP:0000083 Renal insufficiency HPO 0.12
    HP:0004950 Peripheral arterial stenosis HPO 0.11
    HP:0001677 Coronary artery atherosclerosis HPO 0.10
    HP:0012622 Chronic kidney disease HPO 0.10
    HP:0010444 Pulmonary insufficiency HPO 0.10
    HP:0100526 Neoplasm of the lung HPO 0.08
    HP:0006515 Interstitial pneumonitis HPO 0.08
    HP:0000077 Abnormality of the kidney HPO 0.08
    HP:0006510 Chronic pulmonary obstruction HPO 0.07
    HP:0002088 Abnormal lung morphology HPO 0.06
    HP:0002664 Neoplasm HPO 0.05
    HP:0002090 Pneumonia HPO 0.02

    Clinical Trials

    Navigate: Correlations   HPO

    There are 12 clinical trials


    1 Essential Arterial Hypotension and Allostasis Registry

    The essential arterial hypotension and allostasis registry is a prospective, observational research that has the purpose of demonstrating that essential blood pressure (BP) disorders and the associated comorbidities are a result of the inappropriate allostatic response to daily life stress. This required a functioning brain orchestrating the evaluation of the threat and choosing the response, this is a mind-mediated phenomenon. If the response is excessive it contributes to high BP, if deficient to low BP, and the BP itself will identify the allostatic pattern, which in turn will play an important role in the development of the comorbidities. To do so, consecutive patients of any age and gender that visit a cardiologist's office in Medellin, Colombia, are recruited. Individuals are classified according to their arterial BP and allostasis and follow them in time to see what kind of diseases develops the most (including BP) in the follow up according to the categorization of the characteristic chosen and after adjustment for confounder's variables. In addition, stress events with their date are registered. HYPOTHESIS The causes of the diseases are multifactorial. Physical, biochemical, psychological, social, and cultural dimensions of development dynamically interact to shape the health development process. A person´s health depends on their: 1. Biological and physiologic systems 2. External and internal environment (a) physical, b) internal behavioural and arousal state as registered by the brain. 3. Their interaction. The allostatic mechanisms to the internal and external stressors (allostatic load) involves a network composed by: 1. Functional systems; mediated by: 1. The Autonomic Nervous System 2. The endocrine system 3. The immune system 2. Structural changes: whenever the internal and/or external stressors are long lasting and/or strength enough, they may induce changes in: 1. Epigenetic, endophenotypes, polyphenism. 2. Plasticity 3. The interaction between a) and b). The network response do not affect exclusively the BP, propitiating the development of comorbidities, which may prompt strategies for prevention, recognition and ultimately, treatment. The allostatic model defines health as a state of responsiveness. The concept of psycho-biotype: The allostasis is the result of both: biological (allostasis) and psychological (psychostasis) abilities. It is proposed that both components behave in similar direction and magnitude. Immune disorders may be associated with the development of cancer. High BP population has a higher sympathetic and lower vagal tone, this has been associated with a decrease in the immune´s system function. Resources and energy depletion: Terms like weathering have been used to describe how exposures to different allostatic loads gradually scrape away at the protective coating that keeps people healthy. It is postulated that High BP individuals have more resources and energy.

    NCT02018497
    Conditions
    1. Blood Pressure
    2. Depression
    3. Panic Attack
    4. Fibromyalgia
    5. POTS
    6. Inappropriate Sinus Tachycardia
    7. Coronary Heart Disease
    8. Acute Coronary Syndrome (ACS)
    9. Acute Myocardial Infarction (AMI)
    10. Cerebrovascular Disease (CVD)
    11. Transient Ischemic Attack (TIA)
    12. Atrial Fibrillation
    13. Diabetes Mellitus
    14. Cancer
    15. Systolic Heart Failure
    16. Diastolic Heart Failure
    17. Chronic Fatigue Syndrome
    18. Syncope
    19. Vasovagal Syncope
    MeSH:Fatigue Syndrome, Chronic Fibromyalgia Syncope Ischemic Attack, Transient Cerebrovascular Disorders Syncope, Vasovagal Heart Failure Atrial Fibrillation Heart Diseases Myocardial Infarction Acute Coronary Syndrome Hypotension Coronary Disease Tachycardia Heart Failure, Diastolic Heart Failure, Systolic Tachycardia, Sinus Syndrome Panic Disorder
    HPO:Abnormal left ventricular function Atrial fibrillation Carotid sinus syncope Congestive heart failure Hypotension Myocardial infarction Paroxysmal atrial fibrillation Right ventricular failure Sinus tachycardia Syncope Tachycardia Transient ischemic attack Vasovagal syncope

    Primary Outcomes

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Comorbidities: As describe in the protocol, as a summary: 1) cardiovascular, 2) metabolic, 3) Endocrine, 4) psychiatric disorders: depression and panic disorder, 5) orthostatic intolerance: neurally mediated syncope, vasovagal syncope, inappropriate sinus tachycardia, Postural orthostatic syndrome, carotid sinus hypersensitivity; 6) others: chronic fatigue syndrome, fibromyalgia, arthritis, autoimmune diseases, pulmonary thromboembolism, OSA (obstructive sleep apnea), Alzheimer disease, Parkinson disease, others dementias, epilepsia, nephropathies, and others. Cardiovascular mortality Total mortality

    Measure: Relationship between Blood pressure group and comorbidities

    Time: A 7-year prospective study

    Description: Adaptability group: Hyper adaptable, normal adaptability, hypo adaptable. Comorbidities: As describe in the protocol, as a summary: 1) cardiovascular, 2) metabolic, 3) Endocrine, 4) psychiatric disorders: depression and panic disorder, 5) orthostatic intolerance: neurally mediated syncope, vasovagal syncope, inappropriate sinus tachycardia, Postural orthostatic syndrome, carotid sinus hypersensitivity; 6) others: chronic fatigue syndrome, fibromyalgia, arthritis, autoimmune diseases, pulmonary thromboembolism, OSA (obstructive sleep apnea), Alzheimer disease, Parkinson disease, others dementias, epilepsia, nephropathies, and others. Cardiovascular mortality Total mortality

    Measure: Relationship between adaptability group and comorbidities

    Time: A 7-year prospective study

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Adaptability group: Hyper adaptable, normal adaptability, hypo adaptable. Comorbidities: As describe in the protocol, as a summary: 1) cardiovascular, 2) metabolic, 3) Endocrine, 4) psychiatric disorders: depression and panic disorder, 5) orthostatic intolerance: neurally mediated syncope, vasovagal syncope, inappropriate sinus tachycardia, Postural orthostatic syndrome, carotid sinus hypersensitivity; 6) others: chronic fatigue syndrome, fibromyalgia, arthritis, autoimmune diseases, pulmonary thromboembolism, OSA (obstructive sleep apnea), Alzheimer disease, Parkinson disease, others dementias, epilepsia, nephropathies, and others. Cardiovascular mortality Total mortality

    Measure: Relationship between blood pressure group, adaptability group and comorbidities

    Time: A 7-year prospective study

    Secondary Outcomes

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Habits: smoke and drink Anthropometric variables: Body mass index, waist, hip Metabolic variables: Fasting glucose, 2 hs postprandial plasma glucose, insulin plasma levels, homoeostasis model assessment (HOMA), total cholesterol, LDL, HDL, triglycerides. Endocrine variables: plasma cortisol, free cortisol in 24 hs. urine, epinephrine, norepinephrine, metanephrines, vanilmandelic acid, ACTH, aldosterone, renin, thyrotropine, free thyroxine, triiodothyronine, testosterone Electrocardiogram: HR; PR interval, QRS complex, cQT interval Holter variables: HR, standard deviation of NN intervals (SDNN) and sympathovagal balance, at day, night and 24 hs. ABPM: Systolic, diastolic, and heart rate, at day, night and 24 hs., BP matinal surge.

    Measure: Relationship between blood pressure group, habits and anthropometric, metabolic, endocrine, Electrocardiogram, Holter, ambulatory blood pressure monitoring (ABPM)

    Time: A 7-year prospective study

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Adaptability group: Hyper adaptable, normal adaptability, hypo adaptable. Habits: smoke and drink Anthropometric variables: Body mass index, waist, hip Metabolic variables: Fasting glucose, 2 hs postprandial plasma glucose, insulin plasma levels, HOMA, total cholesterol, LDL, HDL, triglycerides. Endocrine variables: plasma cortisol, free cortisol in 24 hs. urine, epinephrine, norepinephrine, metanephrines, vanilmandelic acid, ACTH, aldosterone, renin, thyrotropine, free thyroxine, triiodothyronine, testosterone Electrocardiogram: PR interval, QRS complex, Heart rate, cQT interval Holter variables: HR, SDNN and sympathovagal balance, at day, night and 24 hs. ABPM: Systolic, diastolic, and heart rate, at day, night and 24 hs., BP matinal surge.

    Measure: Relationship between blood pressure group, adaptability group, habits anthropometric, metabolic, endocrine, electrocardiographic, Holter, ambulatory arterial blood pressure monitoring.

    Time: A 7-year prospective study

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Adaptability group: 1) Hyper adaptable, 2) normal adaptability and 3) hypo adaptable. Habits: smoke and drink, exercise Anthropometric variables: Body mass index, waist, hip Metabolic and other variables: Fasting glucose, 2 hs postprandial plasma glucose, insulin plasma levels, HOMA, total cholesterol, LDL, HDL, triglycerides; thyrotropine, Holter variables: HR, standard deviation of NN intervals (SDNN) and sympathovagal balance, at day, night and 24 hs. ABPM: Systolic, diastolic, and heart rate, at day, night and 24 hs., BP matinal surge.

    Measure: For metabolic disorders what it matters the most: the anthropometric variables vs blood pressure group vs adaptability group

    Time: A 7-year prospective study

    Description: Adaptability group: Hyper adaptable, normal adaptability, hypo adaptable. Habits: smoke and drink Anthropometric variables: Body mass index, waist, hip Metabolic variables: Fasting glucose, 2 hs postprandial plasma glucose, insulin plasma levels, HOMA, total cholesterol, LDL, HDL, triglycerides. Endocrine variables: plasma cortisol, free cortisol in 24 hs. urine, epinephrine, norepinephrine, metanephrines, vanilmandelic acid, ACTH, aldosterone, renin, thyrotropine, free thyroxine, triiodothyronine, testosterone Electrocardiogram: PR interval, QRS complex, Heart rate, cQT interval Holter variables: HR, SDNN and sympathovagal balance, at day, night and 24 hs. ABPM: Systolic, diastolic, and heart rate, at day, night and 24 hs., BP matinal surge.

    Measure: Relationship between adaptability group, habits and anthropometric, metabolic, endocrine, Electrocardiogram, Holter, ambulatory blood pressure monitoring (ABPM)

    Time: A 7-year prospective study

    Other Outcomes

    Description: Clinical syncope characteristics (age of first syncope, number of syncope episodes, trauma, duration, clinical score, convulse, sphincter relaxation, etc.) Syncope cause Blood pressure group Adaptability group Prognosis

    Measure: Syncope Registry

    Time: Up 100 weeks

    Description: TTT protocol: describe the protocol, the time at positive response, nitroglycerine use, autonomic and hemodynamic variables. TTT outcome for syncope: positive or negative TTT other outcomes: 1) Chronotropic incompetence, 2) arterial orthostatic hypotension, 3) carotid hypersensitivity, 4) POTS, 5) IST The relationship between TTT results and Clinical score for syncope in regard to: syncope behaviour and other orthostatic intolerance entities, symptoms and comorbidities. The relationship between neurally mediated syncope response at the TTT and comorbidities.

    Measure: Tilt table testing (TTT) registry

    Time: Up to 100 weeks

    Description: EPS variables: AH, AV, CL, sino atrial conduction time (SACT), sinus node recovery time (SNRT), corrected sinus node recovery time (CSNRT), response to Isoproterenol, intrinsic heart rate Diagnosis: control, sick sinus syndrome, IST, chronotropic incompetence at the TTT HR at the ECG HR at the Holter monitoring HR at the TTT HRV at the Holter monitoring Syncope, cardiac or neurally mediated HR at the physical treadmill test Relationship with the blood pressure group Relationship with the adaptability group

    Measure: Sinus node function at the electrophysiological study (EPS)

    Time: Up to 100 weeks

    Description: Define how the blood pressure group and/or the adaptability group may add to the already known and include in this registry, in the diagnosis of cardiovascular complications as coronary artery disease, cerebrovascular disease, peripheral artery disease, nephropathy.

    Measure: Score for coronary artery disease

    Time: Up to 200 weeks

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Adaptability group: Hyper adaptable, normal adaptability, hypo adaptable. Comorbidities: As describe in the protocol, as a summary: 1) cardiovascular, 2) metabolic, 3) Endocrine, 4) psychiatric disorders: depression and panic disorder, 5) orthostatic intolerance: neurally mediated syncope, vasovagal syncope, inappropriate sinus tachycardia, Postural orthostatic syndrome, carotid sinus hypersensitivity; 6) others: chronic fatigue syndrome, fibromyalgia, arthritis, autoimmune diseases, pulmonary thromboembolism, OSA (obstructive sleep apnea), Alzheimer disease, Parkinson disease, others dementias, epilepsia, nephropathies, COPD, and others. Mortality

    Measure: Neurally Mediated Syncope: further of the transient lost of consciousness (TLC)

    Time: A 7-year prospective study

    Description: Blood pressure group: 1) Essential arterial hypotension, 2) normotension and 3) Essential arterial hypertension. Adaptability group: Hyper adaptable, normal adaptability, hypo adaptable. Psychiatric variables: Big Five Questionary (BFQ) for personality. Modify of the Coping Scale (Scale of modified coping strategies) Zung questionary for depression and anxiety MINI in those patients with moderate or severe depression and/or anxiety at the Zung questionary

    Measure: Psychobiotype: relationship between biological and psychological variables

    Time: Up to 100 weeks

    Description: High sodium intake in the diet is recognized as a risk factor for hypertension development. Essential hypotension population is advised to increase the sodium (at least 10 grams a day) and water intake (at least 2 liters a day), or as much as possible, several have taken Fludrocortisone (is not a exclusion criteria). Normal blood pressure population are advised to have a normal or low sodium intake. Physical exercise is recommended in both groups. This registry is a good opportunity to test how important sodium diet is to induce hypertension, or if by the contrary adaptability could prevail over high sodium intake in this registry. Blood pressure groups: essential hypotension and normotension and those with new essential hypertension. Adaptability groups. The results will be adjusted for age, gender and BMI.

    Measure: The role of high sodium intake in the development of essential hypertension. Comparison between essential hypotension (high sodium intake) vs normotension population (normal or low sodium intake) in the follow-up.

    Time: 4 years

    Description: Consistent bradycardia in the ECG at the office and normal HR in the holter monitoring or the contrary. There are patients with complaints that may be attributed to bradycardia, low blood pressure, hypothyroidism, or other entities. Some patients very often have bradycardia in the ECG taken in the office and normal HR in the 24 Holter monitoring, the opposite is also possible. Patients with bradycardia (without medication or physiological condition as exersice affecting heart rate) in at least 2 ECG (less 60 bpm) and at least 2 Holter monitoring will be analyzed, Other variables to consider are: Age, gender, blood pressure group, adaptability group, maximum HR in the treadmill test, white coat or masked hypertension, Tilt-Table-test result or syncope cause, Electrophysiological study if available. The acknowledge of this phenomenon could have clinical implications in the diagnosis of sick sinus syndrome and physiopathological ones.

    Measure: White coat effect in the heart rate or masked bradycardia.

    Time: 1 year

    Description: Bradycardia is the classical presentation form for sinus node dysfunction, mainly when associated with symptoms. Chronotropic incompetence is also a manifestation. Absence of medications with effects on the heart rate (HR) must be ruled out. Variables HR at the ECG, Holter monitoring, stress text, and at the physical examination previous to pacemaker implantation, Electrophysiological study (EPS): Basic cycle length, Sino-atrial conduction time, Sinus node recovery time, Corrected sinus node recovery time, Intrinsic HR when available 3. Pacemaker variables: HR at day and night or rest time Percentage of stimulation in A and V chambers 4. Syncope: Clinical characteriscs and clinical score Tilt table test results Trans Thoracic Echocardiogram in rest and or stress text Hypothesis: patients with ANSD will start to decrease the percentage atrial stimulation.

    Measure: Reversible Bradycardia Mimicking Sinus Node Dysfunction as a Manifestation of Subacute Autonomic Nervous System Dysfunction (ANSD).

    Time: 2 years

    Description: A non invasive, beat to beat BP monitoring, with the ability to measure BP, HR, Cardiac Output and Systemic Vascular Resistance (SVR) was started to use in the EHAR registry since May 2017. A description of this variables in the three BP groups will be collected in the data base (DB). This will allow to characterize whether SVR and/or CO maintain BP. Until now BP levels are related with prognosis. In the prognosis model SVR and CO will be add them to know what matter the most: BP levels, SVR and/or CO? In the EHAR registry a collection of the variables recognized as a risk factor for several comorbidities are available to adjust in multivariable analysis.

    Measure: Description of the blood pressure hemodynamic profile at a medical office and their prognostic implications.

    Time: Three years
    2 Dietary Prevention of Heart Failure in Hypertensive Metabolic Syndrome

    Tens of thousands of Veterans have heart failure with preserved ejection fraction (HFpEF), and suffer poor quality of life, frequent hospitalizations, and high death rates. Older Veterans and those with high blood pressure, obesity, and the metabolic syndrome (abnormal cholesterol and resistance to insulin's effects) are particularly at risk for HFpEF. However, it is not clear why only some Veterans in this risk group eventually develop HFpEF. Extensive information from experimental animal models and some human studies suggests that dietary patterns in vulnerable 'salt-sensitive' people could contribute to the risk for HFpEF. Reducing salt intake and increasing overall dietary quality in at-risk Veterans could prevent heart and blood vessel damage that ultimately leads to HFpEF. Reducing the development of HFpEF, which currently has no definitive treatment, is highly relevant to the VA's mission to emphasize prevention of disease and population health.

    NCT03170375
    Conditions
    1. Heart Failure
    Interventions
    1. Behavioral: Performance of WHEELS-I in promoting DASH/SRD adoption
    2. Behavioral: Effects of a 2-week DASH/SRD intervention vs. control diet on HFpEF functional cardiovascular risk factors
    MeSH:Heart Failure Metabolic Syndrome
    HPO:Abnormal left ventricular function Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: Velocity of pulse wave traveling between carotid and femoral artery; validated measure of arterial stiffness

    Measure: Carotid-femoral pulse wave velocity

    Time: Phase 1 of study, change from baseline at the end of week 2 and week 4

    Description: Left ventricular mass indexed to height

    Measure: Left ventricular mass index

    Time: Phase 2 of study, change from baseline to 6 months

    Secondary Outcomes

    Description: Ventricular stiffness k, by Parametrized Diastolic Formalism analysis

    Measure: Ventricular stiffness

    Time: Phase 1 of study, change from baseline at the end of week 2 and week 4

    Description: Global longitudinal left ventricular strain, a sensitive measure of ventricular systolic function

    Measure: Global longitudinal left ventricular strain

    Time: Phase 1 of study, change from baseline at the end of week 2 and week 4

    Description: Global left atrial strain, a novel measure of atrial function

    Measure: Global left atrial strain

    Time: Phase 1 of study, change from baseline at the end of week 2 and week 4

    Description: Velocity of pulse wave traveling between carotid and femoral artery; validated measure of arterial stiffness

    Measure: Carotid-femoral pulse wave velocity

    Time: Phase 2 of study, change from baseline to 6 months

    Description: Left atrial volume by 3D echocardiography

    Measure: Left atrial volume

    Time: Phase 2 of study, change from baseline to 6 months

    Other Outcomes

    Description: Change in 24-hour mean of >= 8 mmHg will define the salt-sensitive blood pressure phenotype

    Measure: Salt-sensitivity phenotype

    Time: Phase 1 of study, change from baseline at the end of week 2 and week 4

    Description: Measure of dietary sodium intake

    Measure: 24-hour urinary sodium excretion

    Time: Phase 2 of study, change from baseline to 6 months

    Description: Sodium-restricted DASH diet score on Food Frequency Questionnaire, measured by complete or partial adherence to 9 dietary domains

    Measure: Sodium-restricted DASH diet adherence

    Time: Phase 2 of study, change from baseline to 6 months

    Description: Analysis of 3-day food diaries by a Registered Dietitian, utilizing the Nutrition Data System for Research

    Measure: Sodium-restricted DASH diet adherence

    Time: Phase 2 of study, months 1 and 6
    3 Using the Electronic Health Record to Identify and Promote Goals-of-Care Communication for Older Patients With Serious Illness

    The objective of this protocol is to test the effectiveness of a Jumpstart intervention on patient-centered outcomes for patients with chronic illness by ensuring that they receive care that is concordant with their goals over time, and across settings and providers. This study will examine the effect of the EHR-based intervention to improve quality of palliative care for patients over the age of 65 with chronic, life-limiting illness with a particular emphasis on Alzheimer's disease and related dementias (ADRD). The specific aims are: 1) to evaluate the effectiveness of a novel EHR-based (electronic health record) clinician Jumpstart guide, compared with usual care, for improving the quality of care; the primary outcome is documentation of a goals-of-care discussion during the hospitalization. Secondary outcomes focus on intensity of care: ICU use, ICU and hospital length of stay, costs of care during the hospitalization, and 30-day hospital readmissions; and 2) to conduct a mixed-methods evaluation of the implementation of the Jumpstart intervention, guided by the RE-AIM and CFIR frameworks for implementation science, incorporating quantitative assessments of effectiveness, implementation and maintenance and qualitative assessments of clinician perspectives on barriers and facilitators to future implementation and dissemination.

    NCT04281784
    Conditions
    1. Dementia
    2. Chronic Disease
    3. Neoplasm Metastasis
    4. Lung Neoplasm
    5. Pulmonary Disease, Chronic Obstructive
    6. Heart Failure,Congestive
    7. Liver Cirrhosis
    8. Kidney Failure, Chronic
    9. Lung Diseases, Interstitial
    10. Peripheral Vascular Disease
    11. Diabetes With End Organ Injury
    12. Palliative Care, Patient Care
    13. Health Care Quality, Access, and Evaluation
    14. Patient Care
    15. Inpatients
    16. Health Communication
    17. Patient Care Planning
    Interventions
    1. Behavioral: EHR-based Clinician Jumpstart
    MeSH:Neoplasms Neoplasm Metastasis Lung Neoplasms Liver Cirrhosis Lung Diseases Pulmonary Disease, Chronic Obstructive Lung Diseases, Interstitial Renal Insufficiency Kidney Failure, Chronic Heart Failure Vascular Diseases Peripheral Vascular Diseases Peripheral Arterial Disease Chronic Disease
    HPO:Abnormal left ventricular function Abnormal lung morphology Chronic pulmonary obstruction Cirrhosis Congestive heart failure Hepatic fibrosis Interstitial pneumonitis Interstitial pulmonary abnormality Neoplasm Neoplasm of the lung Peripheral arterial stenosis Renal insufficiency Right ventricular failure

    Primary Outcomes

    Description: The primary outcome is the proportion of patients who have a goals-of-care (GOC) discussion that has been documented in the EHR in the period between randomization and 30 days following randomization The proportion is the number of patients with GOC documentation over the number of patients in each study arm. Documentation of goals-of-care discussions will be evaluated using our NLP/ML methods. Study staff will manually review and compare findings using a randomly-selected sample of charts using our standard EHR abstraction methods; manual chart abstraction will be the gold standard.

    Measure: EHR documentation of Goals of Care discussions

    Time: Assessed for the period between randomization and 30 days following randomization

    Secondary Outcomes

    Description: Secondary outcomes include measures of intensity of care, including utilization metrics: Number of ICU admissions during the patient's (index) hospital stay will be collected from the EHR using our automated and validated methods.

    Measure: Intensity of care/ICU use: ICU admissions

    Time: Assessed for the period between randomization and 30 days following randomization

    Description: Secondary outcomes include measures of intensity of care, including utilization metrics: Number of days the patient spent in the ICU during their (index) hospital stay will be collected from the EHR using our automated and validated methods.

    Measure: Intensity of care/ICU use: ICU length of stay

    Time: Assessed for the period between randomization and 30 days following randomization

    Description: Secondary outcomes include measures of intensity of care, including utilization metrics: Number of days the patient spent in the hospital during that (index) hospital stay will be collected from the EHR using our automated and validated methods.

    Measure: Intensity of care/Hospital use: Hospital length of stay

    Time: Assessed for the period between randomization and 30 days following randomization

    Description: Secondary outcomes include measures of intensity of care, including utilization metrics: Number of hospital readmissions between randomization and 30 days following randomization will be collected from the EHR using our automated and validated methods.

    Measure: Intensity of care: Hospital Readmissions 30 days

    Time: Assessed for the period between randomization and 30 days following randomization

    Description: Secondary outcomes include measures of intensity of care, including utilization metrics: Number of ICU readmissions between randomization and 30 days following randomization will be collected from the EHR using our automated and validated methods.

    Measure: Intensity of care: ICU Readmissions 30 days

    Time: Assessed for the period between randomization and 30 days following randomization

    Description: Costs for intervention vs. control will be reported in US dollars and identified from UW Medicine administrative financial databases. Costs will be reported for total hospital costs and disaggregated costs (direct-variable, direct fixed, indirect costs). Direct-variable costs will include supply and drug costs. Direct-fixed costs will include labor, clinical department administration, and overhead fees. Indirect costs represent services provided by cost centers not directly linked to patient care such as information technology and environmental services. Costs for ED (emergency department) days and ICU days will be similarly assessed.

    Measure: Intensity of care: Healthcare costs

    Time: 1 and 3 months after randomization

    Description: From Washington State death certificates.

    Measure: All-cause mortality at 1 year (safety outcome)

    Time: 1 year after randomization

    Other Outcomes

    Description: Qualitative interviews after individual participation. Interviews will be guided by the RE-AIM and Consolidated Framework for Implementation Research (CFIR) to explore the factors associated with implementation (e.g., reach, maintenance, feasibility, inner and outer settings, individuals, and processes of care.) Individual constructs within these domains were chosen to fit this specific intervention and context.

    Measure: Key Implementation Factors

    Time: 3 months after randomization
    4 Integrated Distance Management Strategy for Patients With Cardiovascular Disease (Ischaemic Coronary Artery Disease, High Blood Pressure, Heart Failure) in the Context of the COVID-19 Pandemic

    Management of known patients with cardiovascular disease (in particular the whole spectrum of atherosclerotic ischaemic coronary artery disease, essential hypertension under treatment, and also patients with chronic heart failure under medication) and with other associated chronic pathologies, with obvious effects on the management of the pandemic with modern / distance means (e-Health) of patients at high risk of mortality in contact with coronavirus. Given the Covid-19 Pandemic, all the above complex cardiovascular patients are under the obligation to stay in the house isolated and can no longer come to standard clinical and paraclinical monitoring and control visits. Therefore, a remote management solution (tele-medicine) of these patients must be found. The Investigators endeavour is to create an electronic platform to communicate with these patients and offer solutions for their cardiovascular health issues (including psychological and religious problems due to isolation). The Investigators intend to create this platform for communicating with a patient and stratify their complaints in risk levels. A given specialist will sort and classify their needs on a scale, based on specific algorithms (derived from the clinical European Cardiovascular Guidelines), and generate specific protocols varying from 911 like emergencies to cardiological advices or psychological sessions. These could include medication changing of doses, dietary advices or exercise restrictions. Moreover, in those patients suspected of COVID infection, special assistance should be provided per protocol.

    NCT04325867
    Conditions
    1. Angina Pectoris
    2. Acute Coronary Syndrome
    3. Coronary Syndrome
    4. Coronary Artery Disease
    5. Angioplasty
    6. Stent Restenosis
    7. Hypertension
    8. Heart Failure, Systolic
    9. Depression, Anxiety
    10. Covid-19
    11. Isolation, Social
    Interventions
    1. Other: Tele-medicine platform
    MeSH:Heart Failure Cardiovascular Diseases Coronary Artery Disease Myocardial Ischemia Coronary Disease Acute Coronary Syndrome Angina Pectoris Heart Failure, Systolic Syndrome
    HPO:Abnormal left ventricular function Abnormality of the cardiovascular system Angina pectoris Congestive heart failure Coronary artery atherosclerosis Myocardial infarction Right ventricular failure

    Primary Outcomes

    Description: Development of an electronic (e-HEALTH) framework structure for management of patients with known cardiovascular disease in COVID19 pandemic social context

    Measure: Providing a special electronic platform (e-health) for remote managing cardiovascular outpatients

    Time: 6 months

    Description: patients come into direct contact with the case coordinator, who provides ongoing assistance, including for connecting to devices that ensure real-time data transmission and directing to specialist teams that establish stage diagnosis and management / therapy behavior (including adjustment). doses, decisions to discontinue medication or to add medication);

    Measure: Number of patients included in this platform

    Time: 6 months

    Secondary Outcomes

    Description: Will be the number of sessions per patient multiplied with the number of patients included

    Measure: Number of consultations/sessions given

    Time: 6 months
    5 An Open-label, Single-dose, Randomized, Two-way, Two-period Crossover Study to Compare the Pharmacokinetics and Bioavailability of a Novel Furosemide Regimen Administered Subcutaneously Versus the Same Dose (80 mg) Administered Intravenously in Subjects With Chronic Heart Failure

    The proposed study aims to compare the pharmacokinetics and bioavailability of intravenous and subcutaneous Furosemide. Although these regimens are not intended to be bioequivalent, they are both expected to achieve therapeutic plasma levels and induce effective diuresis. The test formulation in this study is a buffered solution, Furosemide Injection Solution at 30 mg/mL at pH 7.4 (range 7.0 to 7.8) and is intended for SC injection according to the instructions in the protocol. A commercial formulation of Furosemide Injection, USP will serve as the reference drug in this study, which will be administered by IV bolus. It contains furosemide 10 mg/mL in solution at alkaline pH of 8.0 to 9.3 and is marketed for IV and IM injection. The primary objective of the study is to estimate the absolute bioavailability of furosemide administered by subcutaneous infusion compared with an equivalent dose of furosemide administered by IV bolus administration.

    NCT04384653
    Conditions
    1. Heart Failure
    Interventions
    1. Drug: Furosemide Injection Solution for subcutaneous administration (80 mg)
    2. Drug: Furosemide Injection, USP
    MeSH:Heart Failure
    HPO:Abnormal left ventricular function Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: Maximum plasma furosemide concentration after administration by subcutaneous infusion or IV bolus

    Measure: Pharmacokinetic - Cmax

    Time: 0 to 24 hours

    Description: Area under the concentration versus time curve (AUC) from time 0 to the last measurable plasma furosemide concentration after administration by subcutaneous infusion or IV bolus

    Measure: Pharmacokinetic - AUClast

    Time: 0 to 24 hours

    Description: AUC from time 0 to infinity for plasma furosemide after administration by subcutaneous infusion or IV bolus

    Measure: Pharmacokinetic - AUCinf

    Time: 0 to 24 hours

    Secondary Outcomes

    Description: Total collected urine volume after furosemide administration by subcutaneous infusion or IV bolus

    Measure: Pharmacodynamic - Diuresis

    Time: 0 to 8 hours

    Description: Total collected urine volume after furosemide administration by subcutaneous infusion or IV bolus

    Measure: Pharmacodynamic - Diuresis

    Time: 0 to 24 hours

    Description: Total sodium concentration in urine after furosemide administration by subcutaneous infusion or IV bolus

    Measure: Pharmacodynamic - Natriuresis

    Time: 0 to 8 hours

    Description: Total sodium concentration in urine after furosemide administration by subcutaneous infusion or IV bolus

    Measure: Pharmacodynamic - Natriuresis

    Time: 0 to 24 hours
    6 COVID-19 in Hospitalised Patients With Preexisting CArdioVascular Diseases and/or Cardiac Involvement and/or Cardiovascular Risk Factors: the Global PCHF-COVICAV Registry

    Background: Coronavirus disease (COVID-19) is a tremendous challenge the modern world has never seen before and is overwhelming the capacities of healthcare systems worldwide. Patients with cardiovascular diseases, heart failure in particular, and cardiovascular risk factors seem to be at a very high risk if affected by COVID-19 - and vice versa there are more and more reports of cardiac manifestations with the viral disease. Aim: The purpose of the study is to characterise the clinical course of adult inpatients with COVID-19 and concomitant cardiovascular affection in a worldwide, multicentre PCHF registry. Methods: Retrospective and prospective data analysis. Data on demographic, clinical, selected laboratory, electrocardiography and echocardiography parameters, treatment and outcome will be collected. The principal investigator provides dedicated electronic case report form. The primary outcome is in-hospital mortality. The secondary endpoints will be ICU length of stay, hospital length of stay, the need and duration of invasive mechanical ventilation, cardiovascular hospitalisation after 3 and 6 months from index hospitalisation, all-cause and cardiovascular mortality after 3 and 6 months from index hospitalisation.

    NCT04390555
    Conditions
    1. COVID-19
    2. Cardiovascular Diseases
    3. Cardiovascular Risk Factor
    4. Heart Failure
    MeSH:Heart Failure Cardiovascular Diseases
    HPO:Abnormal left ventricular function Abnormality of the cardiovascular system Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: All-cause and cardiovascular mortality during index hospitalization.

    Measure: In-hospital mortality.

    Time: Hospitalization period, assessed up to 30 days

    Secondary Outcomes

    Description: The duration of hospitalization on the intensive care unit.

    Measure: The length of stay in the intensive care unit.

    Time: Hospitalization period in the ICU, assessed up to 30 days

    Description: The total length of stay in the hospital.

    Measure: The duration of hospitalization.

    Time: Hospitalization period, assessed up to 30 days

    Measure: The need and duration of invasive mechanical ventilation.

    Time: Hospitalization period, assessed up to 30 days

    Measure: Hospitalization for cardiovascular causes or cardiovascular deaths within 3 months after hospitalization.

    Time: 3 months

    Measure: Hospitalization for cardiovascular causes or cardiovascular deaths within 6 months after hospitalization.

    Time: 6 months
    7 Extracorporeal Membrane Oxygenation (ECMO) as a Therapeutic Option in Severe Form of COVID-19: a Nationwide Cohort Study

    The role of ECMO in the treatment of patients with severe COVID-19 (Acute Respiratory Distress Syndrome (ARDS) and/or acute refractory heart failure) is not yet known. The present study will aim to report the results of the ECMO management of the most severe forms of COVID-19 through the first French ECMO registry.

    NCT04397588
    Conditions
    1. ARDS Related to Severe Acute Respiratory Syndrome-Coronavirus (SARS-CoV) 2
    2. Acute Refrac
    3. Acute Refractory Heart Failure Related to SARS-CoV 2
    MeSH:Coronavirus Infections Severe Acute Respiratory Syndrome Heart Failure
    HPO:Abnormal left ventricular function Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: Hospital mortality

    Measure: Hospital mortality

    Time: up to 90 days

    Secondary Outcomes

    Description: Mortality Day 28

    Measure: Mortality Day 28

    Time: Day 28

    Description: Mortality Day 90

    Measure: Mortality Day 90

    Time: Day 90

    Description: Ventilator-free days

    Measure: Ventilator-free days

    Time: Day 28

    Description: ICU-free days

    Measure: Intensive care unit-free days

    Time: Day 28

    Description: Hospital-free days

    Measure: Hospital-free days

    Time: Day 28
    8 A Randomized, Double-Blind, Parallel Group Study to Assess the Efficacy and Safety of Once Weekly Subcutaneous Injections of Pemziviptadil (PB1046), a Sustained-Release VIP (Vasoactive Intestinal Peptide) ANalogue, in Hospitalized COVID-19 Patients at HiGh Risk for Rapid Clinical Deterioration and ARDS (PB1046 VANGARD Study)

    This is a multicenter, randomized, double-blind, parallel group study to investigate the efficacy of pemziviptadil (PB1046) by improving the clinical outcomes and increasing days alive and free of respiratory failure in hospitalized COVID-19 patients at high risk for rapid clinical deterioration, acute respiratory distress syndrome (ARDS) and death. The study will enroll approximately 210 hospitalized COVID-19 patients who require urgent decision-making and treatment at approximately 20 centers in the United States.

    NCT04433546
    Conditions
    1. Acute Respiratory Distress Syndrome
    2. Coronavirus
    3. Hypoxic Respiratory Failure
    4. Hypoxemic Respiratory Failure
    5. Respiratory Complicati
    6. Respiratory Complication
    7. Respiratory Insufficiency
    8. Cardiac Dysfunction
    9. Pneumonia
    10. Pulmonary Edema
    11. Pulmonary Inflammation
    12. Respiratory Failure
    13. Cytokine Storm
    14. COVID 19
    15. SARS-CoV-2
    16. Cardiac Event
    17. Cardiac Complication
    18. Cardiac Failure
    19. Cardiac Infarct
    Interventions
    1. Drug: Pemziviptadil (PB1046)
    2. Drug: Low Dose (10 mg) Control
    MeSH:Pneumonia Respiratory Distress Syndrome, Newborn Respiratory Distress Syndrome, Adult Respiratory Insufficiency Acute Lung Injury Pulmonary Edema Pulmonary Valve Insufficiency Heart Failure Syndrome Inflammation Clinical Deterioration
    HPO:Abnormal left ventricular function Congestive heart failure Pneumonia Pulmonary edema Pulmonary insufficiency Right ventricular failure

    Primary Outcomes

    Measure: Days alive and free of respiratory failure from initiation of pemziviptadil (PB1046)

    Time: 28 days

    Secondary Outcomes

    Measure: Time to clinical recovery (being well enough for hospital discharge or returning to normal baseline activity level prior to discharge)

    Time: 28 days

    Description: PaO2:FiO2 ratio is the ratio of partial pressure of arterial oxygen to percentage of inspired oxygen

    Measure: Development of ARDS (PaO2:FiO2 ratio < 300 mm Hg) during hospitalization

    Time: Any time point between injection initiation and Day 28

    Measure: All-cause mortality

    Time: 28 days

    Description: Composite of: Total hospital days, Total ICU days, Total days of ventilator use, Total days of ECMO, Total days of invasive hemodynamic monitoring, Total days of mechanical circulatory support, Total days of inotropic or vasopressor therapy

    Measure: Reduction in hospital resource utilization defined as a composite of:total days: in hospital, in ICU, on ventilator, on ECMO, with invasive hemodynamic monitoring, with mechanical circulatory support, and with inotropic or vasopressor therapy

    Time: 28 days

    Measure: Time to clinical improvement as defined by reduction of at least 2 points on an 8-category ordinal scale of clinical improvement or discharge from hospital, whichever comes first.

    Time: Any time point between injection initiation and Day 28

    Measure: Change from baseline in cardiac marker high sensitivity troponin I (hsTnI)

    Time: Any time point between injection initiation and Day 35+7

    Measure: Change from baseline in cardiac marker NT-proBNP

    Time: Any time point between injection initiation and Day 35+7

    Measure: Change from baseline in TNF alpha

    Time: Any time point between injection initiation and Day 35+7

    Measure: Change from baseline in IL-1

    Time: Any time point between injection initiation and Day 35+7

    Measure: Change from baseline in IL-6

    Time: Any time point between injection initiation and Day 35+7

    Measure: Incidence and severity of any treatment emergent adverse events (TEAEs) or serious adverse events (SAEs) as determined by clinical adverse events (AEs) and their relationship to PB1046

    Time: Any time point between injection initiation and Day 35+7

    Measure: Incidence and severity of any treatment emergent adverse events (TEAEs) or serious adverse events (SAEs) as determined by vital signs and their relationship to PB1046

    Time: Any time point between injection initiation and Day 35+7

    Measure: Incidence and severity of any treatment emergent adverse events (TEAEs) or serious adverse events (SAEs) as determined by laboratory results and their relationship to PB1046

    Time: Any time point between injection initiation and Day 35+7

    Measure: Incidence and severity of any treatment emergent adverse events (TEAEs) or serious adverse events (SAEs) as determined by electrocardiogram (ECG) abnormalities and their relationship to PB1046

    Time: Any time point between injection initiation and Day 35+7

    Measure: Incidence and severity of any treatment emergent adverse events (TEAEs) or serious adverse events (SAEs) as determined by incidence of anti-drug antibodies and their relationship to PB1046

    Time: Any time point between injection initiation and Day 35+7

    Other Outcomes

    Measure: Impact on invasive hemodynamic parameters as measured by pulmonary artery pressure if patients require right-heart catherization

    Time: Any time point between injection initiation and Day 35+7

    Measure: Impact on invasive hemodynamic parameters as measured by cardiac output if patients require right-heart catherization

    Time: Any time point between injection initiation and Day 35+7

    Measure: Incidence of multi-system organ failure (MSOF)

    Time: Any time point between injection initiation and Day 35+7

    Measure: Number of multi-system organ failure (MSOF) free days

    Time: Any time point between injection initiation and Day 35+7

    Measure: Number of subjects requiring extracorporeal membrane oxygenation (ECMO)

    Time: Any time point between injection initiation and Day 35+7
    9 Impact of COVID-19 on the Benefit of Cardiac Rehabilitation

    The COVID-19 attack is polymorphic with otorhinolaryngological, pneumological, cardiac, digestive, neurological, muscular attacks with a higher mortality in subjects with comorbidity [> 70 years old, cardiovascular history in particular Arterial hypertension (hypertension ), heart disease…]. This polymorphism is linked to vasculitis and the immune response. Patients with cardiovascular disease are particularly at risk of decompensating, particularly due to the increased metabolism induced by viral infection and reduced cardiovascular capacities. On the cardiovascular level, two sides can be considered. On the one hand, cardiovascular disease (hypertension, coronary artery disease) is a comorbid factor. On the other hand, the myocardial damage reflected by the increase in troponin or an alteration of the ejection fraction is a very clear risk factor for death or severe form. Cardiovascular involvement is particularly high in hospitalized and deceased patients. The odds ratio calculated in a meta-analysis of severe forms of covid-19 with hypertension is 3 [1.9; 3.1], for cardiovascular pathologies of 2.93 [1.73; 4.96]. Recommendations were made for pulmonary rehabilitation but not for cardiovascular rehabilitation. Cardiac rehabilitation is indicated in most cardiovascular pathologies (after acute coronary syndrome, after coronary angioplasty, in heart failure, after coronary or valve heart surgery, etc.). It consists of a multidisciplinary approach combining therapeutic pharmacological adjustment, physical activity, therapeutic education in order to improve physical capacities for exertion and reduce morbidity and mortality. The physical exercises can be endurance or resistance type. Capacity gain at the end of rehabilitation is measured by visual scales, quality of life questionnaires, and a stress test at the start and end of rehabilitation. Most often, rehabilitation centers only do the stress test and estimate through questioning for subjective improvement. The hypothesis is that patients who contracted COVID-19 would have lower cardiac capacities after recovery from the infection than patients without COVID-19 or that their capacity for recovery would be less. There could be a difference in recovery after cardiac rehabilitation between the two populations regardless of whether the cardiac damage requiring rehabilitation was triggered by COVID-19 or was pre-existing.

    NCT04513964
    Conditions
    1. Heart Failure
    2. Covid19
    MeSH:Heart Failure
    HPO:Abnormal left ventricular function Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: This outcome corresponds to the difference between the average gain in exercise capacity after cardiac rehabilitation between the two groups of patients Control and COVID-19.

    Measure: Impact of COVID-19 on exercise capacity gain after cardiovascular rehabilitation

    Time: Month 3
    10 Absent Visitors: The Wider Implications of COVID-19 on Non-COVID Cardiothoracic ICU Patients, Relatives and Staff

    Patients are part of a family network. When any person in a family becomes critically unwell and requires the assistance of an Intensive Care Unit (ICU), this has an impact on all members of that family. COVID-19 changed visiting for all patients in hospitals across Scotland. It is not known what effect these restrictions will have on patients' recovery, nor do we understand the impact it may have on their relatives or staff caring for them. This study will look at the implications of the visiting restrictions as a consequence of the COVID-19 pandemic upon patients without COVID-19 who are in the cardiothoracic ICU. It will also explore the impact of these restrictions on them, their relatives and staff. This study will be carried out within a single specialised intensive care unit in Scotland using mixed methods. The first arm of this study will use retrospective data that is routinely collected in normal clinical practice. The investigators will compare patient outcomes prior to COVID-19 with outcomes following the implementation of COVID-19 visiting restrictions. The aim is to establish if the restrictions on visiting has an impact on the duration of delirium. Delirium is an acute mental confusion and is associated with longer hospital stays and worse outcomes in this patient group. The second arm of this study involves semi-structured interviews with patients, relatives and staff that will allow deeper exploration of the issues around current visiting policy. The interviews will last approximately 1 hour and will address these issues. They will then be transcribed word for word and analysed using grounded theory, meaning the theories will develop from the data as it is analysed.

    NCT04538469
    Conditions
    1. Cardiovascular Diseases
    2. Delirium
    3. Critical Illness
    4. Intensive Care Unit Delirium
    5. Thoracic Diseases
    6. Respiratory Failure
    7. Cardiac Disease
    8. Cardiac Failure
    Interventions
    1. Other: COVID visitation restrictions
    MeSH:Respiratory Insufficiency Thoracic Diseases Delirium Cardiovascular Diseases Heart Diseases Heart Failure Critical Illness
    HPO:Abnormal left ventricular function Abnormality of the cardiovascular system Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: Number of days patient found to have delirium using the Confusion Assessment Method for the ICU (CAM-ICU)

    Measure: Duration of delirium

    Time: From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months.

    Secondary Outcomes

    Description: CAM-ICU

    Measure: Incidence of delirium

    Time: From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months.

    Description: Days

    Measure: Length of critical care stay

    Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.

    Description: Days

    Measure: Length of hospital stay

    Time: From the date of admission to the hospital until discharge from the hospital or death, whichever came first, up to 12 months.

    Measure: Doses of specified drugs during ICU admission

    Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.

    Description: Days

    Measure: Length of time ventilated

    Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.

    Measure: Mortality

    Time: 6 months

    Other Outcomes

    Description: Semi structured interviews

    Measure: Exploring the experiences of patients, relatives and staff of the visitation restrictions during the COVID-19 pandemic

    Time: 18 months
    11 A Phase 2b, Randomised, Double-Blind, Placebo-Controlled, Multi-Centre Study to Evaluate the Efficacy, Safety and Tolerability of Oral AZD9977 and Dapagliflozin Treatment in Patients With Heart Failure With Left Ventricular Ejection Fraction (LVEF) Below 55% and Chronic Kidney Disease

    The purpose of the study is to evaluate the efficacy and safety of AZD9977 alone and AZD9977 in combination with dapagliflozin and to assess the dose-response relationship of placebo, AZD9977 alone, dapagliflozin alone and 3 doses of AZD9977 combined with dapagliflozin on urinary albumin to creatinine ratio (UACR). The study will be conducted in participants with heart failure (HF) with left ventricular ejection fraction (LVEF [below 55%]) and chronic kidney disease (CKD) with estimated glomerular filtration rate (eGFR [between 20 and 60 mL/min, with at least 30% of participants with eGFR <30 mL/min and a maximum of 25% of participants with eGFR >45 mL/min]), including at least 40% of participants with type 2 diabetes mellitus (T2DM).

    NCT04595370
    Conditions
    1. Heart Failure
    2. Chronic Kidney Disease
    Interventions
    1. Drug: AZD9977
    2. Drug: Dapagliflozin
    3. Drug: Placebo
    MeSH:Kidney Diseases Renal Insufficiency, Chronic Heart Failure
    HPO:Abnormal left ventricular function Abnormality of the kidney Chronic kidney disease Congestive heart failure Nephropathy Right ventricular failure

    Primary Outcomes

    Description: Evaluating the effect of AZD9977 and dapagliflozin in combination and alone compared with placebo on UACR.

    Measure: Percent change from baseline in UACR at 12 weeks

    Time: Baseline (Day 1) until Week 12 (Day 85)

    Secondary Outcomes

    Description: Assessment of the dose-response relationship of placebo, AZD9977 (Dose C) alone, dapagliflozin (10 mg) alone and 3 doses of AZD9977 (A, B or C) combined with dapagliflozin (10 mg) on UACR.

    Measure: Percent change from baseline in UACR at 12 weeks to assess dose-response relationship

    Time: Baseline (Day 1) until Week 12 (Day 85)

    Description: Assessment of the general safety and tolerability of AZD9977 and dapagliflozin in combination and alone compared with placebo.

    Measure: Number of participants with adverse events (AEs) and serious adverse events (SAEs)

    Time: From baseline (Day 1) until Day 113 (Safety Follow-up)

    Description: Assessment of the effect of AZD9977 and dapagliflozin in combination and alone compared with placebo on serum potassium.

    Measure: Absolute value of serum potassium over time

    Time: Days 1, and 3 until Day 85

    Description: Assessment of the effect of AZD9977 and dapagliflozin in combination and alone compared with placebo on serum potassium.

    Measure: Change from baseline in serum potassium over time

    Time: From baseline (Day 1), Day 3 until Day 85

    Description: Assessment of the effect of AZD9977 and dapagliflozin in combination and alone compared with placebo on eGFR.

    Measure: Absolute value of eGFR over time

    Time: Days 1, and 3 until Day 85

    Description: Assessment of the effect of AZD9977 and dapagliflozin in combination and alone compared with placebo on eGFR.

    Measure: Change from baseline in eGFR over time

    Time: From baseline (Day 1), Day 3 until Day 85
    12 Diagnosis of Heart Failure in the Post-COVID-19 Clinic, Primary Care and Hospital Setting Using a Digital Stethoscope With Artificial Intelligence (AI) Electrocardiogram (ECG)

    Abbreviations/acronyms: DUO-EF = prediction of ejection fraction (EF) using the Eko-DUO digital stethoscope algorithm HF = heart failure HFrEF = heart failure with reduced ejection fraction COVID-19 = coronavirus disease 2019 Eko DUO = digital stethoscope device cMRI = cardiac magnetic resonance imaging ECG = electrocardiogram Prospective observational study of left ventricular ejection fraction predicted by application of artificial intelligence to single-lead ECG acquired by a digital stethoscope; in the post-covid-19 follow up clinic, in patients presenting with heart failure symptoms in primary care, and in patients attending for echocardiography and cardiac MRI.

    NCT04601415
    Conditions
    1. Heart Failure
    Interventions
    1. Diagnostic Test: ECG from handheld device
    MeSH:Heart Failure
    HPO:Abnormal left ventricular function Congestive heart failure Right ventricular failure

    Primary Outcomes

    Description: Area under curve (AUC) where maximum value is '1', describing ability of algorithm to discriminate low from not-low ejection fraction

    Measure: Area under receiver operating curve

    Time: up to 18 months

    HPO Nodes


    HP:0001635: Congestive heart failure
    Genes 261
    TBX20 RAB3GAP2 AGPAT2 FLNC LDB3 TMEM127 FOS COG7 PHYH HFE PRKAR1A GNPTAB KCNJ5 LIMK1 TRNK RBM20 PPARG SDHAF2 HBB STAT1 HADHA VHL FGFR3 PRKAG2 ENPP1 RET CAV3 SELENON EYA4 PNPLA2 PRKAR1A SCO2 LMNA RYR1 FBN1 MYL3 HJV ELAC2 TMEM43 TRNL1 CITED2 DES ABCC6 CLIP2 COX3 CYTB JUP TPI1 ADCY5 PSEN1 FH GDF2 DSP ELN TTN IKBKG GJA1 BAZ1B HNRNPA1 GPR35 COL1A1 CCR6 TRNQ AFF4 RFC2 GTF2I TTN GATA4 CACNA1S GLB1 TNNI3 AGGF1 SF3B1 CAVIN1 PLN TRNF TNNI3K TCF4 VCL TUBB RET ATXN7 LMNA LMNA GTPBP3 XYLT2 SDHB FBLN5 HBA1 MYH7 TMEM127 KIF1B DES HADHB DNMT3A VPS33A CAV1 CDH23 TLL1 EPG5 ATP6V1A GLA BMP2 EFEMP2 SLC25A11 HADHB ACTN2 ND1 PSMB8 SCN1B CP TMEM70 MYD88 HBB SMAD4 ALMS1 MTTP MAX ACAD9 VHL SLC25A3 FGD1 NDUFB8 TRNW HBA2 SDHD BCHE WRN SLC2A10 TRNS2 CYTB ENG SDHB NDUFB11 LMNA DMD COX2 CAV1 NKX2-5 LMNA SURF1 HLA-DRB1 GATAD1 SDHC PRKAR1A TRNK PRDM16 TNNT2 GNA11 IFIH1 ABCC6 HBB MDH2 NDUFS2 TRNV SDHA ACAD9 FXN SLC25A26 SLC19A2 GTF2IRD1 RPS19 GLA PPA2 MYPN EYA4 CITED2 DTNA MAX NF1 LMNA XYLT1 ND6 SNAP29 TBX20 DSP MST1 FLNA DLST MYH7 MYH7 ADAMTSL2 MYH7 VCP SCN4A ALMS1 NKX2-5 GDNF HFE TF MECP2 BAG3 HAMP TRNK TET2 ACTC1 RASA1 LMNA LMNA MYH6 TRPM4 TRIM37 SDHD TLL1 TRNC STRADA CCN2 HNRNPA2B1 MYH7 TAZ RET CLIC2 SGCD GTPBP3 PEX7 SDHB TRIP4 MYSM1 TPM1 NDUFAF3 PTEN CEP19 SDHD NDUFAF1 FGF23 EPAS1 ND5 SLC17A5 HADHA GATA6 BSCL2 ATP5F1A ACVRL1 CLIC2 IRF5 ACTC1 TBL2 MAPRE2 JUP CASR KIF1B VHL NSMCE2 TRNL1 ADCY5 DNAJC19 DSP MYLK2 PLOD1 COX1 MYH6 COL1A2 IDS PPARG ENG SCN5A GBA TRNS1 PSEN2 SLC22A5 TRNE
    SNP 0

    HPO

    Alphabetical listing of all HPO terms. Navigate: Correlations   Clinical Trials


    HPO Nodes


    HP:0001635: Congestive heart failure
    Genes 261
    TBX20 RAB3GAP2 AGPAT2 FLNC LDB3 TMEM127 FOS COG7 PHYH HFE PRKAR1A GNPTAB KCNJ5 LIMK1 TRNK RBM20 PPARG SDHAF2 HBB STAT1 HADHA VHL FGFR3 PRKAG2 ENPP1 RET CAV3 SELENON EYA4 PNPLA2 PRKAR1A SCO2 LMNA RYR1 FBN1 MYL3 HJV ELAC2 TMEM43 TRNL1 CITED2 DES ABCC6 CLIP2 COX3 CYTB JUP TPI1 ADCY5 PSEN1 FH GDF2 DSP ELN TTN IKBKG GJA1 BAZ1B HNRNPA1 GPR35 COL1A1 CCR6 TRNQ AFF4 RFC2 GTF2I TTN GATA4 CACNA1S GLB1 TNNI3 AGGF1 SF3B1 CAVIN1 PLN TRNF TNNI3K TCF4 VCL TUBB RET ATXN7 LMNA LMNA GTPBP3 XYLT2 SDHB FBLN5 HBA1 MYH7 TMEM127 KIF1B DES HADHB DNMT3A VPS33A CAV1 CDH23 TLL1 EPG5 ATP6V1A GLA BMP2 EFEMP2 SLC25A11 HADHB ACTN2 ND1 PSMB8 SCN1B CP TMEM70 MYD88 HBB SMAD4 ALMS1 MTTP MAX ACAD9 VHL SLC25A3 FGD1 NDUFB8 TRNW HBA2 SDHD BCHE WRN SLC2A10 TRNS2 CYTB ENG SDHB NDUFB11 LMNA DMD COX2 CAV1 NKX2-5 LMNA SURF1 HLA-DRB1 GATAD1 SDHC PRKAR1A TRNK PRDM16 TNNT2 GNA11 IFIH1 ABCC6 HBB MDH2 NDUFS2 TRNV SDHA ACAD9 FXN SLC25A26 SLC19A2 GTF2IRD1 RPS19 GLA PPA2 MYPN EYA4 CITED2 DTNA MAX NF1 LMNA XYLT1 ND6 SNAP29 TBX20 DSP MST1 FLNA DLST MYH7 MYH7 ADAMTSL2 MYH7 VCP SCN4A ALMS1 NKX2-5 GDNF HFE TF MECP2 BAG3 HAMP TRNK TET2 ACTC1 RASA1 LMNA LMNA MYH6 TRPM4 TRIM37 SDHD TLL1 TRNC STRADA CCN2 HNRNPA2B1 MYH7 TAZ RET CLIC2 SGCD GTPBP3 PEX7 SDHB TRIP4 MYSM1 TPM1 NDUFAF3 PTEN CEP19 SDHD NDUFAF1 FGF23 EPAS1 ND5 SLC17A5 HADHA GATA6 BSCL2 ATP5F1A ACVRL1 CLIC2 IRF5 ACTC1 TBL2 MAPRE2 JUP CASR KIF1B VHL NSMCE2 TRNL1 ADCY5 DNAJC19 DSP MYLK2 PLOD1 COX1 MYH6 COL1A2 IDS PPARG ENG SCN5A GBA TRNS1 PSEN2 SLC22A5 TRNE
    SNP 0

    Reports

    Data processed on September 26, 2020.

    An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.

    Drug Reports   MeSH Reports   HPO Reports  

    Interventions

    4,180 reports on interventions/drugs

    MeSH

    691 reports on MeSH terms

    HPO

    263 reports on HPO terms

    All Terms

    Alphabetical index of all Terms

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